scholarly journals Estrategias de prevención neuromuscular para las lesiones de ligamento cruzado anterior sin contacto en jugadoras de baloncesto. Revisión narrativa

2021 ◽  
Vol 18 (2) ◽  
pp. 1-21
Author(s):  
Cinta Gómez-Tomás ◽  
Tamara Rial Rebullido ◽  
Iván Chulvi-Medrano

Introducción: La lesión del ligamento cruzado anterior sin contacto tiene una mayor incidencia en las mujeres deportistas en edad adolescente. Las características propias del baloncesto (el salto y el aterrizaje) junto con las características biomecánicas y hormonales propias de la mujer (mayor valgo de rodillas, laxitud articular y ciclo menstrual) hace que nos encontremos ante un sector poblacional de especial interés para implementar programas de prevención neuromuscular. El objetivo de este estudio ha sido realizar una revisión bibliográfica para proponer un programa de prevención neuromuscular para las lesiones de ligamento cruzado anterior en mujeres jugadoras de baloncesto. Material y Método: La búsqueda se realizó en las bases de datos PubMed, SportDiscus y PEDro entre diciembre 2019 - enero 2020. Los descriptores “anterior cruciate ligament”, ”neuromuscular training”, “injury rates”, “basketball”, and “women” se utilizaron como criterio de búsqueda. Resultados: Se analizaron 20 artículos que fueron seleccionados acorde a los criterios de inclusión: estudios que aporten información sobre factores de riesgo y programas de prevención de la lesión de ligamento cruzado anterior en mujeres sanas, atletas/deportistas. Se clasificó la información obtenida según estrategia o información preventiva aportada. Conclusiones: Un programa de prevención neuromuscular para lesiones de ligamento cruzado anterior sin contacto en mujeres jugadoras de baloncesto debe basarse en cuatro aspectos fundamentales: entrenamiento de fuerza de miembro inferior, pliometría, retroalimentación en el aterrizaje y trabajo central de tronco.    

2007 ◽  
Vol 35 (7) ◽  
pp. 1070-1074 ◽  
Author(s):  
Nicolas Pujol ◽  
Marie Philippe Rousseaux Blanchi ◽  
Pierre Chambat

Background Little is known about the evolution of anterior cruciate ligament injury rates among elite alpine skiers. Purpose To evaluate epidemiologic aspects of anterior cruciate ligament injuries among competitive alpine skiers during the last 25 years. Study Design Descriptive epidemiology study. Methods Data were collected from elite French national teams (379 athletes: 188 women and 191 men) from 1980 to 2005. Results Fifty-three of the female skiers (28.2%) and 52 of the male skiers (27.2%) sustained at least 1 anterior cruciate ligament injury. The overall anterior cruciate ligament injury incidence was 8.5 per 100 skier-seasons. The primary anterior cruciate ligament injury rate was 5.7 per 100 skier-seasons. The prevalence of reinjury (same knee) was 19%. The prevalence of a bilateral injury (injury of the other knee) was 30.5%. At least 1 additional anterior cruciate ligament surgery (mean, 2.4 procedures) was required for 39% of the injured athletes. Men and women were similar with regard to primary anterior cruciate ligament injury rate (P = .21), career remaining after the injury (P = .44), and skiing specialty (P = .5). There were more anterior cruciate ligament injuries (primary, bilateral, reinjuries) among athletes ranking in the world Top 30 (P < .001). Anterior cruciate ligament-injured athletes had a career length of 7.5 years, whereas athletes with no anterior cruciate ligament injury had a career of 4.5 years (P < .001). Finally, injury rates remained constant over time. Conclusion Anterior cruciate ligament injury rates (primary injury, bilateral injury, reinjury) among national competitive alpine skiers are high and have not declined in the last 25 years. Finding a way to prevent anterior cruciate ligament injury in this population is a very important goal.


2019 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Christopher V. Nagelli ◽  
Samuel C. Wordeman ◽  
Stephanie Di Stasi ◽  
Joshua Hoffman ◽  
Tiffany Marulli ◽  
...  

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0011
Author(s):  
Heath P. Melugin ◽  
Vishal S. Desai ◽  
Christopher Camp ◽  
Timothy E. Hewett ◽  
Todd A. Milbrandt ◽  
...  

