Anterior Cruciate Ligament Injuries: Diagnosis, Treatment, and Prevention

Abstract

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 times more likely to develop degenerative arthritis of the knee. Safe and effective surgical techniques for children and adolescents continue to evolve. Neuromuscular training can reduce risk of ACL injury in adolescent girls. This report outlines the current state of knowledge on epidemiology, diagnosis, treatment, and prevention of ACL injuries in children and adolescents.

Ectopic tissue engineered ligament with silk collagen scaffold for ACL regeneration: A preliminary study

“…As a main stabilizing structure of the knee, the anterior cruciate ligament (ACL) is one of the most commonly injured ligaments during sports and other strenuous physical activities [1]. Because of the unsatisfactory outcomes of conservative treatment modalities, ACL reconstructive surgery is now considered the treatment of choice in the majority of clinical cases [2,3].…”

Can eight weeks of stabilization exercise change the amount of knee flexion and anterior shear force?

“…Moreover, athletes who play team sports such as football, volleyball, and basketball are four to six time more at the risk of ACL injury due to jump, cutting and rotational movements [4]. At least 70% of ACL injuries occur in non-contact conditions [3]. Research findings confirm that the condition of lower extremities during high-risk activities such as running, cutting maneuver, rotation, and landing may be predisposing risk factors for ACL injuries [5,6].…”

“…ACL injury can lead to long-term disability [2]. Children and youth are more prone to ACL injury [3]. Moreover, athletes who play team sports such as football, volleyball, and basketball are four to six time more at the risk of ACL injury due to jump, cutting and rotational movements [4].…”

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION & THE HAMSTRINGS Implications for injury prevention & rehabilitation

“…As a consequence, it has been proposed that strengthening of this muscle group may be important for the prevention of ACL injury (Serpell et al, 2012). It is well established that non-contact ACL injuries are multifactorial (Griffin et al, 2000;LaBella et al, 2014). However, it is of further interest to investigate the influence of hamstring function on ACL injury prevention and rehabilitation.…”

“…In Australia and the United States combined there are reportedly 100,000 to 300,000 ACL injuries each year (Boden, Griffin, & Garrett, 2000;Prodromos, Han, Rogowski, Joyce, & Shi, 2007) and many of these occur in 15-25-year-old athletes participating in sport LaBella et al, 2014). Most ACL tears are non-contact injuries that occur during landing, changes of direction or deceleration while hip adduction, internal femoral rotation, external tibial rotation and knee valgus is often identifiable at the time of injury (Besier, Lloyd, & Ackland, 2003;Cochrane, Lloyd, Buttfield, Seward, & McGivern, 2007).…”