scholarly journals Electromyographic Assessment of Anterior Cruciate Ligament Injury Risk in Male Tennis Players: Which Role for Visual Input? A Proof-of-Concept Study

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 997
Author(s):  
Alessandro de Sire ◽  
Nicola Marotta ◽  
Andrea Demeco ◽  
Lucrezia Moggio ◽  
Pasquale Paola ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Visual Input ◽  
Proof Of Concept ◽  
Tennis Players ◽  
Concept Study ◽  
Acl Injury Risk ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injury incidence is often underestimated in tennis players, who are considered as subjects conventionally less prone to knee injuries. However, evaluation of the preactivation of knee stabilizer muscles by surface electromyography (sEMG) showed to be a predictive value in the assessment of the risk of ACL injury. Therefore, this proof-of-concept study aimed at evaluating the role of visual input on the thigh muscle preactivation through sEMG to reduce ACL injury risk in tennis players. We recruited male, adult, semiprofessional tennis players from July to August 2020. They were asked to drop with the dominant lower limb from a step, to evaluate—based on dynamic valgus stress—the preactivation time of the rectus femoris (RF), vastus medialis, biceps femoris, and medial hamstrings (MH), through sEMG. To highlight the influence of visual inputs, the athletes performed the test blindfolded and not blindfolded on both clay and grass surfaces. We included 20 semiprofessional male players, with a mean age 20.3 ± 4.8 years; results showed significant early muscle activation when the subject lacked visual input, but also when faced with a less-safe surface such as clay over grass. Considering the posteromedial–anterolateral relationship (MH/RF ratio), tennis players showed a significant higher MH/RF ratio if blindfolded (22.0 vs. 17.0% not blindfolded; p < 0.01) and percentage of falling on clay (17.0% vs. 14.0% in grass; p < 0.01). This proof-of-principle study suggests that in case of absence of visual input or falling on a surface considered unsafe (clay), neuro-activation would tend to protect the anterior stress of the knee. Thus, the sEMG might play a crucial role in planning adequate athletic preparation for semiprofessional male athletes in terms of reduction of ACL injury risk.

Anterior Cruciate Ligament Tear in an Athlete: Does Increased Heel Loading Increase ACL Injury Risk? A Case Report

2008 ◽  
Vol 40 (Supplement) ◽  
pp. S80 ◽  
Author(s):  
Bradd G. Burkhart ◽  
Kevin R. Ford ◽  
Greg D. Myer ◽  
Robert S. Heidt ◽  
Timothy E. Hewett
Keyword(s):  
Anterior Cruciate Ligament ◽  
Case Report ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Anterior Cruciate Ligament Tear ◽  
Ligament Tear ◽  
Acl Injury Risk ◽  
Anterior Cruciate

A Systematic Evaluation of Field-Based Screening Methods for the Assessment of Anterior Cruciate Ligament (ACL) Injury Risk

2015 ◽  
Vol 46 (5) ◽  
pp. 715-735 ◽  
Author(s):  
Aaron S. Fox ◽  
Jason Bonacci ◽  
Scott G. McLean ◽  
Michael Spittle ◽  
Natalie Saunders
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Systematic Evaluation ◽  
Screening Methods ◽  
Acl Injury Risk ◽  
Anterior Cruciate

scholarly journals The Cutting Movement Assessment Score (CMAS) Qualitative Screening Tool: Application to Mitigate Anterior Cruciate Ligament Injury Risk during Cutting

Biomechanics ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 83-101
Author(s):  
Thomas Dos’Santos ◽  
Christopher Thomas ◽  
Alistair McBurnie ◽  
Thomas Donelon ◽  
Lee Herrington ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
High Risk ◽  
Injury Risk ◽  
Screening Tool ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Assessment Score ◽  
Movement Assessment ◽  
Acl Injury Risk ◽  
Anterior Cruciate

