Anterior cruciate ligament tears for the primary care sports physician: what to know on the field and in the office

Heard, Wendell; VanSice, Wade; Savoie, Felix H.

doi:10.1080/00913847.2015.1092857

Cited by 6 publications

(3 citation statements)

References 49 publications

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“…As injuries of the ACL are relatively common and in a considerable proportion of cases presented initially at primary care settings, primary care physicians should be familiar with prompt evaluation and diagnosis of such injuries as well as with first aid treatment measures in the form of immediate cessation of sporting activity, application of ice packs and compression, and then adequate referral for continuing the care by specialists. [ 10 ]…”

Section: Introductionmentioning

confidence: 99%

The prevalence and determinants of anterior cruciate ligament rupture among athletes practicing football in Jeddah Avenues 2020

Alqarni¹,

Alshehri²,

Alotaibi³

et al. 2022

Journal of Family Medicine and Primary Care

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Background: Anterior cruciate ligament (ACL) tear is a common sport injury and one of the most serious sport injuries affecting non-professionals and professional athletes. It is most commonly torn during sports that involve sudden stops and changes in direction such as football. Objective: To measure the prevalence and determinants of anterior cruciate ligament rupture as well as assess knowledge about it among young adult athletes practicing football. Materials and Methods: An analytical cross-sectional study based on a questionnaire was carried out during the period from December 2019 to March 2020 among a sample of Saudi athletes recruited from natural grass, artificial turf, and dirt football fields in the Jeddah region. A structured questionnaire composed of four parts was used to collect data: socio-demographic variables, questions to assess awareness and knowledge of ACL, questions to assess the prevalence and determinants of ACL, and description of cases and the Arabic version of the Lysholm Knee Score (LKS) to assess the impact of ACL injury on patients’ daily life. Results: The study included 320 participants. Their age ranged between 15 and 40 years with an arithmetic mean of 27.9 and a standard deviation of ±6.8 years. The majority of them were males (97.8%). The prevalence of ACL injury was 14.7% among the participants; it was significantly higher among overweight and obese subjects ( P = 0.042) as well as those who reported more than 10 training weekly hours ( P = 0.034). Most of the playgrounds at the time of injury were either artificial turf (44.7%) or dirt football fields (34%). Overall, the level of adequate knowledge about ACL was observed among most of the participants (70.3%). The only factor significantly associated with the level of participants’ knowledge about ACL was the level of physical activity, P = 0.011. The total of LKS ranged between 21 and 100 with a median (inter-quartile range) of 82.5 (57–91). Conclusion: The prevalence rate of ACL injury among athletes in Jeddah, Saudi Arabia, is within the world wide range. Their awareness and knowledge of ACL are encouraging, although some risk factors were not well known. The quality of life of injured athletes was high, irrespective of demographic as well as physical factors and the history of surgical repair.

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Section: Introductionmentioning

confidence: 99%

The prevalence and determinants of anterior cruciate ligament rupture among athletes practicing football in Jeddah Avenues 2020

Alqarni¹,

Alshehri²,

Alotaibi³

et al. 2022

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

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“… 1 Failure to identify ACL tears may lead to severe consequences in terms of further injuries, delayed treatment, poor recovery, and slow return to sports. 3 , 12 , 30 , 32 , 35 Because performing a clinical examination in the acute stage is frequently hampered by the substantial knee pain and swelling that follows the injury, a magnetic resonance imaging (MRI) evaluation may bring valuable information about the status of the ACL. 7 , 38 However, MRI entails access to heavily specialized and expensive equipment at medical facilities that may not be available in remote settings or on field during a game situation.…”

Section: Discussionmentioning

confidence: 99%

Identifying Anterior Cruciate Ligament Injuries Through Automated Video Analysis of In-Game Motion Patterns

