In this prospective randomized controlled study, there was no significant difference in the incidence of secondary ACL injury and no difference in objective or subjective outcomes between the DB-HT and RTSB-PT reconstruction at 24-month follow-up. Age, sex, presence of meniscus injury, and BMI affected subjective KOOS subscale scores, while surgical technique did not.
Posterior tibial translation (PTT) of the posterior cruciate ligament (PCL) reconstructed-knee under cyclic loading of 1,000 cycles with a 100-N load was compared between four different procedures, including two reconstructions with patellar tendon graft (transtunnel and inlay techniques) and two reconstructions with hamstring tendon graft (Endobutton and EndoPearl techniques) in twelve fresh-frozen human knees. The EndoPearl technique is a direct tendon fixation using biodegradable interference screws and an anchoring device, while the Endobutton technique is an indirect tendon fixation using a titanium button and surgical tape. The change of PTT after cyclic loading in the Endobutton technique was significantly greater than in the other reconstruction technique. No graft rupture at the killer turn or complete pullout from the bone tunnel was found. The advantage of the inlay technique compared to the transtunnel technique with respect to the posterior stability could not be shown in the current study. Posterior laxity of PCL reconstructed-knees with hamstring tendon graft using the Endobutton technique increased more easily than that with patellar tendon graft. For PCL reconstruction using the hamstring tendon graft, anatomical fixation may be preferable to prevent excessive posterior laxity in the early phase of the rehabilitation protocol.
Background
Anterior cruciate ligament (ACL) injury in knees opposite to the racket-hand side frequent occurs during single-leg landing after overhead stroke in badminton. Although large lateral inclination of trunk during single-leg landing seems to generate knee valgus moment which causes ACL injury, it has not been examined.
Objective
To evaluate if there was a correlation between trunk kinematics and knee valgus moment during single-leg landing after overhead stroke, in addition, to evaluate an association with muscular strength of trunk.
Design
Controlled laboratory study.
Setting
Female college badminton players with no history of knee injury.
Participants
8 right-handed players.
Risk factor assessment
Subjects performed single-left-legged landing after an overhead stroke following back-stepping. The kinematic and kinetic data of the trunk and left lower extremity during landing were measured using 3-dimensional motion analysis system. Isometric trunk flexion and extension strength was measured using a dynamometer.
Main outcome measurement
Change in lateral trunk bending angle and maximum knee valgus moment during landing were measured. The correlation between these and trunk strength were analyzed.
Results
The average of maximum knee valgus moment was 0.34±0.24 Nm/kg/m, and the change in lateral trunk bending angle was 22.9±13.3 degrees, respectively. The mean trunk flexion strength was 2.2±0.9 Nm/kg. The knee valgus moment was significantly correlated with the change in lateral trunk bending angle (r=0.87, P<.05) and the trunk flexion strength (r=−0.94, P<.01). The change in lateral trunk bending angle was also significantly correlated with the trunk flexion strength (r=−0.94, P<.01).
Conclusions
Larger lateral trunk bending associated with weak flexion strength increased knee valgus moment during single-leg landing. The core muscle training focused on trunk flexion strength may improve neuromuscular control of trunk and avoid excessive knee valgus moment in playing badminton, and this may play an important role of ACL injury prevention.
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