The Intrinsic Risk Factors for ACL Ruptures: An Evidence-Based Review

Posthumus, Michael; lins, Malcolm; September, Alison V.; Schwellnus, Martin

doi:10.3810/psm.2011.02.1843

Cited by 7 publications

(11 citation statements)

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“…Thus, the modifiable ACL injury risk factors are variables mainly associated with biomechanics and neuromuscular aspects. Unfortunately, while the investigation of biomechanical and neuromuscular risk factors for ACL injuries has been the scope of numerous studies within the last two decades, available evidence has mainly involved female athletes or has compared male and female athletes without an intra-group comparison for male athletes [3,4,22,23,45,78,82]. Comparing male athletes as ''control'' subjects to female athletes does not provide adequate evidence to investigate risk factors for ACL injury in male athletes [17,19,48].…”

Section: Introductionmentioning

confidence: 94%

Biomechanical and Neuromuscular Characteristics of Male Athletes: Implications for the Development of Anterior Cruciate Ligament Injury Prevention Programs

et al. 2015

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Prevention of anterior cruciate ligament (ACL) injury is likely the most effective strategy to reduce undesired health consequences including reconstruction surgery, long-term rehabilitation, and pre-mature osteoarthritis occurrence. A thorough understanding of mechanisms and risk factors of ACL injury is crucial to develop effective prevention programs, especially for biomechanical and neuromuscular modifiable risk factors. Historically, the available evidence regarding ACL risk factors has mainly involved female athletes or has compared male and female athletes without an intra-group comparison for male athletes. Therefore, the principal purpose of this article was to review existing evidence regarding the investigation of biomechanical and neuromuscular characteristics that may imply aberrant knee kinematics and kinetics that would place the male athlete at risk of ACL injury. Biomechanical evidence related to knee kinematics and kinetics was reviewed by different planes (sagittal and frontal/coronal), tasks (single-leg landing and cutting), situation (anticipated and unanticipated), foot positioning, playing surface, and fatigued status. Neuromuscular evidence potentially related to ACL injury was reviewed. Recommendations for prevention programs for ACL injuries in male athletes were developed based on the synthesis of the biomechanical and neuromuscular characteristics. The recommendations suggest performing exercises with multi-plane biomechanical components including single-leg maneuvers in dynamic movements, reaction to and decision making in unexpected situations, appropriate foot positioning, and consideration of playing surface condition, as well as enhancing neuromuscular aspects such as fatigue, proprioception, muscle activation, and inter-joint coordination.

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Section: Introductionmentioning

confidence: 94%

Biomechanical and Neuromuscular Characteristics of Male Athletes: Implications for the Development of Anterior Cruciate Ligament Injury Prevention Programs

et al. 2015

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“…Recently, advances in biomechanics have demonstrated the reciprocal influence of hip and knee tension, highlighting that restrictions in internal rotation of the hip can increase strain in the ACL. 6,7 One such cause of restricted internal rotation is femoroacetabular impingement (FAI). In a recent prospective study, of patients presenting with groin pain, 17% were diagnosed to have FAI.…”

Section: Introductionmentioning

confidence: 99%

Is restricted hip movement a risk factor for anterior cruciate ligament injury?

Nakano¹,

Bartlett²,

Khanduja

2018

J Orthop Surg (Hong Kong)

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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 studies. Clinical studies primarily assessed the limitations to hip movement in patients with ACL injury, and numerous studies of this kind have demonstrated a relationship between restricted movement and ACL injury. Radiological studies have been able to demonstrate a higher number of bony hip abnormalities in patients with ACL injury. However, due to variable results within these studies, it is unclear which kinds of bony abnormality are specifically associated with an increased risk of ACL injury. Cadaveric studies have demonstrated that peak ACL relative strain was inversely related to the range of internal rotation of the femur, thus providing a potential mechanism for this relationship. In conclusion, clinical and radiological studies have established a correlation between restricted hip and ACL injury, but have been unable to demonstrate an increased risk of future ACL injury in individuals with restricted hip movement. Future prospective cohort studies are necessary to confirm this. Additionally, these findings highlight the need for a thorough clinical assessment of the hip when assessing patients with an ACL injury.Keywords anterior cruciate ligament (ACL), femoroacetabular impingement (FAI), range of movement of the hip, restricted hip movement, sports medicine Date

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“…The risk of ACL rupture is increased in sports requiring rapid changes in direction and/or decelerations such in the case of cutting, pivoting and landing [ 4 ]. Multiple extrinsic [ 5 ] and intrinsic risk factors have been associated with anterior cruciate ligament (ACL) ruptures [ 6 ] and more recently, evidence implicating genetic susceptibility as an intrinsic risk factor has been shown [ 7 ]. Specifically, roles of the COL1A1 gene [ 8 ], COL5A1 gene [ 9 , 10 ], COL12A1 gene [ 11 , 12 ], and the chromosome 11 MMP gene cluster [ 13 ] have been suggested, to name only a few loci.…”

Section: Introductionmentioning

confidence: 99%

Are genes encoding proteoglycans really associated with the risk of anterior cruciate ligament rupture?

Willard¹,

Gronek²,

Żmijewski³

et al. 2017

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Proteoglycans are considered integral structural components of tendon and ligament and have been implicated in the resistance of compressive forces, collagen fibrillogenesis, matrix remodelling and cell signalling. Several sequence variants within genes encoding proteoglycans were recently implicated in modulating anterior cruciate ligament ruptures (ACLR). This study aimed to test the previously implicated variants in proteoglycan and vascular epithelial growth factor encoding genes with risk of ACLR in a population from Poland. A case control genetic association study was conducted using DNA samples from 143 healthy participants without a history of ACL injuries (99 male and 44 females) (CON group) and 229 surgically diagnosed ACLR participants (158 males and 71 females). All samples were genotyped for the ACAN: rs1516797, BGN: rs1042103, rs1126499, DCN: rs516115 and VEGFA: rs699947 variants. Main findings included the (i) ACAN rs1516797 G/T genotype which was underrepresented in the CON group (CON: 36%, n=52, ACLR: 49%, n=112, p=0.017, OR=1.68, 95% CI 1.09 to 2.57) when all participants were investigated and (ii) the BGN rs1042103 A allele was significantly under-represented in the male CON group compared to the male ACLR group (CON: 39%, n=78, ACLR: 49%, n=156, p=0.029, OR=1.5, 95% CI 1.05 to 2.15). Furthermore, BGN inferred haplotypes were highlighted with altered ACLR susceptibility. Although the study implicated the ACAN and BGN genes (combination of genotype, allele and haplotype) in modulating ACLR susceptibility, several differences were noted with previous published findings.

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The Intrinsic Risk Factors for ACL Ruptures: An Evidence-Based Review

Cited by 7 publications

References 0 publications

Biomechanical and Neuromuscular Characteristics of Male Athletes: Implications for the Development of Anterior Cruciate Ligament Injury Prevention Programs

Biomechanical and Neuromuscular Characteristics of Male Athletes: Implications for the Development of Anterior Cruciate Ligament Injury Prevention Programs

Is restricted hip movement a risk factor for anterior cruciate ligament injury?

Are genes encoding proteoglycans really associated with the risk of anterior cruciate ligament rupture?

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