Cruciate Ligament Injury Risk Factors Research Articles

Lack of Correlation between Anterior Cruciate Ligament Injury Risk Factors and Its Severity Degree

Lack of Correlation between Anterior Cruciate Ligament Injury Risk Factors and Its Severity Degree

Qualitative and quantitative return-to-sport test battery and second anterior cruciate ligament injury risk factors

ObjectiveTo determine risk factors for second anterior cruciate ligament (ACL) injury following primary ACL reconstruction (ACLR) using return-to-sport (RTS) tests consisting of qualitative and quantitative measures in young athletes.MethodsA case–control...

Lower-Extremity Visuomotor Reaction Time Is Not Different Between Males and Females Following Anterior Cruciate Ligament Reconstruction

Visuomotor reaction time (VMRT) is predictive of lower-extremity musculoskeletal injury and may be a modifiable anterior cruciate ligament (ACL) injury risk factor that affects the incidence of primary and secondary ACL injuries in females. However, it is unknown if females with ACL reconstruction (ACLR) experience diminished VMRT compared with their male counterparts. The purpose of this study was to compare lower-extremity VMRT (LEVMRT) between males and females with ACLR. Female (n = 40) and male (n = 20) participants who were between 4 and 12 months after primary, unilateral ACLR completed a LEVMRT task with each limb using a series of wireless light discs. Mann–Whitney U tests were used to compare between-group differences for LEVMRT (in milliseconds). No statistically significant sex differences were observed for LEVMRT when the ACLR limb deactivated the light discs (females = 509.5 [132.5], males = 507.0 [79.8]; p = .77) or when the ACLR limb was stabilizing while the nonsurgical limb deactivated the light discs (females = 528.5 [105.3], males = 546.0 [92.5]; p = .77). Both males and females may benefit from visual motor training to improve VMRT after ACLR.

Clinical Determinants of Knee Joint Loads While Sidestepping: An Exploratory Study With Male Rugby Union Athletes.

While several clinical factors have independently been linked to anterior cruciate ligament (ACL) injury risk factors, their collective impact on knee loading during the sidestep maneuver is unknown. To better understand these factors, we assessed the relationship between strength, balance, and sprint kinetics and external knee abduction moments during sidestepping on each leg. Sixteen male academy-level rugby union athletes (age, 20 ± 3 years; body-height, 186 ± 9 cm; body-mass, 99 ± 14 kg) were bilaterally assessed in single-leg: isokinetic concentric and eccentric knee and concentric hip strength, balance at 2 difficulty levels, vertical and horizontal force production during maximal sprinting, and 3-dimensional motion capture while sidestepping on the preferred and non-preferred leg. A hierarchical multiple regression analysis based on this theoretical approach of the mechanics of ACL injury risk was performed. When sidestepping on the preferred leg, larger abduction moments were explained by less concentric hip extension strength and vertical force production during maximal sprinting (R 2 = 41%; ES = 0.64); when sidestepping on the non-preferred leg, larger abduction moments were explained by more concentric hip flexion strength (R 2 = 8%; ES = 0.29). Larger symmetry scores between the legs (representing greater abduction moments) were explained by more horizontal force production during maximal sprinting and less eccentric knee flexion strength (R 2 = 32%; ES = 0.56). Independently, the preferred and non-preferred legs contribute to increased knee abduction moments via unique distributions of strength and/or sprint kinetics. The allocations of strength and sprint kinetics appear interrelated through weaker posterior muscular strength and may be modifiable through a targeted strength training approach.

Effect of Heading a Soccer Ball as an External Focus During a Drop Vertical Jump Task.

