Nonmodifiable risk factors for anterior cruciate ligament injury

Price, Meghan; Tuca, María; Cordasco, Frank A.; Green, Daniel W.

doi:10.1097/mop.0000000000000444

Cited by 37 publications

(26 citation statements)

References 99 publications

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“…The morphological traits attributed to this disparity are a narrow intercondylar femoral notch, a narrow ACL, and a steep posterior tibial plateau . These traits are widely considered to be non‐modifiable . Findings from this murine study raise the possibility that these morphological risk factors may in fact be modifiable to some degree during growth, as both A/J and B6 mice exposed to greater physiological loading during puberty showed significant differences within their ACL‐complex compared with their genetically similar and age‐matched less active controls.…”

Section: Discussionmentioning

confidence: 83%

“…Interestingly, Tuca et al recently reported their findings from a magnetic resonance imaging study conducted on boys and girls ranging from 3 to 14 years old that suggested the significant growth in ACL volume and femoral intercondylar notch volume plateaued by 10 years of age in both sexes. Their finding supports the prevailing dogma of the field that these morphological traits are largely non‐modifiable after the pre‐pubescence phase . However, the findings of Tuca et al research is inconsistent with other musculoskeletal studies conducted on high activity individuals.…”

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confidence: 78%

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Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Schlecht

Martin

Ochocki

et al. 2019

Journal Orthopaedic Research

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Postnatal development and the physiological loading response of the anterior cruciate ligament (ACL) complex (ACL proper, entheses, and bony morphology) is not well understood. We tested whether the ACL-complex of two inbred mouse strains that collectively encompass the musculoskeletal variation observed in humans would demonstrate significant morphological differences following voluntary cage-wheel running during puberty compared with normal cage activity controls. Female A/J and C57BL/6J (B6) 6-week-old mice were provided unrestricted access to a standard cage-wheel for 4 weeks. A/J-exercise mice showed a 6.3% narrower ACL (p = 0.64), and a 20.1% more stenotic femoral notch (p < 0.01) while B6-exercise mice showed a 12.3% wider ACL (p = 0.10), compared with their respective controls. Additionally, A/J-exercise mice showed a 5.3% less steep posterior medial tibial slope (p = 0.07) and an 8.8% less steep posterior lateral tibial slope (p = 0.07), while B6-exercise mice showed a 9.8% more steep posterior medial tibial slope (p < 0.01) than their respective controls. A/J-exercise mice also showed more reinforcement of the ACL tibial enthesis with a 20.4% larger area (p < 0.01) of calcified fibrocartilage distributed at a 29.2% greater depth (p = 0.02) within the tibial enthesis, compared with their controls. These outcomes suggest exercise during puberty significantly influences ACL-complex morphology and that inherent morphological differences between these mice, as observed in their less active genetically similar control groups, resulted in a divergent phenotypic outcome between mouse strains.

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Section: Discussionmentioning

confidence: 83%

mentioning

confidence: 78%

Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Schlecht

Martin

Ochocki

et al. 2019

Journal Orthopaedic Research

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“…e114 the lateral tibial plateau and lateral femoral condyle or hyperlaxity (Beighton >6). 9 Other important considerations are patients with chronic ACL insufficiency, contralateral ACLR, or revision ACLR. The 2 most significant risks and limitations of this procedure include the potential for compromise of the distal femoral physis and convergence of the tenodesis suture anchor with the femoral socket of the ACLR.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 In an attempt to address the previously reported population of active adolescents at a high risk of graft re-tear, this paper aims to describe a lateral extra-articular tenodesis (LET) procedure using the ITB with a modified Lemaire technique to use as an enhancement to ACLR with soft-tissue graft in the high-risk athlete within the pediatric population. 8,9 Surgical Technique: Modified Lemaire ITB Tenodesis (With Video Illustration)…”

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confidence: 99%

Modified Lemaire Lateral Extra-articular Tenodesis in the Pediatric Patient: An Adjunct to Anterior Cruciate Ligament Reconstruction

Schlichte

Aitchison

Green

et al. 2020

Arthroscopy Techniques

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Recent literature has identified a population of active adolescents aged 13 to 15 years who are at high risk for anterior cruciate ligament graft rupture. Addressing the anterolateral complex during primary anterior cruciate ligament reconstruction has recently re-emerged in the literature, with various techniques available. This paper aims to describe a lateral extra-articular tenodesis procedure using the iliotibial band with a modified Lemaire technique. This procedure is recommended for active adolescents at a high risk of graft re-tear as an enhancement to primary anterior cruciate ligament reconstruction with soft-tissue graft.

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“…Family history of ACL injury and generalized joint hypermobility (generalized hypermobility) are two nonmodifiable risk factors for ACL injury (Price, Tuca, Cordasco, & Green, ), which may or may not be related (Hewett et al, ). The interaction of these risk factors may place an individual at greater risk of injury.…”

Section: Introductionmentioning

confidence: 99%

Generalized joint hypermobility in siblings with anterior cruciate ligament injuries and matched unrelated healthy siblings

Keays

Newcombe

Keays

2020

Physiotherapy Res Intl

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Background and Purpose Anterior cruciate ligament (ACL) ruptures are common knee injuries, and siblings of individuals with an ACL injury may be at higher risk of ACL injury. Generalized hypermobility may be a familial factor predisposing siblings to ACL injury and may also relate to faulty lower limb alignment. There is a need to determine whether the interaction between hypermobility, family history, and faulty alignment makes siblings with hypermobility at higher risk for ACL injury so that appropriate preventative measures can be taken. This study therefore aimed to (a) compare the prevalence of generalized hypermobility and faulty limb alignment in siblings with and without injury and (b) assess the relationship between generalized hypermobility and lower limb alignment. Methods In this case‐controlled study, 24 siblings with ACL injuries from 10 families were matched with 24 healthy uninjured siblings from 10 unrelated families. Generalized hypermobility was assessed using Beighton's criteria. Chi‐square analyses compared generalized hypermobility and lower limb alignment between siblings and sibling pairs with and without injuries. Spearman's rho was used to assess correlations between generalized hypermobility and lower limb alignment. Results There were significant differences between the number of injured and uninjured siblings demonstrating generalized hypermobility when tallied individually (p = .003) and in same‐family sibling pairs (p = .019). Significant (or close) differences were found between siblings for knee hyperextension (p < .001), knee valgus (p = .01), and foot pronation (p = .002) and for sibling pairs sharing knee hyperextension (p < .001), knee valgus (p = .06), and foot pronation (p = .06). Generalized hypermobility correlated with knee hyperextension (rs = .722; p < .001), knee valgus (rs = .385; p = .007), and foot pronation (rs = .328; p = .023). Conclusions Generalized hypermobility and faulty limb alignment occur significantly more frequently in injured than uninjured families. Screening for both features would assist in identifying at‐risk siblings. Prevention programmes reduce ACL injuries by 50–70% and should target hypermobile siblings of the ACL injured.

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Nonmodifiable risk factors for anterior cruciate ligament injury

Cited by 37 publications

References 99 publications

Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Modified Lemaire Lateral Extra-articular Tenodesis in the Pediatric Patient: An Adjunct to Anterior Cruciate Ligament Reconstruction

Generalized joint hypermobility in siblings with anterior cruciate ligament injuries and matched unrelated healthy siblings

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