Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000161.xml
Download PDF
J Knee Surg 2016; 29(02): 117-125
DOI: 10.1055/s-0035-1558855
DOI: 10.1055/s-0035-1558855
Special Focus Section
Motion Analysis and the Anterior Cruciate Ligament: Classification of Injury Risk
Further Information
Publication History
23 March 2015
26 May 2015
Publication Date:
18 September 2015 (online)
Abstract
Anterior cruciate ligament (ACL) injuries are common, catastrophic events that incur large expense and lead to degradation of the knee. As such, various motion capture techniques have been applied to identify athletes who are at increased risk for suffering ACL injuries. The objective of this clinical commentary was to synthesize information related to how motion capture analyses contribute to the identification of risk factors that may predict relative injury risk within a population. Individuals employ both active and passive mechanisms to constrain knee joint articulation during motion. There is strong evidence to indicate that athletes who consistently classify as high-risk loaders during landing suffer from combined joint stability deficits in both the active and passive knee restraints. Implementation of prophylactic neuromuscular interventions and biofeedback can effectively compensate for some of the deficiencies that result from poor control of the active knee stabilizers and reduce the incidence of ACL injuries.
-
References
- 1 Agel J, Olson DE, Dick R, Arendt EA, Marshall SW, Sikka RS. Descriptive epidemiology of collegiate women's basketball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train 2007; 42 (2) 202-210
- 2 Dick R, Ferrara MS, Agel J , et al. Descriptive epidemiology of collegiate men's football injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train 2007; 42 (2) 221-233
- 3 Dick R, Hertel J, Agel J, Grossman J, Marshall SW. Descriptive epidemiology of collegiate men's basketball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train 2007; 42 (2) 194-201
- 4 Dick R, Putukian M, Agel J, Evans TA, Marshall SW. Descriptive epidemiology of collegiate women's soccer injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2002-2003. J Athl Train 2007; 42 (2) 278-285
- 5 Yard E, Comstock D. Injury patterns by body mass index in US high school athletes. J Phys Act Health 2011; 8 (2) 182-191
- 6 Lambers K, Ootes D, Ring D. Incidence of patients with lower extremity injuries presenting to US emergency departments by anatomic region, disease category, and age. Clin Orthop Relat Res 2012; 470 (1) 284-290
- 7 Majewski M, Susanne H, Klaus S. Epidemiology of athletic knee injuries: A 10-year study. Knee 2006; 13 (3) 184-188
- 8 Miyasaka KC, Daniel DM, Stone ML, Hirshman P. The incidence of knee ligament injuries in the general population. Am J Knee Surg 1991; 4 (1) 3-8
- 9 Arendt EA, Agel J, Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. J Athl Train 1999; 34 (2) 86-92
- 10 Boden BP, Dean GS, Feagin Jr JA, Garrett Jr WE. Mechanisms of anterior cruciate ligament injury. Orthopedics 2000; 23 (6) 573-578
- 11 Toth AP, Cordasco FA. Anterior cruciate ligament injuries in the female athlete. J Gend Specif Med 2001; 4 (4) 25-34
- 12 Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train 2007; 42 (2) 311-319
- 13 Gianotti SM, Marshall SW, Hume PA, Bunt L. Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study. J Sci Med Sport 2009; 12 (6) 622-627
- 14 Griffin LY, Agel J, Albohm MJ , et al. Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg 2000; 8 (3) 141-150
- 15 Myer GD, Ford KR, Hewett TE. Preventing ACL injuries in Women. J Musculoskel Med. 2006; 23 (1) 12-38
- 16 Johnson DL, Warner JJP. Diagnosis for anterior cruciate ligament surgery. Clin Sports Med 1993; 12 (4) 671-684
- 17 Kim S, Bosque J, Meehan JP, Jamali A, Marder R. Increase in outpatient knee arthroscopy
in the United States: a comparison of National Surveys of Ambulatory Surgery, 1996