Research has demonstrated that performing a secondary task during a drop vertical jump (DVJ) may affect landing kinetics and kinematics. To examine the differences in the trunk and lower extremity biomechanics associated with anterior cruciate ligament (ACL) injury risk factors between a standard DVJ and a DVJ while heading a soccer ball (header DVJ). Descriptive laboratory study. Participants comprised 24 college-level soccer players (18 female and 6 male; mean ± SD age, 20.04 ± 1.12 years; height, 165.75 ± 7.25 cm; weight, 60.95 ± 8.47 kg). Each participant completed a standard DVJ and a header DVJ, and biomechanics were recorded using an electromagnetic tracking system and force plate. The difference (Δ) in 3-dimensional trunk, hip, knee, and ankle biomechanics between the tasks was analyzed. In addition, for each biomechanical variable, the correlation between the data from the 2 tasks was calculated. Compared to the standard DVJ, performing the header DVJ led to significantly reduced peak knee flexion angle (Δ = 5.35°; P = .002), knee flexion displacement (Δ = 3.89°; P = .015), hip flexion angle at initial contact (Δ = -2.84°; P = .001), peak trunk flexion angle (Δ = 13.11°; P = .006), and center of mass vertical displacement (Δ = -0.02m; P = .010), and increased peak anterior tibial shear force (Δ = -0.72 N/kg; P = .020), trunk lateral flexion angle at initial contact (Δ = 1.55°; P < .0001), peak trunk lateral flexion angle (Δ = 1.34°; P = .003), knee joint stiffness (Δ = 0.002 N*m/kg/deg; P = .017), and leg stiffness (Δ = 8.46 N/kg/m; P = .046) compared to those in standard DVJs. In addition, individuals' data for these variables were highly and positively correlated between conditions (r = 0.632-0.908; P < .001). The header DVJ task showed kinetic and kinematic parameters that suggested increased risk of ACL injury as compared with the standard DVJ task. Athletes may benefit from acquiring the ability to safely perform header DVJs to prevent ACL injury. To simulate real-time competition situations, coaches and athletic trainers should incorporate such dual tasks in ACL injury prevention programs.

Using load sensing insoles to identify knee kinetic asymmetries during landing in patients with an Anterior Cruciate Ligament reconstruction

BackgroundKnee extension moment asymmetry is a known second anterior cruciate ligament injury risk factor in patients who have had an anterior cruciate ligament reconstruction. Traditionally, assessing asymmetries requires motion capture and force platforms which are expensive and occupy a large space. Wireless force sensing insoles could be a feasible surrogate. MethodsTwenty-nine patients following anterior cruciate ligament reconstruction performed ten bilateral stop jumps while insole forces, ground reaction forces, and lower extremity kinematics were collected. Peak knee extension moment symmetry was computed using the kinematic and kinetic data, and peak impact force symmetry and impulse symmetry were computed using both the insole force data and vertical ground reaction force data. The relationship between outcomes was analyzed using Pearson correlation coefficients. Patients were classified as symmetric or asymmetric for each outcome based on an 85% symmetry cutoff. The resulting classifications were qualitatively compared across outcome measures. FindingsPeak knee extension moment symmetry had a strong association with the force plate symmetry outcomes (r = 0.72–0.96, p < 0.001) and a moderate to strong association with insole symmetry outcomes (r = 0.67–0.77, p < 0.001). There was strong agreement between insole and force plate symmetry outcomes (r = 0.69–0.90, p < 0.001). Four patients were identified as symmetric when using the peak knee extension moment symmetry, five when using force plate data, and eight when using insole data. InterpretationForce sensing insoles could be used as a surrogate for knee extension moment asymmetry in patients who have had an anterior cruciate ligament reconstruction.

Definition of High-Risk Motion Patterns for Female ACL Injury Based on Football-Specific Field Data: A Wearable Sensors Plus Data Mining Approach.

The aim of the present study was to investigate if the presence of anterior cruciate ligament (ACL) injury risk factors depicted in the laboratory would reflect at-risk patterns in football-specific field data. Twenty-four female footballers (14.9 ± 0.9 year) performed unanticipated cutting maneuvers in a laboratory setting and on the football pitch during football-specific exercises (F-EX) and games (F-GAME). Knee joint moments were collected in the laboratory and grouped using hierarchical agglomerative clustering. The clusters were used to investigate the kinematics collected on field through wearable sensors. Three clusters emerged: Cluster 1 presented the lowest knee moments; Cluster 2 presented high knee extension but low knee abduction and rotation moments; Cluster 3 presented the highest knee abduction, extension, and external rotation moments. In F-EX, greater knee abduction angles were found in Cluster 2 and 3 compared to Cluster 1 (p = 0.007). Cluster 2 showed the lowest knee and hip flexion angles (p < 0.013). Cluster 3 showed the greatest hip external rotation angles (p = 0.006). In F-GAME, Cluster 3 presented the greatest knee external rotation and lowest knee flexion angles (p = 0.003). Clinically relevant differences towards ACL injury identified in the laboratory reflected at-risk patterns only in part when cutting on the field: in the field, low-risk players exhibited similar kinematic patterns as the high-risk players. Therefore, in-lab injury risk screening may lack ecological validity.

