Bilateral multiligament injury of knee caused by entangled dupatta

Directory of Open Access Journals (Sweden)

Shrinand V Vaidya

2012-01-01

Full Text Available We report a rare case of bilateral multiligament knee injury in an 18-year-old female employed in garment industry. Patient was wearing salwar kameez and dupatta while operating an electric laundry machine. In this case we discuss a peculiar mechanism of injury caused due to wearing dupatta near working site and suggest simple preventive measures.

Sidestep cutting technique and knee abduction loading: implications for ACL prevention exercises.

Science.gov (United States)

Kristianslund, Eirik; Faul, Oliver; Bahr, Roald; Myklebust, Grethe; Krosshaug, Tron

2014-05-01

Sidestep cutting technique is essential in programmes to prevent anterior cruciate ligament (ACL) injury. A better understanding of how technique affects potentially harmful joint loading may improve prevention programmes. The purpose of this study was to investigate the effect of sidestep cutting technique on maximum knee abduction moments. Cross-sectional study. Whole-body kinematics and knee joint kinetics were calculated in 123 female handball players (mean±SD, 22.5±7.0 years, 171±7 cm, 67±7 kg) performing sidestep cutting. Three cuts from each side were analysed. Linear regression was applied between selected technique factors and maximum knee abduction moment during the first 100 ms of the contact phase. Furthermore, we investigated to what degree the abduction moment originated from the magnitude of the ground reaction force (GRF) or the knee abduction moment arm of the GRF. Technique factors explained 62% of the variance in knee abduction moments. Cut width, knee valgus, toe landing, approach speed and cutting angle were the most significant predictors. An increase in one of these factors of 1 SD increased the knee abduction moment from 12% to 19%. The effect of the moment arm of the GRF was more important than the force magnitude for maximum knee abduction moments. Lower knee abduction loads during sidestep cutting may be achieved if cuts are performed as narrow cuts with low knee valgus and toe landings. These factors may be targeted in ACL injury prevention programmes.

Overuse Knee Injuries in Athletes

Directory of Open Access Journals (Sweden)

Miroslav Kezunović

2013-03-01

Full Text Available According to many statistics over 55% of all sports-related injuries are incurred in the knee joint (active sportsmen and recreationists. The statistics definitely differ, depending on type of sport and specific movements habitually performed in a particular sport. Therefore, in addition to acute knee injuries overuse syndromes are common in the knee area also due to specificities of patellofemoral joint just because specific diseases like „jumper's knee“ and „runner's knee“ are related to certain sport activities. Generally speaking, these syndromes occur due to poor orientation of the knee extensor mechanism, i.e. friction of iliotibial band and patellofemoral chondromalacia. It is believed that about 45% of all overuse syndromes in the knee area occur as a result of running.

Knee Injuries Are Associated with Accelerated Knee Osteoarthritis Progression: Data from the Osteoarthritis Initiative

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Driban, Jeffrey B.; Eaton, Charles B.; Lo, Grace H.; Ward, Robert J.; Lu, Bing; McAlindon, Timothy E.

2014-01-01

Objective We aimed to evaluate if a recent knee injury was associated with accelerated knee osteoarthritis (KOA) progression. Methods In the Osteoarthritis Initiative (OAI) we studied participants free of KOA on their baseline radiographs (Kellgren-Lawrence [KL]knee that progressed to end-stage KOA (KL Grade 3 or 4) within 48 months, 2) common KOA progression: at least one knee increased in radiographic scoring within 48 months (excluding those defined as accelerated KOA), and 3) no KOA: no change in KL grade in either knee. At baseline, participants were asked if their knees had ever been injured and at each annual visit they were asked about injuries during the prior 12 months. We used multinomial logistic regressions to determine if a new knee injury was associated with the outcome of accelerated KOA or common KOA progression after adjusting for age, sex, body mass index, static knee malalignment, and systolic blood pressure. Results A knee injury during the total observation period was associated with accelerated KOA progression (n=54, odds ratio [OR]=3.14) but not common KOA progression (n=187, OR=1.08). Furthermore, a more recent knee injury (within a year of the outcome) was associated with accelerated (OR=8.46) and common KOA progression (OR=3.12). Conclusion Recent knee injuries are associated with accelerated KOA. Most concerning is that certain injuries may be associated with a rapid cascade towards joint failure in less than one year. PMID:24782446

Knee Injury and Osteoarthritis Outcome Score (KOOS)

DEFF Research Database (Denmark)

Collins, N J; Prinsen, C A C; Christensen, R

2016-01-01

OBJECTIVE: To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). DESIGN: A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties in partici......OBJECTIVE: To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). DESIGN: A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties...... in participants with knee injuries and/or osteoarthritis (OA). Methodological quality was evaluated using the COSMIN checklist. Where possible, meta-analysis of extracted data was conducted for all studies and stratified by age and knee condition; otherwise narrative synthesis was performed. RESULTS: KOOS has...... adequate internal consistency, test-retest reliability and construct validity in young and old adults with knee injuries and/or OA. The ADL subscale has better content validity for older patients and Sport/Rec for younger patients with knee injuries, while the Pain subscale is more relevant for painful...

Noninjured Knees of Patients With Noncontact ACL Injuries Display Higher Average Anterior and Internal Rotational Knee Laxity Compared With Healthy Knees of a Noninjured Population.