and 2006. J Bone Joint Surg Am 2011; 93 (11) 994-1000
MissingFormLabel
- 18 Hewett TE, Lindenfeld TN, Riccobene JV, Noyes FR. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. Am J Sports Med 1999; 27 (6) 699-706
- 19 Bates NA, McPherson AL, Rao MB, Myer GD, Hewett TE. Characteristics of inpatient anterior cruciate ligament reconstructions and concomitant injuries (e-pub ahead of print). Knee Surg Sports Traumatol Arthrosc 2014; ; doi: 10.1007/s00167-014-3478-3
- 20 Nagda SH, Altobelli GG, Bowdry KA, Brewster CE, Lombardo SJ. Cost analysis of outpatient anterior cruciate ligament reconstruction: autograft versus allograft. Clin Orthop Relat Res 2010; 468 (5) 1418-1422
- 21 Renström PA. Eight clinical conundrums relating to anterior cruciate ligament (ACL) injury in sport: recent evidence and a personal reflection. Br J Sports Med 2013; 47 (6) 367-372
- 22 Neuman P, Englund M, Kostogiannis I, Fridén T, Roos H, Dahlberg LE. Prevalence of
tibiofemoral osteoarthritis 15 years after nonoperative treatment of anterior cruciate
ligament injury: a prospective cohort study. Am J Sports Med 2008; 36 (9) 1717-1725
MissingFormLabel
- 23 Myklebust G, Bahr R. Return to play guidelines after anterior cruciate ligament surgery. Br J Sports Med 2005; 39 (3) 127-131
- 24 von Porat A, Roos EM, Roos H. High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: a study of radiographic and patient relevant outcomes. Ann Rheum Dis 2004; 63 (3) 269-273
- 25 Lohmander LS, Ostenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 2004; 50 (10) 3145-3152
- 26 Hewett TE, Myer GD, Ford KR , et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med 2005; 33 (4) 492-501
- 27 Levine JW, Kiapour AM, Quatman CE , et al. Clinically relevant injury patterns after an anterior cruciate ligament injury provide insight into injury mechanisms. Am J Sports Med 2013; 41 (2) 385-395
- 28 Withrow TJ, Huston LJ, Wojtys EM, Ashton-Miller JA. The effect of an impulsive knee valgus moment on in vitro relative ACL strain during a simulated jump landing. Clin Biomech (Bristol, Avon) 2006; 21 (9) 977-983
- 29 Shin CS, Chaudhari AM, Andriacchi TP. The effect of isolated valgus moments on ACL strain during single-leg landing: a simulation study. J Biomech 2009; 42 (3) 280-285
- 30 Dufek JS, Bates BT. Biomechanical factors associated with injury during landing in jump sports. Sports Med 1991; 12 (5) 326-337
- 31 Myer GD, Imwalle LE, Ford KR, Hewett TE. Hip adduction, not hip internal rotation, dictates knee motion related to acl injury during cutting maneuvers. Med Sci Sports Exerc 2006; 38 (5) 614-619
- 32 Imwalle LE, Myer GD, Ford KR, Hewett TE. Relationship between hip and knee kinematics in athletic women during cutting maneuvers: a possible link to noncontact anterior cruciate ligament injury and prevention. J Strength Cond Res 2009; 23 (8) 2223-2230
- 33 Hewett TE, Ford KR, Myer GD, Wanstrath K, Scheper M. Gender differences in hip adduction motion and torque during a single-leg agility maneuver. J Orthop Res 2006; 24 (3) 416-421
- 34 Hewett TE, Myer GD. The mechanistic connection between the trunk, hip, knee, and anterior cruciate ligament injury. Exerc Sport Sci Rev 2011; 39 (4) 161-166
- 35 Winter DA. Biomechanics and Motor Control of Human Movement. 3rd ed. ed. New York, NY: John Wiley & Sons, Inc.; 2005
- 36 Hewett TE, Torg JS, Boden BP. Video analysis of trunk and knee motion during non-contact anterior cruciate ligament injury in female athletes: lateral trunk and knee abduction motion are combined components of the injury mechanism. Br J Sports Med 2009; 43 (6) 417-422
- 37 Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. The effects of core proprioception on knee injury: a prospective biomechanical-epidemiological study. Am J Sports Med 2007; 35 (3) 368-373
- 38 DiCesare CA, Bates NA, Myer GD, Hewett TE. The validity of 2-dimensional measurement of trunk angle during dynamic tasks. Int J Sports Phys Ther 2014; 9 (4) 420-427
