Biomechanical analysis of anterior cruciate ligament injury mechanisms: three‐dimensional motion reconstruction from video sequences

Krosshaug, Tron; Slauterbeck, James R.; Engebretsen, Lars; Bahr, Roald

doi:10.1111/j.1600-0838.2006.00558.x

Cited by 147 publications

(140 citation statements)

References 32 publications

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“…36 For example, incidences of contact injuries should be studied with respect to the adequacy of rules to protect the athletes from injury and potential rule violation; 37 38 motion analysis might help to understanding of the mechanisms of non-contact injuries. 39 The present study focused exclusively on injuries incurred in training and competition. Future studies should also include pre-existing (chronic) injuries and other medical conditions (such as illnesses or disease) since they also can significantly affect the health and performance of the athletes.…”

Section: Discussionmentioning

confidence: 99%

Sports Injuries During the Summer Olympic Games 2008

et al. 2009

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Results: 1055 injuries were reported, resulting in an incidence of 96.1 injuries per 1000 registered athletes. About half of the injuries (49.6%) were expected to prevent the athlete from participating in competition or training. The most prevalent diagnoses were ankle sprains and thigh strains. A quarter of the injuries were incurred during training and 72.5% in competition.One third of the injuries were caused by contact with another athlete, followed by overuse (22%) and non-contact incidences (20%). Injuries were reported from all sports but their incidence and characteristics varied substantially. In relation to the number of registered athletes, the risk of incurring an injury was highest in taekwondo, football, hockey, handball, weightlifting and boxing (all >15% of the athletes), and lowest for sailing, canoe/kayak, rowing, synchronised swimming, diving, fencing and swimming. Conclusion:The data indicate that the injury surveillance system covered almost all of the participating athletes, and the results highlight areas of high risk for sport injury such as the incompetition period, the ankle and thigh, and specific sports. The identification of these factors should stimulate future research and subsequent policy change to prevent injury in elite athletes.

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Section: Discussionmentioning

confidence: 99%

Sports Injuries During the Summer Olympic Games 2008

et al. 2009

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“…Finally, valgus collapse, defined as the combination of knee abduction and internal rotation of the tibia [44], is cited in most retrospective video analyses of noncontact ACL ruptures [11,25,42]. These rotational adjustments were cycled from initial contact orientation because pilot testing revealed that is where peak ACL strain is most likely to occur and injury onset studies suggest that ACL ruptures occur immediately after initial contact in a position of limited flexion [30]. This description is best matched by our initial contact orientations, all of which expressed between 10°a nd 22°of knee flexion.…”

Section: Robot Simulationmentioning

confidence: 99%

Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro

Bates

Nesbitt

Shearn

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Anterior cruciate ligament (ACL) injures incur over USD 2 billion in annual medical costs and prevention has become a topic of interest in biomechanics. However, literature conflicts persist over how knee rotations contribute to ACL strain and ligament injury. To maximize the efficacy of ACL injury prevention, the effects of underlying mechanics need to be better understood. Questions/purposes We applied robotically controlled, in vivo-derived kinematic stimuli to the knee to assess ligament biomechanics in a cadaver model. We asked: (1) Does the application of abduction rotation increase ACL and medial collateral ligament (MCL) strain relative to the normal condition? (2) Does the application of internal tibial rotation impact ACL strain relative to the neutral condition? (3) Does combined abduction and internal tibial rotation increase ligament strain more than either individual contribution?Methods A six-degree-of-freedom robotic manipulator was used to position 17 cadaveric specimens free from knee pathology outside of low-grade osteoarthritis (age, 47 ± 8 years; 13 males, four females) into orientations that mimic initial contact recorded from in vivo male and female drop vertical jump and sidestep cutting activities. Four-degree rotational perturbations were applied in both directions from the neutral alignment position (creating an 8°range) for each frontal, transverse, and combined planes while ACL and MCL strains were continuously recorded with DVRT strain gauges implanted directly on each ligament. Analysis of variance models with least significant difference post hoc analysis were used to assess differences in ligament strain and joint loading between sex, ligament condition, or motion task and rotation type. Results For the female drop vertical jump simulation in the intact knee, isolated abduction and combined abduction/internal rotational stimuli produced the greatest This work was supported by National Institutes of Health/NIAMS Grants #R01-AR049735 (TEH), #R01-AR055563 (TEH), #R01-AR056660 (JTS), and #R01-AR056259 (TEH -017-5367-9 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® change in strain from the neutral position as compared with all other stimuli within the ACL (1.5% ± 1.0%, p B 0.035; 1.8% ± 1.3%, p B 0.005) and MCL (1.8% ± 1.0%, p \ 0.001; 1.6% ± 1.3%, p \ 0.001) compared with all other applied stimuli. There were no differences in mean peak ACL strain between any rotational stimuli (largest mean difference = 2.0%; 95% confidence interval [CI], À0.9% to 5.0%; p = 0.070). These trends were consistent for all four simulated tasks. Peak ACL strain in the intact knee was larger than peak MCL strain for all applied rotational stimuli in the drop vertical jump simulations (smallest mean difference = 2.1%; 95% CI, À0.4% to 4.5%; p = 0.047). Conclusions Kinematically constrained cadaveric knee models using peak strain as an outcome variable require greater than 4°rotational perturbations to elicit changes in intraa...

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“…Others argue that knee abduction must be involved in the injury mechanism (Quatman & Hewett, 2009). This theory is partly based on video analyses of ACL-injured athletes where valgus or valgus collapse are frequently reported (Krosshaug et al, 2007a;Krosshaug, Slauterbeck, Engebretsen, & Bahr, 2007b;Olsen et al, 2004). The combination of external rotation and valgus can possibly result in femoral notch impingement (Fung & Zhang, 2003).…”

Section: Mechanismsmentioning

confidence: 99%

ECSS Position Statement 2009: Prevention of acute sports injuries

Steffen

Andersen

Krosshaug

et al. 2010

European Journal of Sport Science

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To maximize the health benefits of sports and exercise and to minimize the direct and indirect costs associated with injuries, developing and adopting injury prevention strategies is an important goal. The aim of this ECSS consensus paper on injury prevention is to review current evidence on injury prevention methods and training programmes aimed at reducing the most common or severe types of acute injuries. The target audience is everyone involved in protecting the health of the athlete, including coaches, referees, medical staff, sports governing bodies, as well as athletes themselves. Effective sports injury prevention requires successful implementation of efficacious interventions. This paper reviews the main mechanisms and risk factors for acute injuries to the head, shoulder, elbow, hand/wrist, groin, thigh, knee, and ankle, as well as the evidence supporting various strategies to prevent them. Approaches that have been shown to be successful include: (1) using equipment designed to reduce injury risk, (2) adopting the rules of play, and (3) specific exercise programmes developed to reduce injury risk. Sports organizations should adopt available injury prevention strategies as part of their policies.

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Biomechanical analysis of anterior cruciate ligament injury mechanisms: three‐dimensional motion reconstruction from video sequences

Abstract: The model-based image matching technique can be used to extract kinematic characteristics from videotapes of actual ACL injuries, and may provide valuable information on the mechanisms for ACL injuries in sports.

Cited by 147 publications

References 32 publications

Sports Injuries During the Summer Olympic Games 2008

Sports Injuries During the Summer Olympic Games 2008

Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro

ECSS Position Statement 2009: Prevention of acute sports injuries

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