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Mouton, Caroline; Theisen, Daniel; Meyer, Tim; Agostinis, Hélène; Nührenbörger, Christian; Pape, Dietrich; Seil, Romain

2015-08-01

Excessive physiological anterior and rotational knee laxity is thought to be a risk factor for noncontact anterior cruciate ligament (ACL) injuries and inferior reconstruction outcomes, but no thresholds have been established to identify patients with increased laxity. (1) To determine if the healthy contralateral knees of ACL-injured patients have greater anterior and rotational knee laxity, leading to different laxity profiles (combination of laxities), compared with healthy control knees and (2) to set a threshold to help discriminate anterior and rotational knee laxity between these groups. Case-sectional study; Level of evidence, 3. A total of 171 healthy contralateral knees of noncontact ACL-injured patients (ACL-H group) and 104 healthy knees of control participants (CTL group) were tested for anterior and rotational laxity. Laxity scores (measurements corrected for sex and body mass) were used to classify knees as hypolax (score 1). Proportions of patients in each group were compared using χ(2) tests. Receiver operating characteristic curves were computed to discriminate laxity between the groups. Odds ratios were calculated to determine the probability of being in the ACL-H group. The ACL-H group displayed greater laxity scores for anterior displacement and internal rotation in their uninjured knee compared with the CTL group (P knees of patients with noncontact ACL injuries display different laxity values both for internal rotation and anterior displacement compared with healthy control knees. The identification of knee laxity profiles may be of relevance for primary and secondary prevention programs of noncontact ACL injuries. © 2015 The Author(s).

Knee injuries in football

African Journals Online (AJOL)

swimming and basketball.1 In 2001 it was reported to have injury rates of 1 000 times ... knee injury in football are the age of the player, a previous injury and the ligamentous .... football is possible, although the success rates may vary from ...

Knee injury and obesity in patients undergoing total knee replacement: a retrospective study in 115 patients

DEFF Research Database (Denmark)

Jensen, Claus Hjorth; Rofail, S

1999-01-01

The prevalence of obesity and previous knee injury was assessed in a retrospective study of 115 patients under-going total knee replacement due to osteoarthritis. Obesity was considered a contributing factor in the development of osteoarthritis in 37% of the patients, and 33% of the patients had...... had an injury to the knee in question. Unilateral osteoarthritis was significantly more frequent than bilateral osteoarthritis among patients with a history of previous knee injury. The association of previous injury to the knee and unilateral osteoarthritis was stronger in men than women. Aggressive...... treatment of patients with knee injuries seems warranted....

Cartilage Injuries in the Adult Knee

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Moyad, Thomas F.

2011-01-01

Cartilage injuries are frequently recognized as a source of significant morbidity and pain in patients with previous knee injuries. The majority of patients who undergo routine knee arthroscopy have evidence of a chondral defect. These injuries represent a continuum of pathology from small, asymptomatic lesions to large, disabling defects affecting a major portion of one or more compartments within the knee joint. In comparison to patients with osteoarthritis, individuals with isolated chondral surface damage are often younger, significantly more active, and usually less willing to accept limitations in activities that require higher impact. At the present time, a variety of surgical procedures exist, each with their unique indications. This heterogeneity of treatment options frequently leads to uncertainty regarding which techniques, if any, are most appropriate for patients. The purpose of this review is to describe the workup and discuss the management techniques for cartilage injuries within the adult knee. PMID:26069581

Weight-training injuries. Common injuries and preventative methods.

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Mazur, L J; Yetman, R J; Risser, W L

1993-07-01

The use of weights is an increasingly popular conditioning technique, competitive sport and recreational activity among children, adolescents and young adults. Weight-training can cause significant musculoskeletal injuries such as fractures, dislocations, spondylolysis, spondylolisthesis, intervertebral disk herniation, and meniscal injuries of the knee. Although injuries can occur during the use of weight machines, most apparently happen during the aggressive use of free weights. Prepubescent and older athletes who are well trained and supervised appear to have low injury rates in strength training programmes. Good coaching and proper weightlifting techniques and other injury prevention methods are likely to minimise the number of musculoskeletal problems caused by weight-training.

Increasing hip and knee flexion during a drop-jump task reduces tibiofemoral shear and compressive forces: implications for ACL injury prevention training.

Science.gov (United States)

Tsai, Liang-Ching; Ko, Yi-An; Hammond, Kyle E; Xerogeanes, John W; Warren, Gordon L; Powers, Christopher M

2017-12-01

Although most ACL injury prevention programmes encourage greater hip and knee flexion during landing, it remains unknown how this technique influences tibiofemoral joint forces. We examined whether a landing strategy utilising greater hip and knee flexion decreases tibiofemoral anterior shear and compression. Twelve healthy women (25.9 ± 3.5 years) performed a drop-jump task before and after a training session (10-15 min) that emphasised greater hip and knee flexion. Peak tibiofemoral anterior shear and compressive forces were calculated using an electromyography (EMG)-driven knee model that incorporated joint kinematics, EMG and participant-specific muscle volumes and patella tendon orientation measured using magnetic resonance imaging (MRI). Participants demonstrated a decrease in peak anterior tibial shear forces (11.1 ± 3.3 vs. 9.6 ± 2.7 N · kg -1 ; P = 0.008) and peak tibiofemoral compressive forces (68.4 ± 7.6 vs. 62.0 ± 5.5 N · kg -1 ; P = 0.015) post-training. The decreased peak anterior tibial shear was accompanied by a decrease in the quadriceps anterior shear force, while the decreased peak compressive force was accompanied by decreased ground reaction force and hamstring forces. Our data provide justification for injury prevention programmes that encourage greater hip and knee flexion during landing to reduce tibiofemoral joint loading.