- 39 Dingenen B, Malfait B, Vanrenterghem J, Robinson MA, Verschueren SM, Staes FF. Can two-dimensional measured peak sagittal plane excursions during drop vertical jumps help identify three-dimensional measured joint moments?. Knee 2015; 22 (2) 73-79
- 40 Myer GD, Ford KR, Khoury J, Succop P, Hewett TE. Development and validation of a clinic-based prediction tool to identify female athletes at high risk for anterior cruciate ligament injury. Am J Sports Med 2010; 38 (10) 2025-2033
- 41 Myer GD, Ford KR, Khoury J, Succop P, Hewett TE. Clinical correlates to laboratory measures for use in non-contact anterior cruciate ligament injury risk prediction algorithm. Clin Biomech (Bristol, Avon) 2010; 25 (7) 693-699
- 42 Myer GD, Ford KR, Khoury J, Hewett TE. Three-dimensional motion analysis validation of a clinic-based nomogram designed to identify high ACL injury risk in female athletes. Phys Sportsmed 2011; 39 (1) 19-28
- 43 Zebis MK, Andersen LL, Bencke J, Kjaer M, Aagaard P. Identification of athletes at future risk of anterior cruciate ligament ruptures by neuromuscular screening. Am J Sports Med 2009; 37 (10) 1967-1973
- 44 Myer GD, Ford KR, Hewett TE. Tuck Jump Assessment for Reducing Anterior Cruciate Ligament Injury Risk. Athl Ther Today 2008; 13 (5) 39-44
- 45 Myklebust G, Engebretsen L, Braekken IH, Skjølberg A, Olsen OE, Bahr R. Prevention of anterior cruciate ligament injuries in female team handball players: a prospective intervention study over three seasons. Clin J Sport Med 2003; 13 (2) 71-78
- 46 Mandelbaum BR, Silvers HJ, Watanabe DS , et al. Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. Am J Sports Med 2005; 33 (7) 1003-1010
- 47 Sugimoto D, Myer GD, McKeon JM, Hewett TE. Evaluation of the effectiveness of neuromuscular training to reduce anterior cruciate ligament injury in female athletes: a critical review of relative risk reduction and numbers-needed-to-treat analyses. Br J Sports Med 2012; 46 (14) 979-988
- 48 Chappell JD, Limpisvasti O. Effect of a neuromuscular training program on the kinetics and kinematics of jumping tasks. Am J Sports Med 2008; 36 (6) 1081-1086
- 49 Hewett TE, Myer GD, Ford KR. Reducing knee and anterior cruciate ligament injuries among female athletes: a systematic review of neuromuscular training interventions. J Knee Surg 2005; 18 (1) 82-88
- 50 Hewett TE, Ford KR, Myer GD. Anterior cruciate ligament injuries in female athletes: Part 2, a meta-analysis of neuromuscular interventions aimed at injury prevention. Am J Sports Med 2006; 34 (3) 490-498
- 51 Myer GD, Ford KR, McLean SG, Hewett TE. The effects of plyometric versus dynamic stabilization and balance training on lower extremity biomechanics. Am J Sports Med 2006; 34 (3) 445-455
- 52 Myer GD, Ford KR, Brent JL, Hewett TE. Differential neuromuscular training effects on ACL injury risk factors in”high-risk” versus “low-risk” athletes. BMC Musculoskelet Disord 2007; 8 (39) 39
- 53 Myer GD, Ford KR, Brent JL, Hewett TE. The effects of plyometric vs. dynamic stabilization and balance training on power, balance, and landing force in female athletes. J Strength Cond Res 2006; 20 (2) 345-353
- 54 Myer GD, Ford KR, Palumbo JP, Hewett TE. Neuromuscular training improves performance and lower-extremity biomechanics in female athletes. J Strength Cond Res 2005; 19 (1) 51-60
- 55 Lephart SM, Abt JP, Ferris CM. Neuromuscular contributions to anterior cruciate ligament injuries in females. Curr Opin Rheumatol 2002; 14 (2) 168-173
- 56 Myer GD, Brent JL, Ford KR, Hewett TE. Real-time assessment and neuromuscular training feedback techniques to prevent ACL injury in female athletes. Strength Condit J 2011; 33 (3) 21-35
- 57 Ford KR, Myer GD, Hewett TE. Valgus knee motion during landing in high school female and male basketball players. Med Sci Sports Exerc 2003; 35 (10) 1745-1750
- 58 Myer GD, Ford KR, Hewett TE. Rationale and Clinical Techniques for Anterior Cruciate Ligament Injury Prevention Among Female Athletes. J Athl Train 2004; 39 (4) 352-364