Schulc,

Leite,

Csákvári

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: Failure to diagnose anterior cruciate ligament (ACL) injury during a game can delay adequate treatment and increase the risk of further injuries. Artificial intelligence (AI) has the potential to be an accurate, cost-efficient, and readily available diagnostic tool for ACL injury in in-game situations. Purpose: To develop an automated video analysis system that uses AI to identify biomechanical patterns associated with ACL injury and to evaluate whether the system can enhance the ability of orthopaedic and sports medicine specialists to identify ACL injuries on video. Study Design: Descriptive laboratory study. Methods: A total of 91 ACL injury and 38 control movement scenes from online available match recordings were analyzed. The videos were processed to identify and track athletes and to estimate their 3-dimensional (3D) poses. Geometric features, including knee flexion, knee and hip abduction, and foot and hip rotation, were extracted from the athletes’ 3D poses. A recurrent neural network algorithm was trained to classify ACL injury, using these engineered features as its input. Analysis by 2 orthopaedic surgeons examined whether providing clinical experts with the reconstructed 3D poses and their derived signals could increase their diagnostic accuracy. Results: All AI models performed significantly better than chance. The best model, which used the long short-term memory network with engineered features, demonstrated decision interpretability and good performance (F1 score = 0.63 ± 0.01, area under the receiver operating characteristic curve = 0.88 ± 0.01). The analysis by the 2 orthopaedic surgeons demonstrated improved diagnostic accuracy for ACL injury recognition when provided with system data, resulting in a 0.08 increase in combined F1 scores. Conclusion: Our approach successfully reconstructed the 3D motion of athletes from a single-camera view and derived geometry-based biomechanical features from pose sequences. Our trained AI model was able to automatically detect ACL injuries with relatively good performance and prelabel and highlight regions of interest in video footage. Clinical Relevance: This study demonstrated the feasibility of using AI to automatically evaluate in-game video footage and identify dangerous motion patterns. Further research can explore the full potential of the biomechanical markers and use of the system by nonspecialists, potentially diminishing the rate of missed diagnosis and the detrimental outcomes that follow.

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“…The anterior cruciate ligament is the main restraint of anterior tibial translation [7]. Many factors may contribute to its tearing, including intrinsic and extrinsic factors [8,9]. While extrinsic factors may vary greatly and sometimes are difficult to control, intrinsic factors can be assessed and can play a role in the prediction of predisposition to injury.…”

Section: Introductionmentioning

confidence: 99%

Anterior Intercondylar Notch Geometry in Relation to the Native Anterior Cruciate Ligament Size

Cernat,

Dima,

Popescu

et al. 2024

JCM

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Background: The intercondylar notch (ICN) and the anterior cruciate ligament (ACL) are important structures in knee morphometry, with key roles in stabilizing the knee. Aim: To determine the associations between the specific shape of the ICN (A-, W-, or U-shape) and the ACL size in patients with intact ACLs. Methods: Magnetic resonance imaging (MRI) scans were independently analyzed by two experts: one orthopedic surgeon and one imaging physician. In all cases, the following measurements were taken based on the existing definitions: ACL area, anterior ICN (aICN) area, ICN width, lateral trochlear inclination (LTI), and Insall–Salvati index. Results: A total of 65 cases (50.8% male; 33.8 ± 10.2 years mean age at inclusion) were included in the study. The ACL and aICN areas were significantly larger in patients with U-shaped compared with A-shaped and W-shaped ICNs: 0.50 (0.20–0.80) vs. 0.40 (0.20–0.80) vs. 0.40 (0.30–0.80), p = 0.011 and 1.16 (0.57–3.60) vs. 0.47 (0.15–0.95) vs. 0.37 (0.15–0.81), p < 0.001, respectively. Internal meniscal lesions were more common in cases with U-shaped ICNs (64.0%), while external ones were more common in W-shaped ICN cases (35.3%). None of the A-shaped cases had external chondral or meniscal lesions. The ACL area was significantly larger in males and internal meniscal injuries, with no differences between chondral lesions, external meniscal injuries, patellar chondral lesions, patella alta, or trochlear dysplasia. Conclusion: The specific shape of the intercondylar notch was associated with the anterior cruciate ligament–anterior intercondylar notch (ACL–aICN) area size correlation, with a strong correlation between ACL and aICN area when the intercondylar notch was A-shaped or W-shaped, and a low correlation when the notch was U- shaped. The specific shape of the intercondylar notch (A-, W-, or U-shape) was associated with the occurrence of both internal and external meniscal injuries, with the U-shaped intercondylar notch morphometry being more frequent in cases with internal meniscal injuries and the W-shape being more common in cases with external meniscal injuries.

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Anterior cruciate ligament tears for the primary care sports physician: what to know on the field and in the office

Cited by 6 publications

References 49 publications

The prevalence and determinants of anterior cruciate ligament rupture among athletes practicing football in Jeddah Avenues 2020

The prevalence and determinants of anterior cruciate ligament rupture among athletes practicing football in Jeddah Avenues 2020

Identifying Anterior Cruciate Ligament Injuries Through Automated Video Analysis of In-Game Motion Patterns

Anterior Intercondylar Notch Geometry in Relation to the Native Anterior Cruciate Ligament Size

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