Prevention and rehabilitation of paediatric anterior cruciate ligament injuries

Moksnes, Håvard; Grindem, Hege

doi:10.1007/s00167-015-3856-5

Cited by 32 publications

(29 citation statements)

References 75 publications

(104 reference statements)

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“…The rate of ACL injuries in children and adolescents does not appear to be uniform across age groups [17]. Data from a pediatric medical center in Boston, United States of America (USA) between 2000 and 2009 showed that ACL injuries account for 6.3% of all sports injuries in 5- to 12-year-olds, but 10.6% in 13- to 17-year-olds [18].…”

Section: Introductionmentioning

confidence: 99%

Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015

Shaw

Finch

2017

IJERPH

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Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of ACL injuries in children. This study utilizes the Victorian Admitted Episodes Dataset (VAED) to characterize epidemiologic trends of hospital-admitted ACL injuries in those aged 5 to 14 years over a period of 10 years from 2005 to 2015. There was a total of 320 cases and the overall annual rate of ACL injuries increased by 147.8% from 2.74 per 100,000 population in 2005/2006 to 6.79 per 100,000 in 2014/2015. The majority (96.9%) of these injuries were in 10- to 14-year-olds. The main in-hospital procedure provided to over 80% of the hospitalized cases involved ACL reconstruction. Sporting activities accounted for 56.6% of ACL injuries. For females, over half (52.4%) of ACL injuries occurred whilst playing ball sports, compared to 35.4% of males. The large increase in ACL injuries in 5- to 14-year-olds in the state of Victoria, Australia over a 10-year period indicates they are a significant and emerging health burden. Population-wide ACL prevention policies are required to halt these trends. Cost effective prevention programs that involve neuromuscular training must be implemented in schools and junior sports teams.

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Section: Introductionmentioning

confidence: 99%

Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015

Shaw

Finch

2017

IJERPH

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“…When an NMT program optimized just one of the four key components of a prevention program (younger age, high volume, multiple exercise modes, or feedback), a 17–18% ACL injury risk reduction was observed 39. Moksnes and Grindem reviewed the existing literature on prevention of ACL injury in skeletally immature patients, and although they noted evidence for the effectiveness of prevention programs in girls as young as 12 years old, these findings have not yet been found in younger children 29. Additionally, the ideal timing, frequency, and duration of such interventions in children and adolescents are unknown.…”

Section: Prevention Of Acl Injurymentioning

confidence: 99%

Section: Rehabilitationmentioning

confidence: 99%

“…As noted in a recent review, rehabilitation following ACL reconstruction in children is not well described 29. Rehabilitation should be supervised, and functional milestones should be used to help guide therapy progression 29. It is ideal to have a therapist with experience working with younger patients, as techniques to engage and motivate children are different from those used with adults.…”

Section: Rehabilitationmentioning

confidence: 99%

“…The development of neuromuscular control and movement patterns among children is not well understood 28,29. Padua et al30 measured preseason baseline neuromuscular control using the Landing Error Scoring System (LESS) in a group of elite youth soccer players.…”

Section: Introductionmentioning

confidence: 99%

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Prevention, treatment, and rehabilitation of anterior cruciate ligament injuries in children

Lang¹,

Sugimoto²,

Micheli³

2017

OAJSM

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As more children and adolescents participate in competitive organized sports, there has been an increase in the reported incidence of anterior cruciate ligament (ACL) injuries in these age groups. ACL injuries in skeletally immature athletes present a challenge, as reconstruction must preserve the physis of the distal femur and of the proximal tibia to avoid growth disturbances. Historically, a skeletally immature athlete with an ACL injury was treated with a brace and activity modification until skeletal maturity, with ACL reconstruction being performed at that time in the “non-copers” who experienced instability. More recently, evidence has shown that delayed reconstruction may lead to increased damage to the meniscus and articular cartilage. As a result, early reconstruction is favored to protect the meniscus and allow continued physical activity. While adolescents at or those near skeletal maturity may be treated with standard reconstruction techniques, they may result in growth disturbances in younger athletes with significant growth remaining. In response to the growing need for ACL reconstruction techniques in skeletally immature individuals, physeal-sparing and physeal-respecting reconstruction techniques have been developed. In addition to the advancements in surgical technique, ACL injury prevention has also gained attention. This growing interest in ACL prevention is in part related to the high risk of ACL re-tear, either of the ACL graft or of the contralateral ACL, in children and adolescents. Recent reports indicate that well-designed neuromuscular training programs may reduce the risk of primary and subsequent ACL injuries.

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Meta‐analysis of meta‐analyses of anterior cruciate ligament injury reduction training programs

Webster

Hewett

2018

Journal Orthopaedic Research

182

132

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Several meta-analyses have been published on the effectiveness of anterior cruciate ligament (ACL) injury prevention training programs to reduce ACL injury risk, with various degrees of risk reduction reported. The purpose of this research was to perform a systematic review and meta-analysis of overlapping meta-analyses evaluating the effectiveness of ACL injury prevention training programs so as to summarize the amount of reduction in risk for all ACL and non-contact ACL injuries into a single source, and determine if there were sex differences in the relative efficacy of ACL injury prevention training programs. Five databases (Medline, PubMed, Embase, CINAHL, and Cochrane) were searched to identify meta-analyses that evaluated the effectiveness of ACL injury prevention training programs on ACL injury risk. ACL injury data were extracted and the results from each meta-analysis were combined using a summary meta-analysis based on odds ratios (OR). Eight meta-analyses met eligibility criteria. Six of the eight only included data for female athletes. Summary meta-analysis showed an overall 50% reduction (OR = 0.5 [0.41-0.59]; I = 15%) in the risk of all ACL injuries in all athletes and a 67% reduction (OR = 0.33 [0.27-0.41]; I = 15%) for non-contact ACL injuries in females. This paper combines all previous meta-analyses into a single source and shows conclusive evidence that ACL injury prevention programs reduce the risk of all ACL injuries by half in all athletes and non-contact ACL injuries by two-thirds in female athletes. There is insufficient data to make conclusions as to the effectiveness of ACL injury prevention programs in male athletes. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2696-2708, 2018.

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Prevention and rehabilitation of paediatric anterior cruciate ligament injuries

Abstract: This file was dowloaded from the institutional repository Brage NIH -brage.bibsys.no/nih Moksnes, H., Grindem, H. (2015

Cited by 32 publications

References 75 publications

Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015

Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015

Prevention, treatment, and rehabilitation of anterior cruciate ligament injuries in children

Meta‐analysis of meta‐analyses of anterior cruciate ligament injury reduction training programs

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