Background: Avulsion fractures involving the tibial eminence are considered equivalent in etiology to anterior cruciate ligament tears, however there is limited data comparing outcomes of adolescent patients undergoing surgical fixation of tibial eminence fractures to those undergoing anterior cruciate ligament (ACL) reconstruction. Purpose: The purpose of this study was to compare clinical outcomes, subsequent ACL injury rates, and activity levels between adolescent patients who underwent tibial eminence fracture fixation to patients with mid-substance ACL tears who required acute ligament reconstruction. Methods: This study included a group of patients with tibial eminence fractures treated with surgical fixation matched to a group of similar patients with ACL tears treated with reconstruction between the years of 2001 and 2015. Data regarding initial injury, surgical intervention, ACL/ACL graft injury rates, and physical examination findings were recorded. Clinical and functional outcomes were obtained using physical examination, IKDC subjective scores, Lysholm scores, and Tegner Activity levels. Results: Sixty patients with a mean follow-up of 57.7 (24-206) months were included. 20 patients (11 M:9 F) who underwent surgical fixation for tibial eminence fractures (TEF) with a mean age of 11.9 (7-15) years were matched to a group of 40 patients (23 M:17 F) who underwent ACL reconstruction for ACL tears with a mean age of 12.5 (8-15) years. The TEF group demonstrated significantly lower postoperative IKDC (TEF group: 94.0, ACL group: 97.2 (p=0.04)) and Lysholm scores (TEF group: 92.4, ACL group: 96.9 (p=0.02)). The TEF group returned to sport 121 days sooner (p<0.01), but there was no difference in postoperative Tegner scores (TEF group: 7.3, ACL group: 7.6 (p=0.16)). The TEF group demonstrated increased postoperative anterior laxity (p=0.02) and a higher rate of postoperative arthrofibrosis (p=0.04). There was no difference in subsequent ACL injury (p=0.41). Conclusion: Patients with tibial eminence fractures demonstrated lower mean clinical outcome scores compared to patients with ACL tears at minimum 2-year follow up. Additionally, they experienced more postoperative anterior laxity and had a higher rate of postoperative arthrofibrosis. There was no difference in subsequent ACL injury rate. The TEF group returned to sport sooner than the ACL group, but the postoperative activity level was similar.


2016 ◽  
Vol 8 (1) ◽  
pp. 29-37
Author(s):  
Paul I Iyaji ◽  
Abduelmenem Alashkham ◽  
Abdulrahman Alraddadi ◽  
Roger Soames

Incidence of anterior cruciate ligament (ACL) rupture and its consequent reconstruction is on the rise. In contributing to the achievement of anatomic reconstruction this study seek to provide information regarding the position and variability of the tibial attachment sites, dimensions of femoral insertions and compare these measurements in males and females, and in right and left knees. Thirty one cadaveric knees (15 right and 16 left from 9 females and 7 males, mean age 77 years) were dissected. Various ACL footprint dimensions were taken. The mean length and width of the tibial anteromedial (AM) bundle footprint were 8.9 and 9.8 mm while that of the posterolateral (PL) bundle were 9.3 and 8.0 mm respectively. The mean length and width of the tibial AM and PL bundles in males were 8.5 and 9.8 mm, and 9.1 and 8.3 mm while corresponding values in females were and 9.2 and 9.7 mm, and 9.4 and 7.8 mm respectively.  Males had larger femoral footprints (P=0.020) and tibial plateau (P<0.001). No significant difference between the right and left knees were observed. The mean anatomical positions of the AM and PL bundles were 46.0% and 50.0% of the mediolateral diameter of the tibial plateau. The mean length and width of the ACL femoral insertion sites were 8.3 and 7.7 mm for the AM bundle and 7.8 and 6.9 mm for the PL bundle respectively. The smaller ACL attachment parameters in females could be a contributing factor to the higher incidence of ACL rupture in female athletes. La incidencia de la rotura del ligamento cruzado anterior (LCA) y su consiguiente reconstrucción está en aumento. Para contribuir a la actualización de la reconstrucción anatómica del ligamento cruzado anterior, este estudio proporciona información sobre la posición y la variabilidad de los sitios de fijación en la tibia, las dimensiones de las inserciones femorales, así como las relaciones de estas mediciones en hombres y mujeres y en las rodillas derecha e izquierda. Se disecaron treinta y un (15 rodillas de cadáver derecha, 16 izquierda, de 9 mujeres y 7 hombres, con una edad media de 77 años). Se tomaron diversas dimensiones de la huella del LCA. La longitud media y la anchura de la huella del haz tibial anteromedial (AM) eran 8,9 mm y 9,8 mm mientras que la del haz posterolateral (PL) eran 9,3 mm y 8 mm respectivamente. La longitud media y la anchura de la AM tibial y paquetes PL en los varones eran 8,5 y 9,8 mm, y 9,1 y 8,3 mm, mientras que los valores correspondientes en las mujeres eran 9,2 y 9,7 mm, y 9,4 y 7,8 mm, respectivamente. Los varones tenían huellas femorales (P = 0,045 para AM, P = 0,043 para PL) y la meseta tibial (P <0,001) más grandes. No se observó ninguna diferencia significativa entre la rodilla derecha e izquierda. Las posiciones anatómicas medias de los haces de AM y PL fueron 46% y 50% del diámetro mediolateral de la meseta tibial. La longitud media y la anchura de los sitios de inserción femoral del LCA fueron 8,3 y 7,7 mm para el paquete de AM y 7,8 y 6,9 mm para el paquete PL respectivamente. Los parámetros más pequeños de fijación del LCA en las mujeres podría ser un factor que contribuye a la mayor incidencia de rotura del LCA en mujeres atletas.   