Side-step cutting is an action associated with non-contact anterior cruciate ligament (ACL) injury with a plethora of negative economical, health, and psychological implications. Although ACL injury risk factors are multifactorial, biomechanical and neuromuscular deficits which contribute to “high-risk” and aberrant movement patterns are linked to ACL injury risk due to increasing knee joint loads and potential ACL loading. Importantly, biomechanical and neuromuscular deficits are modifiable; thus, being able to profile and classify athletes as potentially “high-risk” of injury is a crucial process in ACL injury mitigation. The Cutting Movement Assessment Score (CMAS) is a recently validated field-based qualitative screening tool to identify athletes that display high-risk postures associated with increased non-contact ACL injury risk during side-step cutting. This article provides practitioners with a comprehensive and detailed overview regarding the rationale and implementation of the CMAS. Additionally, this review provides guidance on CMAS methodological procedures, CMAS operational definitions, and training recommendations to assist in the development of more effective non-contact ACL injury risk mitigation programmes.

Diagnostic of Injury Risk in the Anterior Cruciate Ligament Based On Shape Context Description of the Intercondylar Notch Curvature

2021 ◽  
Author(s):  
Joao Paulo Dias ◽  
Ariful Bhuiyan ◽  
Nabila Shamim
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
False Positives ◽  
Intercondylar Notch ◽  
Mr Images ◽  
Shape Context ◽  
Similarity Factor ◽  
Anterior Cruciate

Abstract An estimated number of 300,000 new anterior cruciate ligament (ACL) injuries occur each year in the United States. Although several magnetic resonance (MR) imaging-based ACL diagnostics methods have already been proposed in the literature, most of them are based on machine learning or deep learning strategies, which are computationally expensive. In this paper, we propose a diagnostics framework for the risk of injury in the anterior cruciate ligament (ACL) based on the application of the inner-distance shape context (IDSC) to describe the curvature of the intercondylar notch from MR images. First, the contours of the intercondylar notch curvature from 91 MR images of the distal end of the femur (70 healthy and 21 with confirmed ACL injury) were extracted manually using standard image processing tools. Next, the IDSC was applied to calculate the similarity factor between the extracted contours and reference standard curvatures. Finally, probability density functions of the similarity factor data were obtained through parametric statistical inference, and the accuracy of the ACL injury risk diagnostics framework was assessed using receiver operating characteristic analysis (ROC). The overall results for the area under the curve (AUC) showed that method reached a maximum accuracy of about 66%. Furthermore, the sensitivity and specificity results showed that an optimum discrimination threshold value for the similarity factor can be pursued that minimizes the incidence of false positives and false positives simultaneously.

Examining the Dynamic Nature of Anterior Cruciate Ligament Injury Risk Factors in Women’s Collegiate Soccer

2021 ◽  
pp. 1-8
Author(s):  
Elena M. D’Argenio ◽  
Timothy G. Eckard ◽  
Barnett S. Frank ◽  
William E. Prentice ◽  
Darin A. Padua
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Range Of Motion ◽  
Injury Risk ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Dynamic Risk Factors ◽  
Dynamic Risk ◽  
Anterior Cruciate

Context: Anterior cruciate ligament (ACL) injuries are a common and devastating injury in women’s soccer. Several risk factors for ACL injury have been identified, but have not yet been examined as potentially dynamic risk factors, which may change throughout a collegiate soccer season. Design: Prospective cohort study. Methods: Nine common clinical screening assessments for ACL injury risk, consisting of range of motion, movement quality, and power, were assessed in 29 Division I collegiate women’s soccer players. Preseason and midseason values were compared for significant differences. Change scores for each risk factor were also correlated with cumulative training loads during the first 10 weeks of a competitive soccer season. Results: Hip external rotation range of motion and power had statistically significant and meaningful differences at midseason compared with preseason, indicating they are dynamic risk factors. There were no significant associations between the observed risk factor changes and cumulative training load. Conclusions: Hip external rotation range of motion and power are dynamic risk factors for ACL injury in women’s collegiate soccer athletes. Serial screening of these risk factors may elucidate stronger associations with injury risk and improve prognostic accuracy of screening tools.

scholarly journals Longitudinal Assessment of Noncontact Anterior Cruciate Ligament Injury Risk Factors During Maturation in a Female Athlete: A Case Report

