Anterior Cruciate Ligament Injury

International Journal of Orthopaedics, 2017

The aim of the present study is to determine the risk factors that promote these injuries and study the available strategy to prevent ACL injuries in young female athletes. MATERIALS AND METHODS: Different database were used to perform the research (PubMed, Cochrane Plus, Trip Database), using the following keywords: anterior cruciate ligament injury, risk factors, prevention, female and athlete. RESULTS: Risk factors for ACL injuries include: dry weather, high temperatures, playing indoors, artificial boil, sleepless, fatigue, stress, sport specialization, burnout, low self-esteem, incorrect pivoting and landing techniques. Avoiding or modifying these risk factors could prevent ACL injuries as well as performing a specific neuromuscular training. CONCLUSION: There are different ways to prevent ACL injuries that have been proven to be effective, a passive one avoiding the risk factors, and active one, by practicing a specific neuromuscular training.

British Journal of Sports Medicine, 2007

The relationships of gender, age and training to the incidence of anterior cruciate ligament (ACL) injury are pivotal to developing a comprehensive neuromuscular and proprioceptive training programme to decrease ACL injuries in female athletes. A prophylactic neuromuscular and proprioceptive training programme may have direct benefit in decreasing the number of ACL injuries in female athletes. This research foundation endorses further epidemiological and biomechanical studies to determine the exact mechanism of ACL injury and the most effective intervention for decreasing ACL injuries in this high-risk population. i52 www.bjsportmed.com

International Journal of Environmental Research and Public Health

Anterior cruciate ligament (ACL) injuries account for a large percentage of knee injuries, disproportionately affecting female athletes. To help health professionals stay current, we performed an umbrella review to evaluate the effectiveness of ACL injury prevention programs in reducing non-contact ACL injury rates, determine the effective components within interventions, and provide clinical recommendations. Twelve databases (Medline, Embase, Cochrane Database of Systematic Reviews, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature, PEDro, Web of Science Core Collection, Epistemonikos, TRIP, BC Guidelines and Protocols, CPG Infobase, ProQuest Dissertations and Theses Global) were searched in May 2021 to identify relevant systematic reviews and meta-analyses. Four databases were searched again in September 2021 to identify recent primary literature. Non-contact ACL injury data were extracted to calculate incidence rate ratios (IRRs) and these were combined using ...

Pediatrics, 2014

The number of anterior cruciate ligament (ACL) injuries reported in athletes younger than 18 years has increased over the past 2 decades. Reasons for the increasing ACL injury rate include the growing number of children and adolescents participating in organized sports, intensive sports training at an earlier age, and greater rate of diagnosis because of increased awareness and greater use of advanced medical imaging. ACL injury rates are low in young children and increase sharply during puberty, especially for girls, who have higher rates of noncontact ACL injuries than boys do in similar sports. Intrinsic risk factors for ACL injury include higher BMI, subtalar joint overpronation, generalized ligamentous laxity, and decreased neuromuscular control of knee motion. ACL injuries often require surgery and/or many months of rehabilitation and substantial time lost from school and sports participation. Unfortunately, regardless of treatment, athletes with ACL injuries are up to 10 time...

American Journal of Sports Medicine, 2006

Female athletes have a 4 to 6 times higher incidence of anterior cruciate ligament injury than do male athletes participating in the same landing and pivoting sports. This greater risk of anterior cruciate ligament injury, coupled with a geometric increase in participation (doubling each decade), has led to a significant rise in anterior cruciate ligament injuries in female athletes. The gender gap in anterior cruciate ligament injury, combined with evidence that the underpinnings of this serious health problem are neuromuscular in nature, leads to the development of neuromuscular interventions designed to prevent injury. A systematic review of the published literature yielded 6 published interventions targeted toward anterior cruciate ligament injury prevention in female athletes. Four of 6 significantly reduced knee injury incidence, and 3 of 6 significantly reduced anterior cruciate ligament injury incidence in female athletes. A meta-analysis of these 6 studies demonstrates a significant effect of neuromuscular training programs on anterior cruciate ligament injury incidence in female athletes (test for overall effect, Z = 4.31, P < .0001). Examination of the similarities and differences between the training regimens gives insight into the development of more effective and efficient interventions. The purpose of this "Current Concepts" review is to highlight the relative effectiveness of these interventions in reducing anterior cruciate ligament injury rates and to evaluate the common training components between the training studies. In addition, the level of rigor of these interventions, the costs and the difficulty of implementation, the compliance with these interventions, and the performance benefits are discussed. This review summarizes conclusions based on evidence from the common components of the various interventions to discuss their potential to reduce anterior cruciate ligament injury risk and assess their potential for combined use in more effective and efficient intervention protocols.