2020 ◽  
Vol 48 (4) ◽  
pp. 812-824 ◽  
Author(s):  
Enda King ◽  
Chris Richter ◽  
Mark Jackson ◽  
Andy Franklyn-Miller ◽  
Eanna Falvey ◽  
...  

Background: Despite the importance of return-to-play (RTP) rates, second anterior cruciate ligament (ACL) injury rates, and patient-reported outcomes of athletes returning to sports after ACL reconstruction (ACLR), these outcomes have not been evaluated together across a single cohort nor the pre- and intraoperative factors influencing outcomes explored. Purpose: To prospectively report outcomes after ACLR relating to RTP, second ACL injury, and International Knee Document Committee (IKDC) scores in a large cohort of athletes at a single center to examine the influence of pre- and intraoperative variables on these outcomes. Design: Cohort study; Level of evidence, 3. Methods: A consecutive cohort of 1432 athletes undergoing primary ACLR by 2 orthopaedic surgeons was followed up prospectively more than 2 years after surgery. Pre- and intraoperative findings were reported with outcomes at follow-up relating to RTP, second ACL injury, and IKDC. Between-group differences for each outcome were reported and the predictive ability of pre- and intraoperative variables relating to each outcome assessed with logistic regression. Results: There was >95% follow-up 2 years after surgery. The RTP rate was 81%, and of those who returned, 1.3% of those with patellar tendon grafts and 8.3% of those with hamstring grafts experienced ipsilateral rerupture (hazard ratio, 0.17). The contralateral ACL injury rate was 6.6%, and the IKDC score at follow-up was 86.8, with a greater proportion of patients with patellar tendon grafts scoring <80 on the IKDC (odds ratio, 1.56; 95% CI, 1.15-3.12). There was no relationship between time to RTP and second ACL injury, and there was a moderate correlation between ACL–Return to Sport After Injury score and RTP at follow-up ( P < .001, rho = 0.46). There were a number of differences in pre- and intraoperative variables between groups for each outcome, but they demonstrated a poor ability to predict outcomes in level 1 athletes at 2-year follow-up. Conclusion: Findings demonstrated high overall RTP rates, lower reinjury rates with patellar tendon graft after 2-year follow-up in level 1 athletes, and no influence of time to RTP on second ACL injury. Despite differences between groups, there was poor predictive ability of pre- and intraoperative variables. Results suggest pre- and intraoperative variables for consideration to optimize outcomes in level 1 athletes after ACLR, but future research exploring other factors, such as physical and psychological recovery, may be needed to improve outcome prediction after ACLR. Registration: NCT02771548 (ClinicalTrials.gov identifier).


2020 ◽  
Vol 8 (5) ◽  
pp. 232596712091917
Author(s):  
Andrew S. Gupta ◽  
Lauren A. Pierpoint ◽  
R. Dawn Comstock ◽  
Michael G. Saper

Background: Anterior cruciate ligament (ACL) tears are common among high school athletes, with sex-based differences accounting for higher injury rates in girls. Previous epidemiological studies on ACL injuries focusing on adolescent athletes have looked at injuries across multiple sports, but few have analyzed ACL tears in solely high school soccer athletes. Purpose: To examine sex-based differences in the epidemiology of ACL injuries among high school soccer players in the United States (US). Study Design: Descriptive epidemiological study. Methods: ACL injury data for US high school soccer players were obtained from the internet-based National High School Sports-Related Injury Surveillance Study’s High School RIO (Reporting Information Online) system. Athletic trainers from a random sample of 100 high schools from 8 strata based on US Census geographic region reported data for athlete-exposures (AEs) (practice or competition) and ACL injuries from 2007 through 2017. Injury rates were calculated as the number of ACL injuries per 100,000 AEs. Subgroup differences were evaluated with rate ratios (RRs) or injury proportion ratios (IPRs) and 95% CIs. Statistical differences in demographics between groups were examined using independent t tests. Comparisons of categorical data (ie, level of play) were performed using the Wald chi-square test. Results: The reported number of ACL injuries corresponded to weighted national estimates of 41,025 (95% CI, 33,321-48,730) ACL injuries in boys’ soccer and 110,028 (95% CI, 95,349-124,709) in girls’ soccer during the study period. The rate of injuries was higher in girls’ soccer (13.23/100,000 AEs) than boys’ soccer (4.35/100,000 AEs) (RR, 3.04 [95% CI, 2.35-3.98]). The rate of ACL injuries was higher in competition compared with practice for girls (RR, 14.77 [95% CI, 9.85-22.15]) and boys (RR, 8.69 [95% CI, 5.01-15.08]). Overall, a smaller proportion of ACL injuries were caused by player-player contact for girls (30.1%) compared with boys (48.6%) (IPR, 0.62 [95% CI, 0.41-0.93]). Conclusion: ACL injury rates and patterns in high school soccer players differed between sex, type of exposure (practice vs competition), and mechanism of injury.


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