Sports Injuries and Prevention
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Sports Injuries and Prevention
Anterior Cruciate Ligament (ACL)
NEWS:
Alternative Warm-Up Program Reduces Risk of ACL Injuries for Female College Soccer Players
Physical Therapists Say Appropriate Exercise Can Help Prevent ACL Injuries In Female Athletes
Torn ACLs, Other Big Injuries Hit Little Athletes
Torn ACL: Is Cadaver Tissue the Right Fix? 'Exceedingly High' Fail Rate Seen in Young Adults Who Have ACL Reconstruction Using Cadaver Tissue, Study Shows "Young, athletic patients who have surgery to repair a torn ACL in their knee could eventually need another procedure if tissue from a cadaver is used during the reconstruction. . analyzed data from 64 patients with an average age of 28 who had ACL surgery using cadaver tissue. After two years of follow up, 15 of the patient's ACL reconstructions had failed. The surgery was considered to be a failure if the patient needed a second ACL surgery or had a poor score on orthopedic-related tests."
ARTICLES:
JOURNAL ARTICLES:
Association of peripheral vertical meniscal tears with anterior cruciate ligament tears. (Skeletal Radiol. 2008)
Bone bruises associated with ACL rupture: correlation with injury mechanism. (Am J Sports Med. 2008)
Complete anterior cruciate ligament tear and the risk for cartilage loss and progression of symptoms in men and women with knee osteoarthritis. (Osteoarthritis Cartilage. 2008) "CONCLUSIONS: Individuals with knee OA and incidental complete ACL tear have an increased risk for cartilage loss that appears to be mediated by concurrent meniscal pathology. The presence of a complete ACL tear did not influence the level of knee pain or physical function over short-term follow-up."
Functional Recovery After Anterior Cruciate Ligament Reconstruction: A Longitudinal Perspective. (Arch Phys Med Rehabil. 2008)
Incidence of anterior cruciate ligament injuries among elite ballet and modern dancers: a 5-year prospective study. (Am J Sports Med. 2008)
Incidence of anterior cruciate ligament injury and other knee ligament injuries: A national population-based study. (J Sci Med Sport. 2008)
Influence of age, gender, and injury mechanism on the development of dynamic knee stability after acute ACL rupture. (J Orthop Sports Phys Ther. 2008)
Long-term results after primary repair or non-surgical treatment of anterior cruciate ligament rupture: a randomized study with a 15-year follow-up. (Scand J Med Sci Sports. 2007 ) “The radiological osteoarthritis (OA) frequency did not differ between surgically or non-surgically treated patients, but if a meniscectomy was performed, two-thirds of the patients showed OA changes regardless of initial treatment of the ACL. There were significantly more meniscus injuries in patients initially treated non-surgically. One-third of the patients in the non-surgically treated group underwent secondary ACL reconstruction due to instability problems. In this study, ACL repair itself could not reduce the risk of OA nor increase the subjective outcome scores. However, one-third of the non-surgical treated patients were later ACL reconstructed due to instability. The status of the menisci was found to be the most important predictor of developing OA. Early ACL repair and also ACL reconstruction can reduce the risk of secondary meniscus tears. Indirectly this supports the hypothesis that early stabilization of the knee after ACL injury is advantageous for the long-term outcome.”
Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. (Br J Sports Med. 2008) "Risk factors for female athletes suffering ACL injury include: (1) being in the preovulatory phase of the menstrual cycle compared with the postovulatory phase; (2) having decreased intercondylar notch width on plain radiography; and (3) developing increased knee abduction moment (a valgus intersegmental torque) during impact on landing. Well-designed injury prevention programmes reduce the risk of ACL for athletes, particularly women. These programmes attempt to alter dynamic loading of the tibiofemoral joint through neuromuscular and proprioceptive training. They emphasise proper landing and cutting techniques. This includes landing softly on the forefoot and rolling back to the rearfoot, engaging knee and hip flexion and, where possible, landing on two feet. Players are trained to avoid excessive dynamic valgus of the knee and to focus on the "knee over toe position" when cutting."
Principles for using hamstring tendons for anterior cruciate ligament reconstruction. (Clin Sports Med. 2007 )
Regional bone density changes in anterior cruciate ligament deficient knees: A DEXA study. (Knee. 2008)
Return to Sports After Anterior Cruciate Ligament Reconstruction - A Review of Patients with Minimum 5-year Follow-up. (Ann Acad Med Singapore. 2008) "Conclusion: Sixty-two per cent of our patients returned to their previous level of sport at 5 years after ACL reconstruction. Fear of reinjury is an important psychological factor for these patients not returning to sports. Our results would allow the attending surgeon to counsel the ACL deficient patient who is considering surgical reconstruction the likelihood of eventual return to sports."