Association of Obesity, Parity, and History of Knee Injury with Knee Osteoarthritis in Female

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Ade Triyadi

2015-12-01

Full Text Available Background: Osteoarthritis is the most joint disorder among elderly. There are a lot of risk factors of knee osteoarthritis. Obesity and high frequent of parity can increase the load on knee joint. Knee injury also decreases the stability of knee joint on bearing body load. This study was conducted to observe the association of obesity, parity ≥3 times and history of knee injury with the occurrence of knee osteoarthritis in female aged >50 years old. Methods: Case control design was chosen in this study. Female patients with age >50 years were recruited by consecutive sampling from rheumatology clinic at Dr. Hasan Sadikin General Hospital Bandung. Data were collected from August to September 2013. Minimal sample size was 60 samples calculated by rule of thumb formula. Obesity was measured by body mass index (BMI. Parity and history of knee injury were assessed by questionnaire. Those variables were analyzed by logistic regression method. Result: Obesity did not associate with knee osteoarthritis in this study, p=0.549 (odd ratio (OR 1.32, 95% confidence interval (CI 0.52–3.32. Parity was associated with knee osteoarthritis in this study p=0.001 (OR 4.7, 95% CI 1.89–11.68. History of knee injury was associated with knee osteoarthritis in this study, p=0.001 (OR 6.19, 95% CI 2.01–18.99. Conclusions: Parity ≥3 times and history of knee injury were associated with the occurrence of knee osteoarthritis. Obesity was not associated with the occurrence of knee osteoarthritis.

Injury risk curves for the skeletal knee-thigh-hip complex for knee-impact loading.

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Rupp, Jonathan D; Flannagan, Carol A C; Kuppa, Shashi M

2010-01-01

Injury risk curves for the skeletal knee-thigh-hip (KTH) relate peak force applied to the anterior aspect of the flexed knee, the primary source of KTH injury in frontal motor-vehicle crashes, to the probability of skeletal KTH injury. Previous KTH injury risk curves have been developed from analyses of peak knee-impact force data from studies where knees of whole cadavers were impacted. However, these risk curves either neglect the effects of occupant gender, stature, and mass on KTH fracture force, or account for them using scaling factors derived from dimensional analysis without empirical support. A large amount of experimental data on the knee-impact forces associated with KTH fracture are now available, making it possible to estimate the effects of subject characteristics on skeletal KTH injury risk by statistically analyzing empirical data. Eleven studies were identified in the biomechanical literature in which the flexed knees of whole cadavers were impacted. From these, peak knee-impact force data and the associated subject characteristics were reanalyzed using survival analysis with a lognormal distribution. Results of this analysis indicate that the relationship between peak knee-impact force and the probability of KTH fracture is a function of age, total body mass, and whether the surface that loads the knee is rigid. Comparisons between injury risk curves for the midsize adult male and small adult female crash test dummies defined in previous studies and new risk curves for these sizes of occupants developed in this study suggest that previous injury risk curves generally overestimate the likelihood of KTH fracture at a given peak knee-impact force. Future work should focus on defining the relationships between impact force at the human knee and peak axial compressive forces measured by load cells in the crash test dummy KTH complex so that these new risk curves can be used with ATDs.

Impact of associated injuries in the Floating knee: A retrospective study

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Rethnam, Ulfin; Yesupalan, Rajam S; Nair, Rajagopalan

2009-01-01

Background Floating knee injuries are usually associated with other significant injuries. Do these injuries have implications on the management of the floating knee and the final outcome of patients? Our study aims to assess the implications of associated injuries in the management and final outcome of floating knee. Methods 29 patients with floating knees were assessed in our institution. A retrospective analysis of medical records and radiographs were done and all associated injuries were identified. The impact of associated injuries on delay in initial surgical management, delay in rehabilitation & final outcome of the floating knee were assessed. Results 38 associated injuries were noted. 7 were associated with ipsilateral knee injuries. Lower limb injuries were most commonly associated with the floating knee. Patients with some associated injuries had a delay in surgical management and others a delay in post-operative rehabilitation. Knee ligament and vascular injuries were associated with poor outcome. Conclusion The associated injuries were quite frequent with the floating knee. Some of the associated injuries caused a delay in surgical management and post-operative rehabilitation. In assessment of the final outcome, patients with associated knee and vascular injuries had a poor prognosis. Majority of the patients with associated injuries had a good or excellent outcome. PMID:19144197

Soft tissue twisting injuries of the knee

International Nuclear Information System (INIS)

Magee, T.; Shapiro, M.

2001-01-01

Twisting injuries occur as a result of differential motion of different tissue types in injuries with some rotational force. These injuries are well described in brain injuries but, to our knowledge, have not been described in the musculoskeletal literature. We correlated the clinical examination and MR findings of 20 patients with twisting injuries of the soft tissues around the knee. Design and patients: We prospectively followed the clinical courses of 20 patients with knee injuries who had clinical histories and MR findings to suggest twisting injuries of the subcutaneous tissues. Patients with associated internal derangement of the knee (i.e., meniscal tears, ligamentous or bone injuries) were excluded from this study. MR findings to suggest twisting injuries included linear areas of abnormal dark signal on T1-weighted sequences and abnormal bright signal on T2-weighted or short tau inversion recovery (STIR) sequences and/or signal to suggest hemorrhage within the subcutaneous tissues. These MR criteria were adapted from those established for indirect musculotendinous junction injuries. Results: All 20 patients presented with considerable pain that suggested internal derangement on physical examination by the referring orthopedic surgeons. All presented with injuries associated with rotational force. The patients were placed on a course of protected weight-bearing of the affected extremity for 4 weeks. All patients had pain relief by clinical examination after this period of protected weight-bearing. Twisting injuries of the soft tissues can result in considerable pain that can be confused with internal derangement of the knee on physical examination. Soft tissue twisting injuries need to be recognized on MR examinations as they may be the cause of the patient's pain despite no MR evidence of internal derangement of the knee. The demonstration of soft tissue twisting injuries in a patient with severe knee pain but no documented internal derangement on MR

