A hip-focused injury prevention program demonstrated significant reduction in the incidence of ACL injury in female collegiate basketball players.

Background: There is a lack of research on the effects of a postoperative rehabilitation program on anterior cruciate ligament (ACL) graft rupture. Hypothesis: We hypothesized that a hip-focused rehabilitation protocol with graft rupture education and avoidance training (HIP-GREAT program) would demonstrate lower ACL graft rupture rates compared with a traditional physical therapy (PT) program. Study Design: Cohort study; Level of evidence, 3. Methods: This study consisted of young athletes who had undergone ACL reconstruction at a single institution. Postoperatively, 136 participants (mean age, 16.9 ± 2.4 years) were enrolled in a traditional PT protocol between 2006 and 2010, and 153 participants (mean age, 17.0 ± 2.3 years) were enrolled in the HIP-GREAT protocol between 2011 and 2015. Follow-up rates were 31% (42/136) and 27% (41/153) in the traditional PT and HIP-GREAT groups, respectively, at 3 years postoperatively. The hazard ratio was calculated, and absolute risk reduction (ARR) and number-needed-to-treat (NNT) analyses were performed to compare the 2 protocols. Results: ACL graft rupture occurred in 10 patients (7.4%) in the traditional PT group and 5 patients (3.3%) in the HIP-GREAT group. This difference was not statistically significant (hazard ratio, 0.39; 95% CI, 0.14 to 1.16; P = .09). The ARR was 0.041 (95% CI, –0.011 to 0.093), and the NNT was 24.5. Conclusion: This study did not demonstrate a statistically significant reduction of ACL graft rupture in patients in the HIP-GREAT group. However, high ARR values and low NNT values were found, which suggests the possible effectiveness of the HIP-GREAT protocol to reduce ACL graft ruptures in young athletes.

The purpose of this study was to examine whether preventive rehabilitation improves the asymmetry between the involved side and the uninvolved side of single-leg landing, dynamic balance, and lower limb muscular strength of young female athletes after anterior cruciate ligament reconstruction (ACLR). [Subjects and Methods] The subjects were twelve young females who returned to sports after preventive rehabilitation after ACLR. Two-dimensional analyses of single-leg landing and lower limb muscular strength (knee extension/flexion, hip abduction/external rotation), and the modified star excursion balance test (M-SEBT) were performed at the time of the return. The difference between the involved side and the uninvolved side of each measure was compared, and the limb symmetry index (LSI) was calculated. [Results] There were no differences in knee valgus and flexion angle in single-leg landing, and in the M-SEBT. LSI of lower limb muscular strength was over 90%. [Conclusion] The asymmetry between the involved side and the uninvolved side was improved by preventive rehabilitation.