The acutely ACL injured knee assessed by MRI: are large volume traumatic bone marrow lesions a sign of severe compression injury? (Osteoarthritis Cartilage. 2008)
The acutely ACL injured knee assessed by MRI: changes in joint fluid, bone marrow lesions, and cartilage during the first year. (Osteoarthritis Cartilage. 2008)
The effects of generalized joint laxity on risk of anterior cruciate ligament injury in young female athletes. (Am J Sports Med. 2008)
The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. (Am J Sports Med. 2007 ) “At 10 to 20 years after the diagnosis, on average, 50% of those with a diagnosed anterior cruciate ligament or meniscus tear have osteoarthritis with associated pain and functional impairment: the young patient with an old knee. These individuals make up a substantial proportion of the overall osteoarthritis population. There is a lack of evidence to support a protective role of repair or reconstructive surgery of the anterior cruciate ligament or meniscus against osteoarthritis development.”
The occurrence of osteoarthritis at a minimum of ten years after reconstruction of the anterior cruciate ligament. (J Orthop Surg. 2008)
Traumatic and overuse injuries of the ischial origin of the hamstrings. (Disabil Rehabil. 2008)
TREATMENT:
A comparison of bone-patellar tendon-bone and bone-hamstring tendon-bone autografts for anterior cruciate ligament reconstruction. (Am J Sports Med. 2006 )
A correlation of time with meniscal tears in anterior cruciate ligament deficiency: stratifying the risk of surgical delay. (Knee Surg Sports Traumatol Arthrosc. 2008)
A randomized controlled trial comparing the effectiveness of functional knee brace and neoprene sleeve use after anterior cruciate ligament reconstruction. (Am J Sports Med. 2008) "CONCLUSIONS: A functional knee brace does not result in superior outcomes compared with a neoprene sleeve after ACL reconstruction. Current evidence does not support the recommendation of using an ACL functional knee brace after ACL reconstruction."
ACL repair often unnecessary: study “Most people who tear the main ligament responsible for stabilizing the knee do not need surgery to rebuild it, according to a study in which researchers compared surgery to physical therapy. "Our research showed that reconstruction of the anterior cruciate ligament (ACL), which is quite common, is not a prerequisite for restoring muscle function," Dr. Eva Ageberg of Lund University, Sweden, told Reuters Health. She and her colleagues note that about half of Swedish patients who rupture the ligament undergo reconstructive surgery, while 90 percent of US patients do. People who injure the ACL lose stability in the knee, boosting their risk of developing osteoarthritis. But despite widespread use of ACL reconstructive surgery, there is no evidence that patients who have the operations are any less likely to develop osteoarthritis.“
[Allografts for cruciate ligament reconstruction.] (Orthopade. 2008)
[Anterior cruciate ligament injuries] (Harefuah. 2006 )
Anterior cruciate ligament insufficiency: does delay in index surgery affect outcome in recreational athletes. (Int Orthop. 2006) "Late ACL reconstruction does not adversely affect the outcome in recreational athletes. ACL reconstruction should be offered to these patients as there is a significant improvement in the knee function and patients are satisfied with the results."
Anterior cruciate ligament reconstruction in patients who have excessive joint laxity. (J Bone Joint Surg Am. 2008)
Arthroscopic reconstruction of the anterior cruciate ligament using bone-patellar tendon-bone autograft: a minimum 10-year follow-up. (Am J Sports Med. 2008)
Autograft contamination during preparation for anterior cruciate ligament reconstruction. (J Bone Joint Surg Am. 2008)
"Biological failure" of the anterior cruciate ligament graft. (Knee Surg Sports Traumatol Arthrosc. 2008)
Comparison of clinical results according to amount of preserved remnant in arthroscopic anterior cruciate ligament reconstruction using quadrupled hamstring graft. (Arthroscopy. 2008)
Factors associated with decreased muscle strength after anterior cruciate ligament reconstruction with hamstring tendon grafts. (Arthroscopy. 2006 )
Hamstring tendons regeneration after ACL reconstruction: an overview. (Knee Surg Sports Traumatol Arthrosc. 2007 )
Is ACL reconstruction only for athletes? A study of the incidence of meniscal and cartilage injuries in an ACL-deficient athlete and non-athlete population: an Indian experience. (Int Orthop. 2008 ) “These results demonstrate that both athletes and non-athletes are equally susceptible for long-term meniscal and cartilage injuries if ACL reconstruction is not carried out early.”