ACL Research Retreat IX March 17–19, 2022 High Point, NC

ACL Research Retreat IX March 17–19, 2022 High Point, NC

Comparing lab and field agility kinematics in young talented female football players: Implications for ACL injury prevention

ABSTRACT Modifiable (biomechanical and neuromuscular) anterior cruciate ligament (ACL) injury risk factors have been identified in laboratory settings. These risk factors were subsequently used in ACL injury prevention measures. Due to the lack of ecological validity, the use of on-field data in the ACL injury risk screening is increasingly advocated. Though, the kinematic differences between laboratory and on-field settings have never been investigated. The aim of the present study was to investigate the lower-limb kinematics of female footballers during agility movements performed both in laboratory and football field environments. Twenty-eight healthy young female talented football (soccer) players (14.9 ± 0.9 years) participated. Lower-limb joint kinematics was collected through wearable inertial sensors (Xsens Link) in three conditions: (1) laboratory setting during unanticipated sidestep cutting at 40-50°; on the football pitch (2) football-specific exercises (F-EX) and (3) football games (F-GAME). A hierarchical two-level random effect model in Statistical Parametric Mapping was used to compare joint kinematics among the conditions. Waveform consistency was investigated through Pearson’s correlation coefficient and standardized z-score vector. In-lab kinematics differed from the on-field ones, while the latter were similar in overall shape and peaks. Lower sagittal plane range of motion, greater ankle eversion, and pelvic rotation were found for on-field kinematics (p < 0.044). The largest differences were found during landing and weight acceptance. The biomechanical differences between lab and field settings suggest the application of context-related adaptations in female footballers and have implications in ACL injury prevention strategies. Highlights Talented youth female football players showed kinematical differences between the lab condition and the on-field ones, thus adopting a context-related motor strategy. Lower sagittal plane range of motion, greater ankle eversion, and pelvic rotation were found on the field. Such differences pertain to the ACL injury mechanism and prevention strategies. Preventative training should support the adoption of non-linear motor learning to stimulate greater self-organization and adaptability. It is recommended to test football players in an ecological environment to improve subsequent primary ACL injury prevention programmes.

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

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. Prospective cohort study. 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 10weeks of a competitive soccer season. 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. 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.

The effects of taekwondo shoes on anterior cruciate ligament injury risk factors during jump whip kicks