Journal of Athletic Training, 2018

Objective: To provide certified athletic trainers, physicians, and other health care and fitness professionals with recommendations based on current evidence regarding the prevention of noncontact and indirect-contact anterior cruciate ligament (ACL) injuries in athletes and physically active individuals. Background: Preventing ACL injuries during sport and physical activity may dramatically decrease medical costs and long-term disability. Implementing ACL injury-prevention training programs may improve an individual's neuromuscular control and lower extremity biomechanics and thereby reduce the risk of injury. Recent evidence indicates that ACL injuries may be prevented through the use of multicomponent neuromusculartraining programs. Recommendations: Multicomponent injury-prevention training programs are recommended for reducing noncontact and indirect-contact ACL injuries and strongly recommended for reducing noncontact and indirect-contact knee injuries during physical activity. These programs are advocated for improving balance, lower extremity biomechanics, muscle activation, functional performance, strength, and power, as well as decreasing landing impact forces. A multicomponent injury-prevention training program should, at minimum, provide feedback on movement technique in at least 3 of the following exercise categories: strength, plyometrics, agility, balance, and flexibility. Further guidance on training dosage, intensity, and implementation recommendations is offered in this statement.

Background: Neuromuscular and proprioceptive training programs can decrease noncontact anterior cruciate ligament injuries; however, they may be difficult to implement within an entire team or the community at large.

Current Reviews in Musculoskeletal Medicine, 2017

Purpose of Review Mechanisms leading to anterior cruciate ligament (ACL) injury have been identified, yet re-injury or a secondary injury persists in the athletic population. The purpose of this review is to identify risk factors associated with ACL injury and investigate programs to prevent injury. Recent Findings Faulty mechanics during dynamic movement that cause excessive valgus force at the knee increases the risk of ACL injury. Faulty mechanics may be a result of lateral displacement of the trunk, unequal limb loading, and lack of control to avoid the valgus knee position. Altered movements that place the ACL at risk are best identified in a fatigued state; however, could be recognized in a standard dynamic assessment. The faulty movement patterns are modifiable and should be addressed in an injury prevention program. Prevention programs include various modes of exercise such as plyometrics, neuromuscular training, and strength training. Summary This review concludes that those programs which utilize neuromuscular training and strength training at a young age show the most promise in reducing ACL injuries. An ongoing thorough dynamic examination is necessary for all athletes while adjusting the intervention program in order to decrease the risk of ACL injury.

Knee Surgery, Sports …, 1996

2009

Soccer is known as a sport with high risk of anterior cruciate ligament (ACL) injury. Until 1980s, an ACL injury was a career-ending injury for a soccer player, but afterwards with the technological advancement in the field of medical sciences it could be treated or cured to a greater extent. Prevalence of this injury is two times greater among female soccer players in comparison to their male counterparts. Many theories have been postulated to explain the reasons for greater occurrence of ACL injuries among female soccer players but the biomechanical elucidation is considered to be the most justified one. The theories are divided into intrinsic and extrinsic aspects depending on the involved factors. Intrinsic factors include variables as such limb alignment, joint laxity, ligament size, notch dimensions, wider pelvis, increased genu valgum, and increased tibial torsion while, extrinsic factors are body movement, shoe-surface interface, muscle strength, coordination, level of skill through conditioning and flexibility. ACL injuries are of three categories (Grade I, Grade II and Grade III) which occur mainly during non-contact episode of the game, e.g., during the landing, kicking, or during stance phases of high-risk postures such as sidestepping. The gender differences observed in knee joint kinematics and forces during these movements are thus viewed as important contributors to ACL injury potential. Primary prevention of ACL injury among soccer player is possible by appropriate intervention strategies, e.g, a variety of training protocols, proper education of the athletes, and bracing. Current studies focus on neuromuscular training as a preventive measure, with programs that include strength, flexibility, plyometrics, sports-specific agility drills, speed enhancement, balance and athlete education.