Compartment syndrome and popliteal vascular injury complicating unicompartmental knee arthroplasty

NARCIS (Netherlands)

Kort, Nanne Pieter; Van Raay, Jos J. J. A. M.; van Horn, Jim R.

Popliteal vascular injury and the compartment syndrome of the leg are rare but important complications of knee arthroplasties. Early diagnosis and treatment are of paramount importance in preventing the devastating complications of these conditions. To our knowledge, these complications have not

Incidence, aetiology and prevention of musculoskeletal injuries in volleyball: A systematic review of the literature.

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Kilic, O; Maas, M; Verhagen, E; Zwerver, J; Gouttebarge, V

2017-07-01

Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies.

Collateral Ligament Knee Injuries in Pediatric and Adolescent Athletes.

Science.gov (United States)

Kramer, Dennis E; Miller, Patricia E; Berrahou, Iman K; Yen, Yi-Meng; Heyworth, Benton E

2017-12-08

The majority of research on medial (MCL) and lateral (LCL) collateral ligament injuries has focused on adults and combined collateral/cruciate injuries. The purpose of this study was to determine characteristics associated with isolated collateral ligament injuries in adolescents, and assess timing for return to sports. Electronic medical records were queried to identify patients aged below 17 years who sustained a magnetic resonance imaging-confirmed isolated MCL or LCL injury over an 8-year period. Retrospective review then documented patient and injury characteristics and clinical course. General linear modeling was used to analyze risk factors for prolonged return to sports, continued pain or reinjury. Fifty-one knees (33 in males, 65%), mean age 13.8 years (range, 5 to 17), were identified, of which 40 (78%) had MCL injuries. Over half (29, 57%) of knees had an open distal femoral physis including all 5 bony avulsion injuries. Eleven (22%) had LCL injuries of which 3 (6%) had concurrent posterolateral corner injuries. Forty-two (82%) knees had injuries that occurred during sports. Eleven knees (28%) with MCL tears had a simultaneous patellar instability episode. Knee injuries that occurred during sports had 37% shorter recovery time (P=0.02). Eight knees (16%) experienced a reinjury and 12 (24%) were followed over an extended period of time for various knee issues. Football injuries were more likely to be grade 3 (P=0.03), and football and soccer accounted for all grade III injuries. The mean return to sports was 2.2 months, with grade III cases returning at 2.4 months, and 95% of cases within 4 months. Isolated collateral ligament injuries are rare in adolescent athletes. MCL injuries, one-quarter of which occurred in conjunction with patellar instability events, were 4 times more common than LCL injuries, one quarter of which have other posterolateral corner structures involved. Grade III injuries represent 20% to 25% of collateral ligament injuries and

A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?

Directory of Open Access Journals (Sweden)

Duncan KJ

2016-01-01

Full Text Available Koji J Duncan, Jaclyn N Chopp-Hurley, Monica R Maly School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada Purpose: Among a variety of conservative and surgical options to treat anterior cruciate ligament (ACL injuries, we do not understand which options could potentially prevent knee osteoarthritis (OA. The aim of this systematic review was to examine the evidence pertaining to exercise treatment of ACL injuries in the context of knee OA. Methods: Medline, Embase, CINAHL, PubMed, and PEDro (Physiotherapy Evidence Database databases were systematically searched using keywords encompassed within four primary key terms: knee, osteoarthritis, anterior cruciate ligament, and exercise. Clinical studies evaluating the effect of an exercise treatment for ACL injuries on the development of knee OA in adult humans were included. The PEDro scale was used to critically assess the studies included in the review. Results: Eighteen studies were included in this review, with a median PEDro score of 6/11 (range, 2/11–9/11. Three studies provided statistical evidence that exercise following ACL injury lowered the risk for knee OA development. Nine studies demonstrated no benefit of exercise in preventing knee OA incidence relative to either operative treatment or the contralateral, unaffected knee. However, exercise resulted in higher knee instability. Nonetheless, there were no significant differences in subjective or objective knee outcomes for early versus late ACL reconstruction. Limitations: This review was not registered through PROSPERO. Conclusion: The relationship between a rehabilitative exercise for ACL injuries and long-term knee OA prevalence is inconclusive. However, research suggests initial conservative treatment with optional late ACL reconstruction because this treatment strategy may reduce the risk of knee OA. More research, ideally randomized controlled trials or comparable designs, is required prior to establishing

Utilization and cost of a new model of care for managing acute knee injuries: the Calgary acute knee injury clinic