2009 ◽  
Vol 44 (1) ◽  
pp. 101-109 ◽  
Author(s):  
Gregory D. Myer ◽  
Kevin R. Ford ◽  
Jon G. Divine ◽  
Eric J. Wall ◽  
Leamor Kahanov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Body Mass ◽  
Female Athlete ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Knee Abduction ◽  
Injury Risk Factors ◽  
Anterior Cruciate

Abstract Objective: To present a unique case of a young pubertal female athlete who was prospectively monitored for previously identified anterior cruciate ligament (ACL) injury risk factors for 3 years before sustaining an ACL injury. Background: In prospective studies, previous investigators have examined cross-sectional measures of anatomic, hormonal, and biomechanical risk factors for ACL injury in young female athletes. In this report, we offer a longitudinal example of measured risk factors as the participant matured. Differential Diagnosis: Partial or complete tear of the ACL. Measurements: The participant was identified from a cohort monitored from 2002 until 2007. No injury prevention training or intervention was included during this time in the study cohort. Findings: The injury occurred in the year after the third assessment during the athlete's club basketball season. Knee examination, magnetic resonance imaging findings, and arthroscopic evaluation confirmed a complete ACL rupture. The athlete was early pubertal in year 1 of the study and pubertal during the next 2 years; menarche occurred at age 12 years. At the time of injury, she was 14.25 years old and postpubertal, with closing femoral and tibial physes. For each of the 3 years before injury, she demonstrated incremental increases in height, body mass index, and anterior knee laxity. She also displayed decreased hip abduction and knee flexor strength, concomitant with increased knee abduction loads, after each year of growth. Conclusions: During puberty, the participant increased body mass and height of the center of mass without matching increases in hip and knee strength. The lack of strength and neuromuscular adaptation to match the increased demands of her pubertal stature may underlie the increased knee abduction loads measured at each annual visit and may have predisposed her to increased risk of ACL injury.

Optimizing Whole-Body Kinematics During Single-Leg Jump Landing to Reduce Peak Abduction/Adduction and Internal Rotation Knee Moments: Implications for Anterior Cruciate Ligament Injury Risk

2021 ◽  
pp. 1-8
Author(s):  
Dhruv Gupta ◽  
Jeffrey A. Reinbolt ◽  
Cyril J. Donnelly
Keyword(s):  
Internal Rotation ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Whole Body ◽  
Jump Landing ◽  
Peak Knee ◽  
Knee Abduction ◽  
Acl Injury Risk ◽  
Anterior Cruciate

Knee abduction/adduction moment and knee internal rotation moment are known surrogate measures of anterior cruciate ligament (ACL) load during tasks like sidestepping and single-leg landing. Previous experimental literature has shown that a variety of kinematic strategies are associated or correlated with ACL injury risk; however, the optimal kinematic strategies needed to reduce peak knee moments and ACL injury are not well understood. To understand the complex, multifaceted kinematic factors underpinning ACL injury risk and to optimize kinematics to prevent the ACL injury, a musculoskeletal modeling and simulation experimental design was used. A 14-segment, 37-degree-of-freedom, dynamically consistent skeletal model driven by force/torque actuators was used to simulate whole-body single-leg jump landing kinematics. Using the residual reduction algorithm in OpenSim, whole-body kinematics were optimized to reduce the peak knee abduction/adduction and internal/external rotation moments simultaneously. This optimization was repeated across 30 single-leg jump landing trials from 10 participants. The general optimal kinematic strategy was to bring the knee to a more neutral alignment in the transverse plane and frontal plane (featured by reduced hip adduction angle and increased knee adduction angle). This optimized whole-body kinematic strategy significantly reduced the peak knee abduction/adduction and internal rotation moments, transferring most of the knee load to the hip.

scholarly journals The Combined Effect of Body Mass Index and Tibial Slope Angles on Anterior Cruciate Ligament Injury Risk in Male Knees: A Case-Control Study