- 59 Renström P, Arms SW, Stanwyck TS, Johnson RJ, Pope MH. Strain within the anterior cruciate ligament during hamstring and quadriceps activity. Am J Sports Med 1986; 14 (1) 83-87
- 60 Podraza JT, White SC. Effect of knee flexion angle on ground reaction forces, knee moments and muscle co-contraction during an impact-like deceleration landing: implications for the non-contact mechanism of ACL injury. Knee 2010; 17 (4) 291-295
- 61 Bates NA, Myer GD, Shearn JT, Hewett TE. Anterior cruciate ligament biomechanics during robotic and mechanical simulations of physiologic and clinical motion tasks: a systematic review and meta-analysis. Clin Biomech (Bristol, Avon) 2015; 30 (1) 1-13
- 62 Malinzak RA, Colby SM, Kirkendall DT, Yu B, Garrett WE. A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clin Biomech (Bristol, Avon) 2001; 16 (5) 438-445
- 63 Hewett TE, Paterno MV, Myer GD. Strategies for enhancing proprioception and neuromuscular control of the knee. Clin Orthop Relat Res 2002; (402) 76-94
- 64 Colby S, Francisco A, Yu B, Kirkendall D, Finch M, Garrett Jr W. Electromyographic and kinematic analysis of cutting maneuvers. Implications for anterior cruciate ligament injury. Am J Sports Med 2000; 28 (2) 234-240
- 65 Pappas E, Carpes FP. Lower extremity kinematic asymmetry in male and female athletes performing jump-landing tasks. J Sci Med Sport 2012; 15 (1) 87-92
- 66 Paterno MV, Schmitt LC, Ford KR , et al. Biomechanical measures during landing and postural stability predict second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport. Am J Sports Med 2010; 38 (10) 1968-1978
- 67 Hewett TE, Myer GD, Ford KR. The influence of growth and pubertal maturation on neuromuscular performance in high-risk female athletes. Med Sci Sports Exerc 2002; 34 (5) S247
- 68 Pappas E, Zampeli F, Xergia SA, Georgoulis AD. Lessons learned from the last 20 years of ACL-related in vivo-biomechanics research of the knee joint. Knee Surg Sports Traumatol Arthrosc 2013; 21 (4) 755-766
- 69 Hewett TE, Ford KR, Hoogenboom BJ, Myer GD. Understanding and preventing acl injuries: current biomechanical and epidemiologic considerations - update 2010. N Am J Sports Phys Ther 2010; 5 (4) 234-251
- 70 Wordeman SC, Quatman CE, Kaeding CC, Hewett TE. In vivo evidence for tibial plateau slope as a risk factor for anterior cruciate ligament injury: a systematic review and meta-analysis. Am J Sports Med 2012; 40 (7) 1673-1681
- 71 Alentorn-Geli E, Mendiguchía J, Samuelsson K , et al. Prevention of anterior cruciate ligament injuries in sports. Part I: systematic review of risk factors in male athletes. Knee Surg Sports Traumatol Arthrosc 2014; 22 (1) 3-15
- 72 Butler DL, Noyes FR, Grood ES. Ligamentous restraints to anterior-posterior drawer in the human knee. A biomechanical study. J Bone Joint Surg Am 1980; 62 (2) 259-270
- 73 Markolf KL, Gorek JF, Kabo JM, Shapiro MS. Direct measurement of resultant forces
in the anterior cruciate ligament. An in vitro study performed with a new experimental
technique. J Bone Joint Surg Am 1990; 72 (4) 557-567
MissingFormLabel
- 74 Souryal TO, Freeman TR. Intercondylar notch size and anterior cruciate ligament injuries in athletes. A prospective study. Am J Sports Med 1993; 21 (4) 535-539
- 75 Myer GD, Ford KR, Di Stasi SL, Foss KD, Micheli LJ, Hewett TE. High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: is PFP itself a predictor for subsequent ACL injury?. Br J Sports Med 2015; 49 (2) 118-122
- 76 Myer GD, Ford KR, Barber Foss KD , et al. The incidence and potential pathomechanics of patellofemoral pain in female athletes. Clin Biomech (Bristol, Avon) 2010; 25 (7) 700-707
- 77 Myer GD, Ford KR, Foss KD, Rauh MJ, Paterno MV, Hewett TE. A predictive model to estimate knee-abduction moment: implications for development of a clinically applicable patellofemoral pain screening tool in female athletes. J Athl Train 2014; 49 (3) 389-398
