Video Analysis of Anterior Cruciate Ligament Tears in Professional American Football Athletes

Johnston, Jeffrey T.; Mandelbaum, Bert R.; Schub, David; Rodeo, Scott A.; Matava, Matthew J.; Silvers-Granelli, Holly; Cole, Brian J.; ElAttrache, Neil S; McAdams, Tim R; Brophy, Robert H.

doi:10.1177/0363546518756328

Cited by 109 publications

(138 citation statements)

References 45 publications

Supporting

Mentioning

119

Contrasting

Order By: Relevance

“…Anterior cruciate ligament injuries during ball team sports typically occur in single-leg activities such as landing on one leg or changing direction, requiring a complex coordination of peripheral and central responses [92–95]. For injury prevention, it is difficult to delineate peripheral and central fatigue mechanisms as dynamic sports maneuvers require explicit force production and motor control at both the peripheral and central (spinal and supraspinal) levels [64, 96].…”

Section: Discussionmentioning

confidence: 99%

Revised Approach to the Role of Fatigue in Anterior Cruciate Ligament Injury Prevention: A Systematic Review with Meta-Analyses

et al. 2019

View full text Add to dashboard Cite

BackgroundCauses of anterior cruciate ligament (ACL) injuries are multifactorial. Anterior cruciate ligament injury prevention should thus be approached from a multifactorial perspective as well. Training to resist fatigue is an underestimated aspect of prevention programs given that the presence of fatigue may play a crucial role in sustaining an ACL injury.ObjectivesThe primary objective of this literature review was to summarize research findings relating to the kinematic and kinetic effects of fatigue on single-leg landing tasks through a systematic review and meta-analysis. Other objectives were to critically appraise current approaches to examine the effects of fatigue together with elucidating and proposing an optimized approach for measuring the role of fatigue in ACL injury prevention.MethodsA systematic literature search was conducted in the databases PubMed (1978–November 2017), CINAHL (1992–November 2017), and EMBASE (1973–November 2017). The inclusion criteria were: (1) full text, (2) published in English, German, or Dutch, (3) healthy subjects, (4) average age ≥ 18 years, (5) single-leg jump landing task, (6) evaluation of the kinematics and/or kinetics of the lower extremities before and after a fatigue protocol, and (7) presentation of numerical kinematic and/or kinetic data. Participants included healthy subjects who underwent a fatigue protocol and in whom the effects of pre- and post-fatigue on three-dimensional lower extremity kinematic and kinetics were compared. Methods of data collection, patient selection, blinding, prevention of verification bias, and study design were independently assessed.ResultsTwenty studies were included, in which four types of single-leg tasks were examined: the single-leg drop vertical jump, the single-leg drop landing, the single-leg hop for distance, and sidestep cutting. Fatigue seemed to mostly affect initial contact (decreased angles post-fatigue) and peak (increased angles post-fatigue) hip and knee flexion. Sagittal plane variables at initial contact were mostly affected under the single-leg hop for distance and sidestep cutting conditions whilst peak angles were affected during the single-leg drop jump.ConclusionsTraining to resist fatigue is an underestimated aspect of prevention programs given that the presence of fatigue may play a crucial role in sustaining an ACL injury. Considering the small number of variables affected after fatigue, the question arises whether the same fatigue pathways are affected by the fatigue protocols used in the included laboratory studies as are experienced on the sports field.Electronic supplementary materialThe online version of this article (10.1007/s40279-019-01052-6) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Revised Approach to the Role of Fatigue in Anterior Cruciate Ligament Injury Prevention: A Systematic Review with Meta-Analyses

et al. 2019

View full text Add to dashboard Cite

show abstract

“…COD tasks such as cutting manoeuvres (which for the purpose of this review will be referred to as changes of direction between 30° and 110°) are key actions associated with non-contact ACL injuries; thus, understanding the biomechanical determinants of multiplanar KJLs in cutting is of great importance, particularly for athletes who participate in cutting dominant sports. Cutting has retrospectively been identified as the primary action associated with non-contact ACL injury in rugby (66% [ 7 ];) American football (60% [ 5 ];) and handball (60% [ 2 ];). Furthermore, cutting has been found to elicit greater multiplanar KJLs than both single legged landings (SLLs) [ 25 ] and multiplanar side jumps amongst athletes [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Determinants of Knee Joint Loads Associated with Increased Anterior Cruciate Ligament Loading During Cutting: A Systematic Review and Technical Framework

