Noncontact Anterior Cruciate Ligament Tears Research Articles

Risk factors associated with noncontact injury of the anterior cruciate ligament: a prospective four-year evaluation of 859 West Point cadets.

The causes of noncontact anterior cruciate ligament injury remain an enigma. To prospectively evaluate risk factors for noncontact anterior cruciate ligament injuries in a large population of young athletic people. Prospective cohort study. In 1995, 1198 new United States Military Academy cadets underwent detailed testing and many parameters were documented. During their 4-year tenure, all anterior cruciate ligament injuries that occurred were identified. Statistical analyses were used to identify the factors that may have predisposed the cadets to noncontact anterior cruciate ligament injuries. Among the 895 cadets who completed the entire 4-year study, there were 24 noncontact anterior cruciate ligament tears (16 in men, 8 in women). Significant risk factors included small femoral notch width, generalized joint laxity, and, in women, higher than normal body mass index and KT-2000 arthrometer values that were 1 standard deviation or more above the mean. The presence of more than one of these risk factors greatly increased the relative risk of injury. All female cadets who had some combination of risk factors sustained noncontact anterior cruciate ligament injuries, indicating that some combinations of factors are especially perilous to the female knee. Several risk factors may predispose young athletes to noncontact anterior cruciate ligament injury.

The Female Athlete: Evaluation and Treatment of Sports-Related Problems.

Although many of the problems faced by the female athlete affect the male athlete as well, some occur exclusively or more commonly in women. These include spondylolisthesis, stress fractures in the pelvis and hip, and pelvic floor dysfunction. Female athletes are also more likely to have patellofemoral problems, noncontact anterior cruciate ligament tears, and bunions. For many of these conditions, the relative influences of osseous anatomy, ligamentous laxity, and the effect of sex hormones have not yet been established. There are also problems related specifically to the menstrual cycle and pregnancy. Amenorrhea is present in up to 20% of vigorously exercising women. The term "female athlete triad" has been coined to describe the complex interplay of menstrual irregularity, disordered eating, and premature osteoporosis seen in the female athlete. Many of the concerns related to exercise during pregnancy focus on the safety of the fetus rather than the athlete herself. Musculoskeletal problems in the physically active pregnant woman are related to weight gain, ligamentous relaxation, lordosis, and change in the center of gravity.

Intercondylar notch size and anterior cruciate ligament injuries in athletes. A prospective study.

Published reports agree that there is a strong association between intercondylar notch stenosis and anterior cruciate ligament injuries. In a previously published retrospective study on bilateral anterior cruciate ligament injuries and associated intercondylar notch stenosis, we formulated the notch width index to measure and compare intercondylar notch width. The purpose of this prospective study was to establish a normal range for the notch width index and to correlate intercondylar notch size and anterior cruciate ligament injuries. We gathered data on 902 high school athletes, including range of motion, thigh girth, ligament stability and intercondylar notch width using the notch width index. The population was then followed prospectively and anterior cruciate ligament injuries were recorded and correlated with notch width index in a blind manner. Two-year results showed that the overall anterior cruciate ligament injury rate was 3%. The normal intercondylar notch ratio was 0.231 +/- 0.044. Intercondylar notch width index for men was larger than that for women. Athletes sustaining noncontact anterior cruciate ligament tears have statistically significant intercondylar notch stenosis (notch width index, 0.189). Ten of 14 athletes with noncontact anterior cruciate ligament injuries had a notch width index that was at least 1 SD below the mean. Athletes with contact anterior cruciate ligament injuries had a mean of 0.233. We conclude that athletes with a stenotic intercondylar notch are at significantly greater risk for sustaining noncontact anterior cruciate ligament injury.