Understanding and preventing noncontact anterior cruciate ligament injuries: A review of the Hunt Valley II Meeting, January 2005

University of Toronto, Toronto, Ontario, Canada
The American Journal of Sports Medicine (Impact Factor: 4.36). 10/2006; 34(9):1512-32. DOI: 10.1177/0363546506286866
Source: PubMed


The incidence of noncontact anterior cruciate ligament injuries in young to middle-aged athletes remains high. Despite early diagnosis and appropriate operative and nonoperative treatments, posttraumatic degenerative arthritis may develop. In a meeting in Atlanta, Georgia (January 2005), sponsored by the American Orthopaedic Society for Sports Medicine, a group of physicians, physical therapists, athletic trainers, biomechanists, epidemiologists, and other scientists interested in this area of research met to review current knowledge on risk factors associated with noncontact anterior cruciate ligament injuries, anterior cruciate ligament injury biomechanics, and existing anterior cruciate ligament prevention programs. This article reports on the presentations, discussions, and recommendations of this group.

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Available from: Frank Noyes, M.D.
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    • "La rupture du ligament croisé antérieur (LCA) se produit généralement lors d'une réception de saut ou au cours d'un pivot rotatoire [1] [2]. Le risque lésionnel peut être augmenté par des facteurs intrinsèques ou extrinsèques [3]. Si les facteurs extrinsèques peuvent être modifiés par des programmes de prévention comme l'amélioration de la force des ischio-jambiers [4] [5], la proprioception [6] et le contrôle neuromusculaire [7] [8], les facteurs intrinsèques comme les structures ligamentaires [9] [10] et l'anatomie du genou ne peuvent être modifiés [11] [12]. "

    Full-text · Article · Dec 2013 · Journal de Traumatologie du Sport
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    • "Specifically, for females the injury rate-reported in number of injuries/1000 athlete-exposures (1 exposure ¼ 1 game or practice) was 0.28 for soccer, 0.23 for basketball, relatively smaller for volleyball (0.09) and the highest for gymnastics (0.33) (Hootman et al., 2007). Scientific studies support that females are at increased risk for an ACL injury due to sex specific anatomical and hormonal differences as well as sex disparities in neuromuscular (NM) factors (Alentorn-Geli et al., 2009; Griffin et al., 2006; Hewett, Myer, & Ford, 2006). Studies examining the relation of female hormones and increased risk of ACL injury in females have not yet concluded on the relative importance of this factor (Beynnon, 2008; Hewett, Zazulak, & Myer, 2007). "
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    ABSTRACT: Background Anterior Cruciate Ligament (ACL) injury is frequently encountered in sports. Purpose To analyze the effects of ACL injury prevention programs, on injury rates in female athletes between different sports. Methods A comprehensive literature search was performed in September 2012 using Pubmed Central, Science Direct, CINAHL, PEDro, Cochrane Library, SCOPUS, SPORTDiscus. The key words used were: ‘anterior cruciate ligament’, ‘ACL’, ‘knee joint’, ‘knee injuries’, ‘female’, ‘athletes’, ‘neuromuscular’, ‘training’, ‘prevention’. The inclusion criteria applied were: (1) ACL injury prevention training programs for female athletes; (2) Athlete–exposure data reporting; (3) Effect of training on ACL incidence rates for female athletes. Results 13 studies met the inclusion criteria. Three training programs in soccer and one in handball led to reduced ACL injury incidence. In basketball no effective training intervention was found. In season training was more effective than preseason in ACL injury prevention. A combination of strength training, plyometrics, balance training, technique monitoring with feedback, produced the most favorable results. Conclusion Comparing the main components of ACL injury prevention programs for female athletes, some sports-dependent training specificity issues may need addressing in future studies, related primarily to the individual biomechanics of each sport but also their most effective method of delivery.
    Full-text · Article · Jan 2013 · Physical Therapy in Sport
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    • "There is some evidence that kinematic patterns, particularly at the knee, are characteristic of musculoskeletal conditions or related to lower limb injury risk [1-3]. An increase in knee valgus angle during functional tasks, for example, is recognised as an important risk factor for non-contact anterior cruciate ligament injury [1,4]. "
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    ABSTRACT: The single-leg squat (SLS) is a common test used by clinicians for the musculoskeletal assessment of the lower limb. The aim of the current study was to reveal the kinematic parameters used by experienced and inexperienced clinicians to determine SLS performance and establish reliability of such assessment. Twenty-two healthy, young adults (23.8 ± 3.1 years) performed three SLSs on each leg whilst being videoed. Three-dimensional data for the hip and knee was recorded using a 10-camera optical motion analysis system (Vicon, Oxford, UK). SLS performance was rated from video data using a 10-point ordinal scale by experienced musculoskeletal physiotherapists and student physiotherapists. All ratings were undertaken a second time at least two weeks after the first by the same raters. Stepwise multiple regression analysis was performed to determine kinematic predictors of SLS performance scores and inter- and intra-rater reliability were determined using a two-way mixed model to generate intra-class correlation coefficients (ICC3,1) of consistency. One SLS per leg for each participant was used for analysis, providing 44 SLSs in total. Eight experienced physiotherapists and eight physiotherapy students agreed to rate each SLS. Variance in physiotherapist scores was predicted by peak knee flexion, knee medio-lateral displacement, and peak hip adduction (R2 = 0.64, p = 0.01), while variance in student scores was predicted only by peak knee flexion, and knee medio-lateral displacement (R2 = 0.57, p = 0.01). Inter-rater reliability was good for physiotherapists (ICC3,1 = 0.71) and students (ICC3,1 = 0.60), whilst intra-rater reliability was excellent for physiotherapists (ICC3,1 = 0.81) and good for students (ICC3,1 = 0.71). Physiotherapists and students are both capable of reliable assessment of SLS performance. Physiotherapist assessments, however, bear stronger relationships to lower limb kinematics and are more sensitive to hip joint motion than student assessments.
    Full-text · Article · Oct 2012 · BMC Musculoskeletal Disorders
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