et al. 2020

View full text Add to dashboard Cite

Background Cutting actions are associated with non-contact ACL injuries in multidirectional sports due to the propensity to generate large multiplanar knee joint loads (KJLs) that have the capacity to increase ACL loading and strain. Numerous studies have investigated the biomechanical determinants of KJLs in cutting tasks. The aim of this systematic review was to comprehensively review the literature regarding biomechanical determinants of KJLs during cutting, in order to develop a cutting technical framework alongside training recommendations for practitioners regarding KJL mitigation. Methods Databases (SPORTDiscus, Web of Science and PubMed) were systematically searched using a combination of the following terms: “Biomechanical determinants”, or “Knee abduction moment”, or “Technical determinants”, or “Knee loading”, or “Knee loads”, or “Mechanical determinants”, or “ACL strain”, or “Knee adduction moment”, or “Anterior tibial shear”, or “Knee internal rotation moment”, or “Knee valgus moment” AND “Change of direction”, or “Cutting manoeuvre”, or “Run and cut”, or “Run-and-cut”, or “Sidestepping”, or “Side-stepping”, or “Shuttle run”. Inclusion criteria were as follows: studies examining a cutting task < 110° with a preceding approach run that examined biomechanical determinants of KJLs using three-dimensional motion analysis. Results The search returned 6404 possibly eligible articles, and 6 identified through other sources. Following duplicate removal, 4421 titles and abstracts were screened, leaving 246 full texts to be screened for inclusion. Twenty-three full texts were deemed eligible for inclusion and identified numerous determinants of KJLs; 11 trunk, 11 hip, 7 knee, 3 multiplanar KJLs, 5 foot/ankle and 7 identifying ground reaction forces (GRFs) as determinants of KJLs. Conclusion Using the framework developed from the results, cutting KJLs can be mitigated through the following: reducing lateral foot-plant distances, thus lowering hip abduction and orientating the foot closer to neutral with a mid-foot or forefoot placement strategy; minimising knee valgus and hip internal rotation angles and motion at initial contact (IC) and weight acceptance (WA); avoiding and limiting lateral trunk flexion and attempt to maintain an upright trunk position or trunk lean into the intended direction; and finally, reducing GRF magnitude during WA, potentially by attenuation through increased knee flexion and emphasising a greater proportion of braking during the penultimate foot contact (PFC).

show abstract

“…For documentation of the injury mechanism, injury type was classified into contact and non-contact injury, according to the presence of a direct impact onto the lower extremities [7,[12][13][14]. In addition, according to the position of the lower leg at the time of injury, contact injury was classified as valgus, varus, or hyperextension, and non-contact injury was classified as landing in valgus, varus, or changing direction [7,[12][13][14]. The duration of exercise was divided into 30-min intervals in order to investigate the relationship between the duration of exercise and the incidence of ACL injury.…”

Section: Methodsmentioning

confidence: 99%

“…For the prevention of ACL injury it is crucial to identify the commonly associated injury mechanism and then apply strategies to lower the risk. Several previous studies in the sports environment have not only analyzed the risk factors and injury mechanisms associated with ACL injuries through biomechanics studies and sports video analysis [7], but have also reported that the application of prevention programs developed through the analysis was effective in preventing ACL injuries [4,[8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

The mechanism and cause of anterior cruciate ligament tear in the Korean military environment

Ahn

Choi

Lee

et al. 2019

Knee Surg & Relat Res

View full text Add to dashboard Cite

Purpose: Anterior cruciate ligament (ACL) injury is very common but few studies have analyzed the injury mechanism and cause of ACL tear in a specific environment such as a military institution. The purpose of this study was to analyze the injury mechanism and cause of ACL injury in the military environment. Additionally, this study could provide outcomes that may aid future studies on prevention of ACL injury in military personnel. Materials and methods: This study retrospectively analyzed 168 patients who sustained ACL tear while in military service and underwent ACL reconstruction surgery in a military hospital. Analysis of the injury mechanism and the cause was evaluated by analyzing the medical records. Knee magnetic resonance imaging analysis was also conducted for further evaluation of associated injury. Results: The majority of ACL injuries in the military environment occurred through non-contact injury. Changing direction (46.4%) was the most common lower-leg position, followed by landing with the knee in a valgus position (26.8%). The activity undertaken at the time of injury was exercise in 76.2% of cases and military training/daily activities in 23.8% of cases. The incidence of ACL injury was higher in the soldier compared to the officer group during exercise (P = 0.017). Soccer was the most common activity at the time of injury (54.1%), followed by military training/daily activities, futsal, and basketball. The most common injury time was between 30 and 60 min after the start of exercise. Commonly associated injury sites were the medial meniscus and the medial collateral ligament. Conclusions: The main mechanism of ACL injury occurring in the military environment was non-contact injury, especially on changing the direction of the lower leg. Soccer was the most frequent activity at the time of the injury. These findings suggested that preventive strategies against ACL injury in the military environment could effectively reduce the incidence of ACL injury.

show abstract

Video Analysis of Anterior Cruciate Ligament Tears in Professional American Football Athletes

Cited by 109 publications

References 45 publications

Revised Approach to the Role of Fatigue in Anterior Cruciate Ligament Injury Prevention: A Systematic Review with Meta-Analyses

Revised Approach to the Role of Fatigue in Anterior Cruciate Ligament Injury Prevention: A Systematic Review with Meta-Analyses

Biomechanical Determinants of Knee Joint Loads Associated with Increased Anterior Cruciate Ligament Loading During Cutting: A Systematic Review and Technical Framework

The mechanism and cause of anterior cruciate ligament tear in the Korean military environment

Contact Info

Product

Resources

About