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Lau Breda HF

2012-12-01

Full Text Available Abstract Background Musculoskeletal disorders (MSDs affect a large proportion of the Canadian population and present a huge problem that continues to strain primary healthcare resources. Currently, the Canadian healthcare system depicts a clinical care pathway for MSDs that is inefficient and ineffective. Therefore, a new inter-disciplinary team-based model of care for managing acute knee injuries was developed in Calgary, Alberta, Canada: the Calgary Acute Knee Injury Clinic (C-AKIC. The goal of this paper is to evaluate and report on the appropriateness, efficiency, and effectiveness of the C-AKIC through healthcare utilization and costs associated with acute knee injuries. Methods This quasi-experimental study measured and evaluated cost and utilization associated with specific healthcare services for patients presenting with acute knee injuries. The goal was to compare patients receiving care from two clinical care pathways: the existing pathway (i.e. comparison group and a new model, the C-AKIC (i.e. experimental group. This was accomplished through the use of a Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ. Results Data from 138 questionnaires were analyzed in the experimental group and 136 in the comparison group. A post-hoc analysis determined that both groups were statistically similar in socio-demographic characteristics. With respect to utilization, patients receiving care through the C-AKIC used significantly less resources. Overall, patients receiving care through the C-AKIC incurred 37% of the cost of patients with knee injuries in the comparison group and significantly incurred less costs when compared to the comparison group. The total aggregate average cost for the C-AKIC group was $2,549.59 compared to $6,954.33 for the comparison group (p Conclusions The Calgary Acute Knee Injury Clinic was able to manage and treat knee injured patients for less cost than the existing state of healthcare delivery. The

A conceptual framework for a sports knee injury performance profile (SKIPP) and return to activity criteria (RTAC).

Science.gov (United States)

Logerstedt, David; Arundale, Amelia; Lynch, Andrew; Snyder-Mackler, Lynn

2015-01-01

Injuries to the knee, including intra-articular fractures, ligamentous ruptures, and meniscal and articular cartilage lesions, are commonplace within sports. Despite advancements in surgical techniques and enhanced rehabilitation, athletes returning to cutting, pivoting, and jumping sports after a knee injury are at greater risk of sustaining a second injury. The clinical utility of objective criteria presents a decision-making challenge to ensure athletes are fully rehabilitated and safe to return to sport. A system centered on specific indicators that can be used to develop a comprehensive profile to monitor rehabilitation progression and to establish return to activity criteria is recommended to clear athletes to begin a progressive and systematic approach to activities and sports. Integration of a sports knee injury performance profile with return to activity criteria can guide clinicians in facilitating an athlete's safe return to sport, prevention of subsequent injury, and life-long knee joint health.

Preventing musculoskeletal injuries among recreational adult volleyball players : design of a randomised prospective controlled trial

NARCIS (Netherlands)

Gouttebarge, Vincent; Zwerver, Johannes; Verhagen, Evert

2017-01-01

BACKGROUND: Both acute and overuse injuries are common among recreational volleyball players, especially finger/wrist, ankle, shoulder and knee injuries. Consequently, an intervention ('VolleyVeilig') was developed to prevent or reduce the occurrence of finger/wrist, shoulder, knee and ankle

Preventing musculoskeletal injuries among recreational adult volleyball players: design of a randomised prospective controlled trial

NARCIS (Netherlands)

Gouttebarge, Vincent; Zwerver, Johannes; Verhagen, Evert

2017-01-01

Background: Both acute and overuse injuries are common among recreational volleyball players, especially finger/wrist, ankle, shoulder and knee injuries. Consequently, an intervention ('VolleyVeilig') was developed to prevent or reduce the occurrence of finger/wrist, shoulder, knee and ankle

Safe Care to Knee Injuries in Athletes

Directory of Open Access Journals (Sweden)

Gerardo Águila Tejeda

2013-04-01

Full Text Available Background: the guarantee of sporting success lies in the appropriate functioning of the musculoskeletal system, given that its vulnerability hinders the performance of each athlete. Being timely is critical to provide safe care to the affections of knee; late diagnosis in this system may lead to the development of complications and hinder sport practice. Objective: to characterize knee injuries in athletes of the sport system in the province of Cienfuegos.Methods: an observational, quantitative and qualitative, longitudinal and retrospective study was conducted. It included 104 athletes who attended the Traumatology Consultation from 2009 to 2011, presenting different types of knee injuries in various stages of training. Variables such as age, sex, sport, site of injury, stage of training, kilocalories consumed, type of training, quality of equipment and diagnosis were analyzed. The procedure used consists of a comprehensive review of case notes and medical records of all patients that attended consultation during the period analyzed, from which the necessary data was collected. Interviews with coaches and technical staff were carried out as well. Results: knee injuries occur in all ages of athletes, with a slight predominance of males. Highest frequencies are those of the ligament and meniscus, with the highest incidence in athletics, volleyball and judo. Conservative treatment predominated.Conclusions: knee injuries require a timely treatment in order to achieve athlete's success and safety.

An Evidence-Based Framework for Strengthening Exercises to Prevent Hamstring Injury.

