Mapping current research trends on anterior cruciate ligament injury risk against the existing evidence: In vivo biomechanical risk factors

Sharir, Raihana; Rafeeuddin, Radin; Staes, Filip; Dingenen, Bart; George, Keith; Vanrenterghem, Jos; Robinson, Mark A.

doi:10.1016/j.clinbiomech.2016.05.017

Cited by 16 publications

(10 citation statements)

References 74 publications

(109 reference statements)

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“…Although the mechanisms of ACL injury are multifactorial [ 85 ], COD lower limb and whole-body postures are critical factors associated with knee joint loading [ 8 , 14 , 86 – 89 ]. Consequently, several investigations have examined the effect of COD angle on associative biomechanical risk factors connected to increased risk of injury (Table 1 ).…”

Section: Effect Of Angle On Cod Biomechanicsmentioning

confidence: 99%

The Effect of Angle and Velocity on Change of Direction Biomechanics: An Angle-Velocity Trade-Off

et al. 2018

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Changes of direction (CODs) are key manoeuvres linked to decisive moments in sport and are also key actions associated with lower limb injuries. During sport athletes perform a diverse range of CODs, from various approach velocities and angles, thus the ability to change direction safely and quickly is of great interest. To our knowledge, a comprehensive review examining the influence of angle and velocity on change of direction (COD) biomechanics does not exist. Findings of previous research indicate the biomechanical demands of CODs are ‘angle’ and ‘velocity’ dependent and are both critical factors that affect the technical execution of directional changes, deceleration and reacceleration requirements, knee joint loading, and lower limb muscle activity. Thus, these two factors regulate the progression and regression in COD intensity. Specifically, faster and sharper CODs elevate the relative risk of injury due to the greater associative knee joint loading; however, faster and sharper directional changes are key manoeuvres for successful performance in multidirectional sport, which subsequently creates a ‘performance-injury conflict’ for practitioners and athletes. This conflict, however, may be mediated by an athlete’s physical capacity (i.e. ability to rapidly produce force and neuromuscular control). Furthermore, an ‘angle-velocity trade-off’ exists during CODs, whereby faster approaches compromise the execution of the intended COD; this is influenced by an athlete’s physical capacity. Therefore, practitioners and researchers should acknowledge and understand the implications of angle and velocity on COD biomechanics when: (1) interpreting biomechanical research; (2) coaching COD technique; (3) designing and prescribing COD training and injury reduction programs; (4) conditioning athletes to tolerate the physical demands of directional changes; (5) screening COD technique; and (6) progressing and regressing COD intensity, specifically when working with novice or previously injured athletes rehabilitating from an injury.

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Section: Effect Of Angle On Cod Biomechanicsmentioning

confidence: 99%

The Effect of Angle and Velocity on Change of Direction Biomechanics: An Angle-Velocity Trade-Off

et al. 2018

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“…4 Still, efforts to identify individuals at elevated risk are complicated by the multifactorial nature of noncontact ACL injury etiology and inter-individual variation in risk factors, even within known highrisk cohorts. 5 Some of the inter-individual variation in risk may be driven by differences in the process of pubertal development. Several ACL injury risk factors emerge or are exacerbated during puberty, with injury rates in both sexes increasing around puberty and remaining high well into young adulthood.…”

Section: Introductionmentioning

confidence: 99%

Effect of Age at Menarche on Anterior Cruciate Ligament Injury Incidence and Anterior Knee Laxity in Collegiate Athletes

Froehle¹,

Cox²,

May³

et al. 2020

JSMAHS

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Female athletes suffer painful, costly, and career-limiting non-contact anterior cruciate ligament (ACL) injuries more often than males. Previous research suggests that pubertal neuromusculoskeletal development contributes to this sex-bias, but the manner in which variation in pubertal development affects injury risk within females is poorly understood. Age at menarche is a variable, significant pubertal developmental event, signaling the onset of estrogen cycling and affecting musculoskeletal development. Earlier menarche may increase injury risk, possibly by increasing anterior knee laxity through prolonged estrogen exposure. The purpose of this case-control study was to test the primary hypothesis that collegiate athletes with previous ACL injuries have earlier age at menarche than their uninjured peers, and to test the secondary hypothesis that earlier menarche is related to greater anterior knee laxity in injured and uninjured athletes. The study sample consisted of female NCAA Division-I varsity athletes (N=14 injured, N=120 uninjured). Outcome measures included: menstrual history and ACL injury details (injury age, activity at time of injury, contact vs. non-contact), assessed by questionnaire; and anterior knee laxity assessed by KT-1000 arthrometer. Correlation, t-tests, and regression analysis were used to test for associations between age at menarche, injury incidence, and knee laxity. Fourteen athletes reported ≥1 non-contact ACL injury, and had significantly earlier menarche than uninjured athletes (12.6±1.3 y vs. 13.4±1.4 y; P=0.05). Earlier menarche also significantly predicted injury status (Wald c2=7.43; Pb=-1.02±0.37; OR=0.36; 95% CI:0.17-0.75), but was not correlated with anterior knee laxity. Within injured athletes, however, laxity in the unaffected knee was significantly related to time since menarche (r2=0.79, Pr2=0.72, P

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“…13 Furthermore, a combination of knee valgus and lateral trunk motion during a single-leg drop jump has been suggested being associated with increased risk of non-contact knee injuries. 9 Nevertheless, prospective evidence gathered from these investigations is still limited and partly conflicting 7,14 highlighting the need for additional studies with larger study populations.…”

mentioning

confidence: 99%

Altered hip control during a standing knee‐lift test is associated with increased risk of knee injuries

Leppänen

Rossi

Parkkari

et al. 2020

Scandinavian Med Sci Sports

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A few prospective studies have investigated hip and pelvic control as a risk factor for lower extremity (LE) injuries. The purpose of this study was to investigate whether deficits in hip and lumbopelvic control during standing knee‐lift test are associated with increased risk of acute knee and LE injuries in youth team sports. At baseline, 258 basketball and floorball players (aged 12‐21 years) participated in a standing knee‐lift test using 3‐dimensional motion analysis. Two trials per leg were recorded from each participant. Peak sagittal plane pelvic tilt and frontal plane pelvic drop/hike were measured. Both continuous and categorical variables were analyzed. New non‐contact LE injuries, and match and training exposure, were recorded for 12 months. Seventy acute LE injuries were registered. Of these, 17 were knee injuries (eight ACL ruptures) and 35 ankle injuries. Risk factor analyses showed that increased contralateral pelvic hike was significantly associated with knee injury risk when using categorical variable (HR for high vs low group 4.07; 95% CI 1.32‐12.6). Furthermore, significant association was found between high lateral pelvic hike angles and ACL injury risk in female players (HR for high vs low group 9.10; 95% CI 1.10‐75.2). Poor combined sensitivity and specificity of the test was observed. In conclusion, increased contralateral pelvic hike is associated with non‐contact knee injury risk among young team sport players and non‐contact ACL injuries among female players. More research to determine the role of pelvic control as a risk factor for knee injuries is needed.

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Mapping current research trends on anterior cruciate ligament injury risk against the existing evidence: In vivo biomechanical risk factors

Cited by 16 publications

References 74 publications

The Effect of Angle and Velocity on Change of Direction Biomechanics: An Angle-Velocity Trade-Off

The Effect of Angle and Velocity on Change of Direction Biomechanics: An Angle-Velocity Trade-Off

Effect of Age at Menarche on Anterior Cruciate Ligament Injury Incidence and Anterior Knee Laxity in Collegiate Athletes

Altered hip control during a standing knee‐lift test is associated with increased risk of knee injuries

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