This study aimed to investigate the effect of taekwondo shoes on anterior cruciate ligament injury risk factors in taekwondo athletes performing jump whip kicks. The participants comprised 10 taekwondo athletes with no history of anterior cruciate ligament or lower extremity injuries within the past 12 months. The maximum hip flexion angle, maximum knee valgus angle, maximum knee extension moment, maximum knee lateral rotation moment, and quadriceps and hamstring muscle activity ratios were analyzed using video, ground reaction force, and electromyography analysis systems. The maximum knee valgus angle was significantly lower when wearing taekwondo shoes while performing taekwondo jump whip kicks ( p = 0.04), and the activity ratio of the quadriceps and hamstring muscles was low ( p = 0.10). Wearing taekwondo shoes had a positive effect on preventing anterior cruciate ligament injury; therefore, the importance of wearing taekwondo shoes should be communicated clearly to athletes and coaches to increase their frequency of use and change negative perceptions regarding taekwondo shoe use during training. Taekwondo competition movements can cause damage to the anterior cruciate ligament owing to sudden changes in direction and jump movements. Our results suggest that wearing taekwondo shoes can help prevent anterior cruciate ligament injuries. Cette étude visait à étudier l’effet des chaussures de taekwondo sur les facteurs de risque de blessure au ligament croisé antérieur chez les athlètes de taekwondo effectuant des coups de fouet sautés. Les participants comprenaient 10 athlètes de taekwondo sans antécédents de ligament croisé antérieur ou de blessures aux membres inférieurs au cours des 12 derniers mois. L’angle de flexion maximal de la hanche, l’angle maximal de valgus du genou, le moment maximal d’extension du genou, le moment maximal de rotation latérale du genou et les rapports d’activité des quadriceps et des ischio-jambiers ont été analysés à l’aide de systèmes d’analyse vidéo, de force de réaction au sol et d’électromyographie. L’angle de valgus maximal du genou était significativement plus faible lorsque l’on portait des chaussures de taekwondo tout en exécutant des coups de fouet de taekwondo ( p = 0,04), et le rapport d’activité des quadriceps et des muscles ischio-jambiers était faible ( p = 0,10). Le port de chaussures de taekwondo a eu un effet positif sur la prévention des blessures du ligament croisé antérieur; par conséquent, l’importance du port de chaussures de taekwondo doit être clairement communiquée aux athlètes et aux entraîneurs pour augmenter leur fréquence d’utilisation et changer les perceptions négatives de l’utilisation des chaussures de taekwondo pendant l’entraînement. Les mouvements de compétition de taekwondo peuvent endommager le ligament croisé antérieur en raison de changements brusques de direction et de mouvements de saut. Nos résultats suggèrent que les blessures du ligament croisé antérieur pourraient être évitées en portant des chaussures de taekwondo.

Anterior Cruciate Ligament Injury Risk Factors by Landing Error Scoring System (LESS) and Muscle Activities during Drop Vertical Jump for Overweight Females

PURPOSE The purpose of this study was to investigate the risk factors for anterior cruciate ligament injury using the Landing Error Scoring System (LESS) and muscle activity during the drop vertical jump for overweight females.METHODS The body mass index was 18.5-22.9 kg/㎡ for normal weight females and 23-24.9 kg/㎡ for overweight females among 10 participants aged 20-30 years classified into groups of participants without any injury history and those who were right-footed. An automatic heigh-tweight machine, body composition analyzer, diagnostic imaging, electromyography with the LESS, and muscle activity analysis were used for measurements. The difference in muscle activity between the normal weight and overweight females was evaluated by independent t-test.RESULTS Overweight females had a smaller angle of knee bending during the drop vertical landing, leading to a smaller knee curve angle. In addition, they landed with an unbalanced foot touch on the ground inclined backward, thereby breaking the whole body balance. Overweight females had an incorrect posture compared with normal weight females, with higher LESS points. The muscle activity of the rectus femoris was higher than that of the biceps femoris, indicating a higher load on the muscle.CONCLUSIONS Overweight females take more load on the knee joint and cannot absorb the impact force properly. These results suggest a higher risk of anterior cruciate ligament injury in overweight females.

Increased Ankle Range of Motion Reduces Knee Loads During Landing in Healthy Adults.

Decreased dorsiflexion range of motion (DROM) can be modified using static stretching and joint mobilizations and may attenuate known knee anterior cruciate ligament injury risk factors. It is not known how these interventions compare to each other and how they improve knee landing mechanics. This study's purpose was to determine the immediate effects of static stretching and joint mobilization interventions on DROM measurement changes and right-leg drop jump knee landing mechanics. Eighteen females and 7 males, all recreationally active, completed 2 study sessions. Active and passive DROM, the weight-bearing lunge test, the anterior reach portion of the Star Excursion Balance Test, and a right-leg drop jump landing task were completed before and after the intervention. Change in DROM (ΔDROM) was calculated for DROM assessments between preintervention and postintervention. Pairwise dependent t tests determined no differences in ΔDROM between interventions, and statistical parametric mapping determined increased knee flexion (P = .004) and decreased anterior shear force (P = .015) during landing after both interventions. Increased DROM improves sagittal plane displacement and loading at the knee. Stretching may be a more feasible option in a healthy population for those wanting to maintain range of motion and decrease knee injury risk without physical therapist involvement.

