Abstract:Restricted hip movement along with femoroacetabular impingement (FAI) has been reported to be an important risk factor in anterior cruciate ligament (ACL) injury. We performed a literature review assessing the evidence that FAI, or restricted hip movement, contributes to the likelihood of sustaining an ACL injury to provide an evidence-based and comprehensive update on the relationship between these pathologies. Studies were divided into three categories: clinical studies, radiological studies and cadaveric st… Show more
“…As already noted, there is no biomechanical factor that is really a demonstrable cause to conclude that, as in other sports such as basketball, handball, volleyball or football, the risk of ACL injury is higher in women than in men [5][6][7]35]. This is probably due to the way in which they occur.…”
The anterior cruciate ligament (ACL) injury stands as a significant concern in judo, necessitating preventive measures. The primary injury mechanism involves knee collapse in valgus, often linked to deficiencies in core strength, neuromuscular control, external rotators, hip abductors, and limitations in ankle and hip mobility. Sex-wise, the injury is more prevalent in women across various sports. Therefore, in the present study we observed this possible intersexual disparity in the difference of movement patterns among elite judokas according to their sex, in order to identify those athletes with a higher risk of ACL injury. Notably, there were no discernible differences between sexes in the single leg squat test. Both men and women exhibited compromised neuromuscular control in the non-dominant leg. While ankle dorsiflexion and hip external rotation showed no gender disparities, differences in internal rotation were noted. This particular movement restriction may elevate the risk of ACL injury.
“…As already noted, there is no biomechanical factor that is really a demonstrable cause to conclude that, as in other sports such as basketball, handball, volleyball or football, the risk of ACL injury is higher in women than in men [5][6][7]35]. This is probably due to the way in which they occur.…”
The anterior cruciate ligament (ACL) injury stands as a significant concern in judo, necessitating preventive measures. The primary injury mechanism involves knee collapse in valgus, often linked to deficiencies in core strength, neuromuscular control, external rotators, hip abductors, and limitations in ankle and hip mobility. Sex-wise, the injury is more prevalent in women across various sports. Therefore, in the present study we observed this possible intersexual disparity in the difference of movement patterns among elite judokas according to their sex, in order to identify those athletes with a higher risk of ACL injury. Notably, there were no discernible differences between sexes in the single leg squat test. Both men and women exhibited compromised neuromuscular control in the non-dominant leg. While ankle dorsiflexion and hip external rotation showed no gender disparities, differences in internal rotation were noted. This particular movement restriction may elevate the risk of ACL injury.
“…The restriction of hip ROM will impose strong rotational force on the knee joint, leading to the increased strain of the ACL accompanying the risk of ACL fatigue failure and therefore, a higher rate of ACL tear (13,15,35,37). In line with this potential mechanism of ACL injury, several cadaveric studies have demonstrated that peak ACL strain was inversely related to the range of internal rotation of the femur (38).…”
Introduction : Soccer is a popular sport with a high injury rate. Lower limb injuries are accounted for 85% of injuries in professional Soccer player. It is important to identify the predisposing factors in professional Soccer players for screening players at an increased risk of injury. It is unclear whether to assume limited hip range of motion (ROM) as one of these factors this study aimed to evaluate the association between hip passive ROM and lower limb injury in Iranian professional Soccer players.Design : This prospective cohort study was conducted on 266 male professional Soccer players (with a mean age of 24.91 ± 4.38 years) playing in the Iran Soccer Premium League during the 2017-2018 and 2018-2019 season. Baseline hip joint passive ROM was evaluated in all subjects. All athletes were followed for two consecutive seasons and their lower limb injuries causing at least an absent from a competitive match was reported. The association between hip ROM and the incidence of lower limb injuries was analyzed.Results : The most common lower limb injuries were ankle and foot injuries (12.4%), groin pain (11.5%) and muscle strain (10.9%), respectively. Restricted hip internal rotation (IR) was associated with a higher incidence of groin pain, ACL injury and knee injury. A significant correlation was observed between decreased hip external rotation (ER) with muscle strain and knee injuries. The higher knee injury was also associated with reduced hip abduction. There was no association between ankle and foot injuries and hip passive ROM.Conclusions : This study showed that hip passive ROM could be used to identify Soccer players at a higher risk of lower limb injuries. Hip rotational ROM and abduction limitation were significantly associated with the incidence of several common Soccer injuries, including groin pain, muscle strain and ACL/knee injuries and precedes their development and could be used as a screening tool for professional male soccer players.
“…The hip impingement is an anatomical condition often associated with a predisposition to ACL rupture and thus a higher risk of failure of ACL-R. It is accompanied by limited ROM, especially during internal rotation, simulating a pivot landing on the ipsilateral knee, which therefore increases stress on the ACL ( 60 , 61 ). Figure 2 Stenotic, very small notch with a vertical, non-anatomical graft.…”
Despite the general success of anterior cruciate ligament reconstructions (ACL-R), there are still studies reporting a high failure rate. Orthopedic surgeons are therefore increasingly confronted with the treatment of ACL retears, which are often accompanied by other lesions, such as meniscus tears and cartilage damage and which, if overlooked, can lead to poor postoperative clinical outcomes.
The literature shows a wide variety of causes for ACL-R failure. Main causes are further trauma and possible technical errors during surgery, among which the position of the femoral tunnel is thought to be one of the most important.
A successful postoperative outcome after ACL-revision surgery requires good preoperative planning, including a thorough evaluation of patient's medical history, e.g. instability during daily or sports activity, increased general joint laxity, and hints for a low-grade infection. A careful clinical examination should be performed. Additionally, comprehensive imaging is necessary. Besides a magnetic resonance imaging, a CT scan is helpful to determine location of tunnel apertures and to analyze for tunnel enlargement. A lateral knee radiograph is helpful to determine the tibial slope.
The range of surgical options for the treatment of ACL-R failure is broad today. Orthopedic surgeons and experts in Sports Medicine must deal with various possible associated injuries of the knee or unfavorable anatomical conditions for ACL-R.
The aim of this review was to highlight predictors and reasons of failures of ACL-R as well as describe diagnostic procedures to individualize treatment strategies for improved outcome after revision ACL-R.
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