Risk Factors Associated with Noncontact Injury of the Anterior Cruciate Ligament

Abstract

Several risk factors may predispose young athletes to noncontact anterior cruciate ligament injury.

Mapping current research trends on neuromuscular risk factors of non-contact ACL injury

“…Soderman et al (Söderman, et al, 2001) found that an imbalance of the hamstrings to quadriceps ratio (H/Q ratio) between legs in female athletes was predictive of players who suffered an ACL injury, with a lower H/Q ratio on the side that would become injured (Söderman, et al, 2001). On the contrary, Uhorchak et al (Uhorchak, et al, 2003) did not find differences in H/Q ratios for males and females who go on to suffer ACL injury.…”

“…Of the 4 prospective studies observing the neuromuscular markers of ACL injury, 3 evaluated muscular capacity (comprising of isokinetic knee strength and H/Q ratio) as risk factor of non-contact ACL injury (Myer, et al, 2009;Söderman, Alfredson, Pietilä, & Werner, 2001;Uhorchak, et al, 2003), and 1 study evaluated muscular activation patterns (Mette K. Zebis, Andersen, Bencke, Kjaer, & Aagaard, 2009) (see Table 4). …”

“…This systematic review found only four prospective studies of which three studies looked into muscular capacity (Myer, et al, 2009;Söderman, et al, 2001;Uhorchak, et al, 2003) and only one study into muscular activation patterns (Mette K. Zebis, et al, 2009). From the studied cohorts, there were only a small number of individuals who incurred an injury with injury rates ranging from 1.3% to 9.0%.…”

“…Differences between injured and non-injured individuals were small, providing relatively low sensitivity and specificity of the measure to predict injury (Myer, et al, 2009;Söderman, et al, 2001;Uhorchak, et al, 2003;Mette K. Zebis, et al, 2009). The value of the risk factors for targeted screening with a focus on differentiating interventions based on risk is therefore limited.…”

“…Particularly concerning neuromuscular factors, the link between muscular activation patterns and muscles' capacity to generate torque is often referred to when interpreting findings of one or the other (Myer, et al, 2009;Söderman, et al, 2001;Uhorchak, et al, 2003;Mette K. Zebis, et al, 2009), but whether this link holds true in the context of ACL injury risk remains unknown. Also, muscular capacity as well as muscular activation patterns at the knee are related to capacity and activation patterns at the ankle and probably at hip and abdominal musculature (S. J.…”