Joint infection unique to hamstring tendon harvester used during anterior cruciate ligament reconstruction surgery. (Arthroscopy. 2008)
Methicillin-resistant Staphylococcus aureus-induced septic arthritis after anterior cruciate ligament reconstruction. (Arthroscopy. 2008)
Muscle strength evaluations after ACL reconstruction. (Int J Sports Med. 2007 )
Neuromuscular function after reconstruction of anterior cruciate ligament--a case study using evoked electromyography. (Electromyogr Clin Neurophysiol. 2008)
Oral corticosteroid use for loss of flexion after primary anterior cruciate ligament reconstruction. (Arthroscopy. 2008)
Osteoarthritis in patients with anterior cruciate ligament rupture: A review of risk factors. (Knee. 2008)
Patients With Anterior Cruciate Ligament Injuries May Not Need Surgery “Patients with ACL injury who undergo training with and without surgical reconstruction have similar muscle strength and functional performance at 2 to 5 years after injury. • ACL injury is associated with reduced muscle strength and lower limb performance 2 to 5 years after injury. “
Partial ACL tears augmented with distally inserted hamstring tendons and over-the-top fixation: an MRI evaluation. (Knee. 2008)
Postoperative range of motion following anterior cruciate ligament reconstruction using autograft hamstrings: a prospective, randomized clinical trial of early versus delayed reconstructions. (Am J Sports Med. 2008) "BACKGROUND: There is a common belief that surgical reconstruction of an acutely torn anterior cruciate ligament (ACL) should be delayed for at least 3 weeks because of the increased incidence of postoperative motion loss (arthrofibrosis) and suboptimal clinical results"
Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. (Arthroscopy. 2008)
Reconstruction of the ACL with a semitendinosus tendon graft: a prospective randomized single blinded comparison of double-bundle versus single-bundle technique in male athletes. (Knee Surg Sports Traumatol Arthrosc. 2008)
Reconstruction of the anterior cruciate ligament using the polyester ABC ligament scaffold: a minimum follow-up of four years. (J Bone Joint Surg Br. 2006 )
Rehabilitation for hamstring injuries. (Cochrane Database Syst Rev. 2007 )
[Retraining between months 4 and 6 after anterior cruciate ligament reconstruction with hamstring graft: comparison between cycling and running with an untrained operated subject group] (Ann Readapt Med Phys. 2006)
Return to Sports After Anterior Cruciate Ligament Reconstruction - A Review of Patients with Minimum 5-year Follow-up. (Ann Acad Med Singapore. 2008) "From the remaining 45 patients, 28 patients (62.2%) returned to their previous level of sports and 17 patients (28.8%) did not return to their previous level of sports. Of whom, 9 (20%) said that they did not return due to fear of re-injury and the remaining 8 (17.8%) said they had not returned because of knee instability and pain. . Conclusion: Sixty-two per cent of our patients returned to their previous level of sport at 5 years after ACL reconstruction. Fear of reinjury is an important psychological factor for these patients not returning to sports. Our results would allow the attending surgeon to counsel the ACL deficient patient who is considering surgical reconstruction the likelihood of eventual return to sports."
Sensibility loss after ACL reconstruction with hamstring graft. (Int J Sports Med. 2008)
Twelve-year follow-up on anterior cruciate ligament reconstruction: long-term outcomes of prospectively studied osseous and articular injuries. (Am J Sports Med. 2008)
Update On Surgical Technique for Anterior Cruciate Ligament Repair
GUIDELINES:
INTERNET SITES:
A Patient's Guide to Anterior Cruciate Ligament Injuries
A Patient's Guide to Hamstring Tendon Graft Reconstruction of the ACL
Anterior Cruciate Ligament Injury
Anterior Cruciate Ligament (ACL) Sprain
Anterior Cruciate Ligament / ACL Injury “A torn ACL is an injury or tear to the anterior cruciate ligament. The ACL is one of the four main stabilising ligaments of the knee, the others being the Posterior Cruciate Ligament (PCL), Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL). The ACL attaches to the knee end of the Femur (thigh bone), at the back of the joint and passes down through the knee joint to the front of the flat upper surface of the Tibia (shin bone). ”
NIH - Anterior cruciate ligament repair - series: Normal anatomy (Medical Encyclopedia)
NIH - Anterior cruciate ligament (ACL) injury - Medical Encyclopedia
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