2019 ◽  
Vol 12 ◽  
pp. 117954411986792
Author(s):  
Volkan Kızılgöz ◽  
Ali Kemal Sivrioğlu ◽  
Hasan Aydın ◽  
Gökhan Ragıp Ulusoy ◽  
Türkhun Çetin ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Anterior Cruciate Ligament ◽  
Body Mass ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Tibial Slope ◽  
Receiver Operating Characteristics ◽  
Operating Characteristics ◽  
Anterior Cruciate

Introduction: Tibial slope angles (TSAs) have been identified as potential risk factors of anterior cruciate ligament (ACL) injury in the literature. A higher body mass index (BMI) might increase the risk of ACL tear because of greater axial compressive force. The aim of this study was to determine the relationship of these factors and the combined effect of BMI and TSA in determination of risk potential for ACL injury. Methods: The preoperative magnetic resonance (MR) images of 81 ACL-injured male knees and of 68 male individuals with no ACL injuries were evaluated by 2 radiologists to measure the TSA. The Mann-Whitney U-test was performed to indicate the significant difference in height, weight, and BMI values. The independent samples t-test was used to determine the differences between ACL-injured and non-injured groups regarding TSA values. Odds ratios were calculated by logistic regression tests, and receiver operating characteristics (ROC) curves revealed the area under the receiver operating characteristics curve (AUC) values to compare the relationships of these parameters with ACL injury. Results: Body mass index, lateral tibial slope (LTS), and medial tibial slope (MTS) were predictive of ACL risk injury. Body mass index alone had the greatest effect among these parameters, and there were no statistically significant differences in coronal tibial slope values between the ACL-ruptured and control groups. The greatest AUC was observed for the combination of BMI, MTS, and LTS. Conclusions: Body mass index, LTS, and MTS angles were associated with ACL injury risk and BMI + MTS + LTS together revealed the greatest effect on ACL injury.

Femoral and Tibial Bony Risk Factors for Anterior Cruciate Ligament Injuries Are Present in More Than 50% of Healthy Individuals

2021 ◽  
pp. 036354652110504
Author(s):  
Grégoire Micicoi ◽  
Chistophe Jacquet ◽  
Raghbir Khakha ◽  
Sally LiArno ◽  
Ahmad Faizan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Reference Population ◽  
Acl Injuries ◽  
Notch Width ◽  
Injury Risk Factor ◽  
Acl Injury Risk ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injuries are multifactorial events that may be influenced by morphometric parameters. Associations between primary ACL injuries or graft ruptures and both femoral and tibial bony risk factors have been well described in the literature. Purpose: To determine values of femoral and tibial bony morphology that have been associated with ACL injuries in a reference population. Further, to define interindividual variations according to participant demographics and to identify the proportion of participants presenting at least 1 morphological ACL injury risk factor. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Computed tomography scans of 382 healthy participants were examined. The following bony ACL risk factors were analyzed: notch width index (NWI), lateral femoral condylar index (LFCI), medial posterior plateau tibial angle (MPPTA), and lateral posterior plateau tibial angle (LPPTA). The proportion of this healthy population presenting with at least 1 pathological ACL injury risk factor was determined. A multivariable logistic regression model was constructed to determine the influence of demographic characteristics. Results: According to published thresholds for ACL bony risk factors, 12% of the examined knees exhibited an intercondylar notch width <18.9 mm, 25% had NWI <0.292, 62% exhibited LFCI <0.67, 54% had MPPTA <83.6°, and 15% had LPPTA <81.6°. Only 14.4% of participants exhibited no ACL bony risk factors, whereas 84.5% had between 2 and 4 bony risk factors and 1.1% had all bony risk factors. The multivariate analysis demonstrated that only the intercondylar notch width ( P < .0001) was an independent predictor according to both sex and ethnicity; the LFCI ( P = .012) and MMPTA ( P = .02) were independent predictors according to ethnicity. Conclusion: The precise definition of bony anatomic risk factors for ACL injury remains unclear. Based on published thresholds, 15% to 62% of this reference population would have been considered as being at risk. Large cohort analyses are required to confirm the validity of previously described morphological risk factors and to define which participants may be at risk of primary ACL injury and reinjury after surgical reconstruction.

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