- 78 Myer GD, Ford KR, Khoury J, Succop P, Hewett TE. Biomechanics laboratory-based prediction algorithm to identify female athletes with high knee loads that increase risk of ACL injury. Br J Sports Med 2011; 45 (4) 245-252
- 79 Myer GD, Ford KR, Hewett TE. New method to identify athletes at high risk of ACL injury using clinic-based measurements and freeware computer analysis. Br J Sports Med 2011; 45 (4) 238-244
- 80 Myer GD, Wordeman SC, Sugimoto D , et al. Consistency of clinical biomechanical measures between three different institutions: implications for multi-center biomechanical and epidemiological research. Int J Sports Phys Ther 2014; 9 (3) 289-301
- 81 Ford KR, Myer GD, Hewett TE. Longitudinal effects of maturation on lower extremity joint stiffness in adolescent athletes. Am J Sports Med 2010; 38 (9) 1829-1837
- 82 Bates NA, Ford KR, Myer GD, Hewett TE. Kinetic and kinematic differences between first and second landings of a drop vertical jump task: implications for injury risk assessments. Clin Biomech (Bristol, Avon) 2013; 28 (4) 459-466
- 83 Bates NA, Ford KR, Myer GD, Hewett TE. Timing differences in the generation of ground reaction forces between the initial and secondary landing phases of the drop vertical jump. Clin Biomech (Bristol, Avon) 2013; 28 (7) 796-799
- 84 Bates NA, Ford KR, Myer GD, Hewett TE. Impact differences in ground reaction force and center of mass between the first and second landing phases of a drop vertical jump and their implications for injury risk assessment. J Biomech 2013; 46 (7) 1237-1241
- 85 Ford KR, Myer GD, Hewett TE. Reliability of landing 3D motion analysis: implications for longitudinal analyses. Med Sci Sports Exerc 2007; 39 (11) 2021-2028
- 86 Andrews JR, Axe MJ. The classification of knee ligament instability. Orthop Clin North Am 1985; 16 (1) 69-82
- 87 Lloyd DG, Besier TF. An EMG-driven musculoskeletal model to estimate muscle forces and knee joint moments in vivo. J Biomech 2003; 36 (6) 765-776
- 88 McLean SG, Huang X, Su A, Van Den Bogert AJ. Sagittal plane biomechanics cannot injure the ACL during sidestep cutting. Clin Biomech (Bristol, Avon) 2004; 19 (8) 828-838
- 89 Hewett TE, Myer GD, Ford KR. Decrease in neuromuscular control about the knee with maturation in female athletes. J Bone Joint Surg Am 2004; 86-A (8) 1601-1608
- 90 Hewett TE, Stroupe AL, Nance TA, Noyes FR. Plyometric training in female athletes. Decreased impact forces and increased hamstring torques. Am J Sports Med 1996; 24 (6) 765-773
- 91 Kiapour AM, Wordeman SC, Paterno MV , et al. Diagnostic value of knee arthrometry in the prediction of anterior cruciate ligament strain during landing. Am J Sports Med 2014; 42 (2) 312-319
- 92 Wordeman SC, Paterno MV, Quatman CE, Bates NA, Hewett TE. Arthrometric curve-shape variables to assess anterior cruciate ligament deficiency. Clin Biomech (Bristol, Avon) 2012; 27 (8) 830-836
- 93 Tate JJ, Milner CE. Real-time kinematic, temporospatial, and kinetic biofeedback during gait retraining in patients: a systematic review. Phys Ther 2010; 90 (8) 1123-1134
- 94 Onate JA, Guskiewicz KM, Sullivan RJ. Augmented feedback reduces jump landing forces. J Orthop Sports Phys Ther 2001; 31 (9) 511-517
- 95 Verhoeff LL, Horlings CG, Janssen LJ, Bridenbaugh SA, Allum JH. Effects of biofeedback on trunk sway during dual tasking in the healthy young and elderly. Gait Posture 2009; 30 (1) 76-81
- 96 Teran-Yengle P, Birkhofer R, Weber MA, Patton K, Thatcher E, Yack HJ. Efficacy of gait training with real-time biofeedback in correcting knee hyperextension patterns in young women. J Orthop Sports Phys Ther 2011; 41 (12) 948-952
- 97 Ford KR, DiCesare CA, Myer GD, Hewett TE. Real-time biofeedback to target risk of anterior cruciate ligament injury: a technical report for injury prevention and rehabilitation. J Sport Rehabil 2015; ;Technical Notes. doi: 10.1123/jsr.2013-0138