Association between biological maturation and anterior cruciate ligament injury risk factors during cutting.

Adolescent females are particularly susceptible to suffering anterior cruciate ligament (ACL) injuries, likely influenced by well-established maturational changes. This study investigated ACL biomechanical injury risk factors and their association with biological maturation in females. Thirty-five adolescent females (15±1 year) completed a series of maximum-effort 90° unanticipated cutting maneuvers. Established biomechanical ACL injury risk factors (including external knee abduction moments, knee abduction, hip abduction, knee flexion, ground reaction force) were derived from an optoelectronic motion analysis system and force platforms, with inter-limb asymmetries in these risk factors also computed. Biological maturation (percentage of predicted adult stature) was assessed using validated regression equations, incorporating anthropometric measures of participants and their biological parents. Significant bilateral asymmetries were observed with higher peak external knee abduction moments, higher ground reaction forces and less knee flexion (from 0-18% and 30-39% of contact) during the non-dominant vs. dominant cuts (effect sizes =0.36, 0.63 and 0.50, respectively). Maturation did not appear to influence these asymmetries; however, less hip abduction was observed (e.g., 21-51% of contact for dominant cuts) in more biologically-mature females. These results highlight a potential maturation-related change in cutting technique that may explain the apparent heightened ACL injury risk in this population. As females mature, training targeted at neuromuscular control of hip abductor (e.g. gluteal) muscle groups could potentially mitigate ACL injury risk.

First-time anterior cruciate ligament injury in adolescent female elite athletes: a prospective cohort study to identify modifiable risk factors

PurposeTo identify modifiable biomechanical and neuromuscular anterior cruciate ligament (ACL) injury risk factors for first-time ACL injury in adolescent female elite football and team handball players.MethodsAdolescent female elite football and handball players with no previous ACL injury participated in the present study. At baseline, players were tested during side-cutting manoeuvres performed in a 3-dimensional motion analysis laboratory with concomitant electromyography (EMG) measurements. Maximal isometric lower limb muscle strength was assessed by handheld dynamometry. Players were prospectively followed for 2 years after baseline testing, and all magnetic resonance imaging (MRI) verified ACL injuries were registered. The effect of 16 risk factor candidates on the relative risk (RR) of ACL injury was estimated using Poisson regression analysis.ResultsNinety players (age 16.9 ± 1.2 years) were included in the analyses. Nine first-time ACL injuries (injury incidence 10.0% (95% confidence interval (CI) 5.4–18.6%)) were registered during the 2-year follow-up period. Four risk factor candidates were significantly associated with the risk of ACL injury: (1) hip flexion angle at initial contact (IC) [RR 0.56, 95% confidence interval (CI) 0.34–0.92], (2) internal knee rotation angle at IC [RR 1.13, 95% CI 1.08–1.19], (3) semitendinosus EMG activity 50 ms prior to IC [RR: 0.62, 95% CI 0.43–0.89], and (4) external hip rotator strength [RR: 0.77, 95% CI 0.66–0.89].ConclusionFour distinct ACL injury risk factors related to the side-cutting manoeuvre were identified in a population of adolescent female elite football and team handball players with no previous ACL injury. As ACL injury typically occur during side-cutting, intervention programmes to modify these risk factors pose a promising strategy for ACL injury prevention in adolescent female elite football and team handball.Level of evidenceII.

Risk Factors for Lower Limb Injury in Female Team Field and Court Sports: A Systematic Review, Meta-analysis, and Best Evidence Synthesis.