Science.gov (United States)

Bourne, Matthew N; Timmins, Ryan G; Opar, David A; Pizzari, Tania; Ruddy, Joshua D; Sims, Casey; Williams, Morgan D; Shield, Anthony J

2018-02-01

Strength training is a valuable component of hamstring strain injury prevention programmes; however, in recent years a significant body of work has emerged to suggest that the acute responses and chronic adaptations to training with different exercises are heterogeneous. Unfortunately, these research findings do not appear to have uniformly influenced clinical guidelines for exercise selection in hamstring injury prevention or rehabilitation programmes. The purpose of this review was to provide the practitioner with an evidence-base from which to prescribe strengthening exercises to mitigate the risk of hamstring injury. Several studies have established that eccentric knee flexor conditioning reduces the risk of hamstring strain injury when compliance is adequate. The benefits of this type of training are likely to be at least partly mediated by increases in biceps femoris long head fascicle length and improvements in eccentric knee flexor strength. Therefore, selecting exercises with a proven benefit on these variables should form the basis of effective injury prevention protocols. In addition, a growing body of work suggests that the patterns of hamstring muscle activation diverge significantly between different exercises. Typically, relatively higher levels of biceps femoris long head and semimembranosus activity have been observed during hip extension-oriented movements, whereas preferential semitendinosus and biceps femoris short head activation have been reported during knee flexion-oriented movements. These findings may have implications for targeting specific muscles in injury prevention programmes. An evidence-based approach to strength training for the prevention of hamstring strain injury should consider the impact of exercise selection on muscle activation, and the effect of training interventions on hamstring muscle architecture, morphology and function. Most importantly, practitioners should consider the effect of a strength training programme on

Knee injuries in skiing. A prospective study from northern Sweden.

Science.gov (United States)

Edlund, G; Gedda, S; Hemborg, A

1980-01-01

This paper evaluates 420 ski injuries occurring in Northern Sweden in 1977. Our main aim was to correlate knee injuries with types of skiing and to note a change in incidence with evolution of equipment. Fifty-eight lesions (13.8%) affected the knee joint which is about the same frequency as 10 years earlier nor has introduction of high stiff boots in downhill skiing increased incidence of knee injuries. Cross-country and long-distance skiing produced more knee injuries (24.7%) than downhill skiing (11.4%). Cross-country skiers were older and more women in this group sustained knee injuries. The use of non-release type bindings is probably the main reason for this higher incidence but age and different skiing techniques seem to contribute.

The Knee injury and Osteoarthritis Outcome Score (KOOS)

DEFF Research Database (Denmark)

Roos, Ewa M.; Lohmander, L Stefan

2003-01-01

The Knee injury and Osteoarthritis Outcome Score (KOOS) was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and long-term symptoms and function in subjects with knee injury and osteoarthritis. The KOOS holds five separately scored subscales...... be used for short-term and long-term follow-up of several types of knee injury including osteoarthritis. The measure is relatively new and further use of the instrument will add knowledge and suggest areas that need to be further explored and improved....

Trunk and hip control neuromuscular training for the prevention of knee joint injury.

Science.gov (United States)

Myer, Gregory D; Chu, Donald A; Brent, Jensen L; Hewett, Timothy E

2008-07-01

This article provide evidences to outline a novel theory used to define the mechanisms related to increased risk of ACL injury in female athletes. In addition, this discussion will include theoretical constructs for the description of the mechanisms that lead to increased risk. Finally, a clinical application section will outline novel neuromuscular training techniques designed to target deficits that underlie the proposed mechanism of increased risk of knee injury in female athletes.

ASSOCIATION OF ISOMETRIC STRENGTH OF HIP AND KNEE MUSCLES WITH INJURY RISK IN HIGH SCHOOL CROSS COUNTRY RUNNERS.

Science.gov (United States)

Luedke, Lace E; Heiderscheit, Bryan C; Williams, D S Blaise; Rauh, Mitchell J

2015-11-01

High school cross country runners have a high incidence of overuse injuries, particularly to the knee and shin. As lower extremity strength is modifiable, identification of strength attributes that contribute to anterior knee pain (AKP) and shin injuries may influence prevention and management of these injuries. To determine if a relationship existed between isometric hip abductor, knee extensor and flexor strength and the incidence of AKP and shin injury in high school cross country runners. Sixty-eight high school cross country runners (47 girls, 21 boys) participated in the study. Isometric strength tests of hip abductors, knee extensors and flexors were performed with a handheld dynamometer. Runners were prospectively followed during the 2014 interscholastic cross country season for occurrences of AKP and shin injury. Bivariate logistic regression was used to examine risk relationships between strength values and occurrence of AKP and shin injury. During the season, three (4.4%) runners experienced AKP and 13 (19.1%) runners incurred a shin injury. Runners in the tertiles indicating weakest hip abductor (chi-square = 6.140; p=0.046), knee extensor (chi-square = 6.562; p=0.038), and knee flexor (chi-square = 6.140; p=0.046) muscle strength had a significantly higher incidence of AKP. Hip and knee muscle strength was not significantly associated with shin injury. High school cross country runners with weaker hip abductor, knee extensor and flexor muscle strength had a higher incidence of AKP. Increasing hip and knee muscle strength may reduce the likelihood of AKP in high school cross country runners. 2b.

Association between MRI-defined osteoarthritis, pain, function and strength 3-10 years following knee joint injury in youth sport.