Identifying risk factors for lower limb injury is an important step in developing injury risk reduction training and testing for player monitoring. Female athletes are distinct from male athletes, warranting separate investigation into risk factors. To systematically review the literature and synthesise the evidence for intrinsic risk factors for lower limb injury in female team field and court sports. Five online databases were searched from inception to April 2020. To be eligible for inclusion, studies were required to be a prospective study presenting intrinsic risk factors for lower limb injury in female team field or court sport athletes. Risk of bias was assessed using the Quality of Prognosis Studies tool. Sixty-nine studies, capturing 2902 lower limb injuries in 14,492 female athletes, and analysing 80 distinct factors met the inclusion criteria. Risk factors for any lower limb injury included greater body mass (standardised mean difference [SMD] = 0.24, 95% confidence interval [95% CI] 0.18-0.29), greater body mass index (BMI) (SMD = 0.22, 95% CI 0.05-040), older age (SMD = 0.20, 95% CI 0.09-0.31), greater star excursion balance test (SEBT) anterior reach distance (SMD = 0.18, 95% CI 0.12-0.24), and smaller single-leg hop distance (SMD = - 0.09, 95% CI - 0.12 to - 0.06). Lower knee injury and osteoarthritis outcome score (KOOS) increased the risk of knee injury. Anterior cruciate ligament (ACL) injury risk factors included prior ACL injury (odds ratio [OR] = 3.94, 95% CI 2.07-7.50), greater double-leg postural sway (SMD = 0.58, 95% CI 0.02-1.15), and greater body mass (SMD = 0.25, 95% CI 0.12-0.39). Ankle injury risk factors included smaller SEBT anterior reach distance (SMD = - 0.13, 95% CI - 0.14 to - 0.13), greater single-leg hop distance asymmetry (OR = 3.67, 95% CI 1.42-9.45), and slower agility course time (OR = 0.20, 95% CI 0.05-0.88). Remaining factors were not associated with injury or had conflicting evidence. Prior injury, older age, greater body mass, and greater BMI are risk factors for lower limb injury in female athletes. Limited evidence showed an association between KOOS, SEBT anterior reach, single-leg hop distance and asymmetry, double-leg postural sway, agility, and lower limb injury. CRD42020171973.

An individualised approach to assess the sidestep manoeuvre in male rugby union athletes

ObjectivesThis study aimed to (1) quantitatively assess external knee abduction moments between legs, and (2) qualitatively assess anterior cruciate ligament injury risk between group mean and individual athlete data during the sidestep manoeuvre. DesignDescriptive cross-sectional study. MethodsSixteen male academy-level rugby union athletes (20.4±2.7yr; 186.3±9.1cm; 99.1±14.4kg) performed three maximal effort sidesteps (>6.0ms−1) on each leg. Three-dimensional motion analysis was used to obtain external knee abduction moments, wherein the two legs were separated by the preferred and non-preferred kicking leg. Quantitative comparisons were made between legs, while qualitative comparisons were made been group mean and individual athlete data. ResultsWhen sidestepping on the non-preferred leg, athletes produced 25% greater knee abduction moments (ES=0.43) and presented modified postural adjustments associated with injury risk (extended knee [ES=−0.26; −8%], more trunk lateral flexion [ES=0.42; 17%] and more distance between the centre-of-mass and ankle-joint-centre of the stance leg [ES=0.97; 11%]) compared to the preferred leg. Individually, only 9 out of 16 athletes presented a higher abduction moment in their non-preferred leg with individual asymmetries ranging between 2.2 and 47%. ConclusionsNearly half of the athletes assessed in this study showed the potential to “slip under the radar” when using the group mean for assessment. When assessing athletes for anterior cruciate ligament injury risk factors, individual athlete data should be examined in conjunction with the group mean for a more holistic view of the data.

Differences in anterior cruciate ligament injury risk factors between female dancers and female soccer players during single- and double-leg landing