Science.gov (United States)

Whittaker, Jackie L; Toomey, Clodagh M; Woodhouse, Linda J; Jaremko, Jacob L; Nettel-Aguirre, Alberto; Emery, Carolyn A

2017-10-10

Youth and young adults who participate in sport have an increased risk of knee injury and subsequent osteoarthritis. Improved understanding of the relationship between structural and clinical outcomes postinjury could inform targeted osteoarthritis prevention interventions. This secondary analysis examines the association between MRI-defined osteoarthritis and self-reported and functional outcomes, 3-10 years following youth sport-related knee injury in comparison to healthy controls. Participants included a subsample (n=146) of the Alberta Youth Prevention of Early Osteoarthritis cohort: specifically, 73 individuals with 3-10 years history of sport-related intra-articular knee injury and 73 age-matched, sex-matched and sport-matched controls with completed MRI studies. Outcomes included: MRI-defined osteoarthritis, radiographic osteoarthritis, Knee Injury and Osteoarthritis Outcome Score, Intermittent and Constant Osteoarthritis Pain, knee extensor/flexor strength, triple-hop and Y-balance test. Descriptive statistics and univariate logistic regression were used to compare those with and without MRI-defined osteoarthritis. Associations between MRI-defined osteoarthritis and each outcome were assessed using multivariable linear regression considering the influence of injury history, sex, body mass index and time since injury. Participant median age was 23 years (range 15-27), and 63% were female. MRI-defined osteoarthritis varied by injury history, injury type and surgical history and was not isolated to participants with ACL and/or meniscal injuries. Those with a previous knee injury had 10-fold (95% CI 2.3 to 42.8) greater odds of MRI-defined osteoarthritis than uninjured participants. MRI-defined osteoarthritis was independently significantly associated with quality of life, but not symptoms, strength or function. MRI-detected structural changes 3-10 years following youth sport-related knee injury may not dictate clinical symptomatology, strength or function

A conceptual framework for a sports knee injury performance profile (SKIPP and return to activity criteria (RTAC

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David Logerstedt

2015-10-01

Full Text Available ABSTRACTInjuries to the knee, including intra-articular fractures, ligamentous ruptures, and meniscal and articular cartilage lesions, are commonplace within sports. Despite advancements in surgical techniques and enhanced rehabilitation, athletes returning to cutting, pivoting, and jumping sports after a knee injury are at greater risk of sustaining a second injury. The clinical utility of objective criteria presents a decision-making challenge to ensure athletes are fully rehabilitated and safe to return to sport. A system centered on specific indicators that can be used to develop a comprehensive profile to monitor rehabilitation progression and to establish return to activity criteria is recommended to clear athletes to begin a progressive and systematic approach to activities and sports. Integration of a sports knee injury performance profile with return to activity criteria can guide clinicians in facilitating an athlete's safe return to sport, prevention of subsequent injury, and life-long knee joint health.

Lower limb fractures associated with multiligament knee injury

Science.gov (United States)

Stagnaro, Joaquin; Yacuzzi, Carlos; Barla, Jorge; Zicaro, Juan Pablo; Costa-Paz, Matias

2017-01-01

Objectives: Knee ligament injuries related to lower limb fractures are common and frequently unnoticed. Management of acute polytrauma is usually focused in the bone lesion and a complete physical examination might be really difficult. The purpose of this study was to analyze a series of patients who suffered multiligament knee injuries associated to a lower limb fracture. Hypothesis: The use of magnetic resonance imaging (MRI) during the initial management can lead to an early diagnosis of ligament injuries. Methods: A retrospective search was conducted from our hospital´s electronic database. We evaluated the initial diagnosis and acute surgical treatment, and management and functional outcomes after the ligament lesion was diagnosed. Results: Seven patients who presented a knee multiligament injury associated with a lower limb fracture were evaluated. The average age was 29 years. Primary diagnoses were: four tibial plateau fractures; one open fracture-dislocation of the knee; one open leg fracture and ipsilateral hip dislocation; and one bifocal femur fracture. Only three patients had an MRI during the initial management of trauma. Six out of seven patients had to be operated on for the multiligament knee injury. The period between the resolution of the fracture and the ligamentous repair was from 3 to 24 months. Conclusion: Poor functional outcomes are reported in patients with multiligament knee injuries associated with high-energy lower limb fractures. We consider an MRI during the initial management can lead to better outcomes. A trauma surgeon working alongside an arthroscopic surgeon might optimize the results for these lesions.

Effects of sports injury prevention training on the biomechanical risk factors of anterior cruciate ligament injury in high school female basketball players.

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Lim, Bee-Oh; Lee, Yong Seuk; Kim, Jin Goo; An, Keun Ok; Yoo, Jin; Kwon, Young Hoo

2009-09-01

Female athletes have a higher risk of anterior cruciate ligament injury than their male counterparts who play at similar levels in sports involving pivoting and landing. The competitive female basketball players who participated in a sports injury prevention training program would show better muscle strength and flexibility and improved biomechanical properties associated with anterior cruciate ligament injury than during the pretraining period and than posttraining parameters in a control group. Controlled laboratory study. A total of 22 high school female basketball players were recruited and randomly divided into 2 groups (the experimental group and the control group, 11 participants each). The experimental group was instructed in the 6 parts of the sports injury prevention training program and performed it during the first 20 minutes of team practice for the next 8 weeks, while the control group performed their regular training program. Both groups were tested with a rebound-jump task before and after the 8-week period. A total of 21 reflective markers were placed in preassigned positions. In this controlled laboratory study, a 2-way analysis of variance (2 x 2) experimental design was used for the statistical analysis (P training effects on all strength parameters (P = .004 to .043) and on knee flexion, which reflects increased flexibility (P = .022). The experimental group showed higher knee flexion angles (P = .024), greater interknee distances (P = .004), lower hamstring-quadriceps ratios (P = .023), and lower maximum knee extension torques (P = .043) after training. In the control group, no statistical differences were observed between pretraining and posttraining findings (P = .084 to .873). At pretraining, no significant differences were observed between the 2 groups for any parameter (P = .067 to .784). However, a comparison of the 2 groups after training revealed that the experimental group had significantly higher knee flexion angles (P = .023

A Hypothesis: Could Portable Natural Grass be a Risk Factor for Knee Injuries?