The purpose of this study was to compare anterior cruciate ligament (ACL) injury risk factors between female dancers and female soccer players during single- and double-leg drop landing vertical jump tasks. Fifteen elite female soccer players and 45 professional female dancers (15 ballet, 15 modern, and 15 Korean dancers) were recruited to participate in this study. ACL injury risk factors were obtained from motion and ground reaction force data. Two-way repeated measure of analyses of variance (participant groups and landing tasks, 4 × 2) were used. The female dancers landed with a significantly lower trunk flexion, trunk external rotation, knee external rotation, and knee valgus moment than the female soccer players. In addition, the single-leg drop landing task demonstrated higher trunk external rotation and knee valgus moment than the double-leg drop landing vertical jump task. The female dancers had lower ACL injury risk factors than the female soccer players during landing tasks. The single-leg drop landing task is statistically correlated with ACL injury risk factors compared with double-leg drop landing vertical jump task in all groups. Le but de cette étude était de comparer les facteurs de risque de lésion du ligament croisé antérieur (LCA) entre les danseuses et les footballeuses lors de tâches de saut vertical à une ou deux jambes. Quinze joueuses de football d’élite et 45 danseuses professionnelles (15 danseuses, 15 danseuses modernes et 15 danseuses coréennes) ont été recrutées pour participer à cette étude. Les facteurs de risque de lésion du LCA ont été obtenus à partir des données de force de réaction au sol et au mouvement. Des mesures répétées d’analyses de variance (groupes de participants et tâches d’atterrissage, 4 × 2) ont été utilisées. Les danseuses ont atterri avec une flexion du tronc, une rotation externe du tronc, une rotation externe du genou et un valgus du genou significativement plus faible que les footballeuses. En outre, la tâche d’atterrissage en chute libre sur une jambe a démontré une rotation externe du tronc et un moment valgus au genou plus élevé que la tâche de saut vertical en atterrissage en chute double. Les femmes danseuses présentaient des facteurs de risque de lésion du LCA plus faibles que les footballeuses lors des tâches d’atterrissage. La tâche d’atterrissage en chute libre sur une jambe est statistiquement corrélée aux facteurs de risque de lésion du LCA par rapport à la tâche de saut vertical en atterrissage en chute double pour tous les groupes.

Anterior cruciate ligament injury risk factors in football.

Anterior cruciate ligament (ACL) lesion represents one of the most dramatic injuries in a football (soccer) player's career. There are many injury risk factors related to intrinsic (non-modifiable) and/or extrinsic (modifiable) factors of ACL injury. Research of the studies was conducted until September 2018 without publication data limitation or language restriction on the following databases: PubMed/MEDLINE, Scopus, ISI, EXCERPTA. To date, evidence from the literature suggests that the risk of ACL injury is multifactorial and involves biomechanical, anatomical, hormonal, and neuromuscular factors. Despite this relative complexity, the mechanisms of injury are well known and rationally classified into two categories: mechanisms of injury based on contact or on non-contact with another player, with the non-contact injury mechanisms clearly prevailing over the mechanisms of contact injury. One of the most frequent biomechanical risk factors, associated with ACL non-contact injury, is represented by the valgus knee in the pivoting and cutting movements and in the landing phase after jumping. Gender-related risk factors show female populations to have a higher predisposition to ACL injury than males However, there are still some theoretical and practical aspects that need further investigation such as; genetic risks together with the role of estrogen and progesterone receptors in female populations, and the in-vivo interaction shoe-playing surface. In particular, the genetic risk factors of ACL lesion seem to be an interesting and promising field of investigation, where considerable progress has still to be made. This narrative review provides an insight into the risk factors of ACL injury that could be used by practitioners for preventing injury in football (soccer).

Comparing Anterior Cruciate Ligament Injury Risk Variables Between Unanticipated Cutting and Decelerating Tasks

To examine the relationship between anterior cruciate ligament injury risk factors in unanticipated cutting and decelerating. Three-dimensional kinematics and ground reaction forces were collected on 11 females (22 [2]y, 1.67 [0.08]m, and 68.5 [9.8]kg) during 2 unanticipated tasks. Paired samples t tests were performed to compare dependent variables between tasks. Spearman rank correlation coefficients were calculated to analyze the relationship between peak internal knee adduction moment and peak anterior tibial shear force (ASF) during 2 unanticipated tasks. Significantly greater knee abduction angles, peak knee adduction moments, and peak ASFs were observed during cutting (P ≤ .05). A strong positive correlation existed between decelerating ASF and cutting ASF (ρ = .67), while correlations between decelerating knee adduction moment and cutting knee adduction moment and decelerating ASF and cutting knee adduction moment were not significant. In situations where time management is a necessity and only one task can be evaluated, it may be more appropriate to utilize an unanticipated cutting task rather than an unanticipated deceleration task because of the increased knee adduction moment and ASF. These data can help future clinicians in better designing more effective anterior cruciate ligament injury risk screening methods.