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Orchard, John; Rodas, Gil; Til, Lluis; ArdevÒl, Jordi; Chivers, Ian

2008-01-01

Previous study has shown a likely link between increased shoe- surface traction and risk of knee Anterior Cruciate Ligament (ACL) injury. Portable natural grass systems are being used more often in sport, but no study to date has investigated their relative safety. By their nature, they must have high resistance to falling apart and therefore newly laid systems may be at risk of creating excessive shoe-surface traction. This study describes two clusters of knee injuries (particularly non-contact ACL injuries), each occurring to players of one professional football team at single venue, using portable grass, in a short space of time. The first series included two ACL injuries, one posterolateral complex disruption and one lateral ligament tear occurring in two rugby league games on a portable bermudagrass surface in Brisbane, Australia. The second series included four non-contact ACL injuries over a period of ten weeks in professional soccer games on a portable Kentucky bluegrass/perennial ryegrass surface in Barcelona, Spain. Possible intrinsic risk factors are discussed but there was no common risk shared by the players. Although no measures of traction were made at the Brisbane venue, average rotational traction was measured towards the end of the injury cluster at Camp Nou, Barcelona, to be 48 Nm. Chance undoubtedly had a part to play in these clusters, but the only obvious common risk factor was play on a portable natural grass surface soon after it was laid. Further study is required to determine whether portable natural grass systems may exhibit high shoe-surface traction soon after being laid and whether this could be a risk factor for knee injury. Key pointsExcessive shoe-surface traction is a hypothesised risk factor for knee ligament injuries, including anterior cruciate ligament injuries.Portable natural grass systems (by their nature in order to prevent grass rolls or squares from falling apart) will tend to exhibit high resistance to tearing when first

Magnetic resonance imaging of knee injuries in children

International Nuclear Information System (INIS)

King, S.J.

1997-01-01

The appearances of knee injuries on MR imaging are less well documented in children than adults. Some patterns of injury are shared by both groups of patients, e. g. meniscal damage. The frequency of specific injuries may differ, e. g. anterior cruciate ligament (ACL) tear. Congenital abnormality, coexistent pathology and previous treatment of the knee appear to be associated with meniscal problems. Discoid menisci are seen most frequently in children and have unique features on MR scans. Cruciate ligament tears are difficult to diagnose in the smallest children. The ACL may not be identified due to its small size. Normal bone marrow signal may be confused with marrow infiltration or bone microfracture. Radiographically occult fractures around the knee appear to be strongly associated with ligamentous injury as in adult patients. Osteochondral fractures, osteochondral lesions and articular cartilage damage are revealed on MR scans, but their long-term effects are uncertain. It is possible to diagnose a range of knee injuries on MR scans in children. The biggest diagnostic challenge is in pre-school children. (orig.). With 9 figs., 1 tab

Effect of Interventions on Potential, Modifiable Risk Factors for Knee Injury in Team Ball Sports : A Systematic Review

NARCIS (Netherlands)

ter Stege, Marloes H. P.; Dallinga, Joan M.; Benjaminse, Anne; Lemmink, Koen A. P. M.

2014-01-01

Background Knee injuries are one of the most common types of injuries in team ball sports, and prevention is crucial because of health and economic implications. To set up effective prevention programs, these programs must be designed to target potential, modifiable risk factors. In addition, it is

How Anterior Cruciate Ligament Injury was averted during Knee Collapse in a NBA Point Guard.

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Schilaty, Nathan D; Bates, Nathaniel A; Krych, Aaron J; Hewett, Timothy E

2017-01-01

Non-contact anterior cruciate ligament (ACL) injuries occur with rapid decelerations and pivoting. A recent injury to a high-level National Basketball Association (NBA) player demonstrated neuromuscular control and injury-sparing mechanisms that resulted in only minor ligament injury to the medial collateral ligament. We analyzed biomechanical mechanisms via publically available orthogonal 2-D video to demonstrate how this potential ACL injury was averted. Analysis of the knee injury mechanism demonstrated that the NBA player experienced low ground reaction force, high sagittal plane flexion, and maintenance of frontal plane stability with neuromuscular control. The outcome of these factors inhibited dynamic valgus collapse of the knee throughout the fall, avoiding ACL injury - a potentially career-altering injury. Many athletes, professional and recreational, will be subjected to similar mechanisms of injury and will have improved outcomes if they can successfully utilize preventive strategies of neuromuscular control to limit injury mechanisms.

Risk Factors for Knee Injuries in Children 8-15 Years

DEFF Research Database (Denmark)

Junge, Tina; Runge, Lisbeth; Juul-Kristensen, Birgit

2016-01-01

.14). For overuse knee injuries, intrinsic risk factors were sex (girls OR 1.38), and previous knee injury (OR 1.78), while participation in soccer (OR 1.64), handball (OR 1.95), basket (OR 2.07), rhythmic (OR 1.98), and tumbling gymnastics (OR 1.74) were additional risk factors. For both injury types, sport...... and participation in soccer, handball, basket, rhythmic and tumbling gymnastics. Further risk factors for both types of injury were participation in sports above two times/week. Although growth-related overuse knee injuries are a self-limiting condition, a major part of children are affected by these injuries...... intrinsic and extrinsic factors for risk of these injuries. METHODS: Weekly musculoskeletal pain, sport participation and sports type were reported by 1326 school children (8-15 years). Knee injuries were classified as traumatic or overuse. Multinomial logistic regression was used for analyses. RESULTS...

Hyperextended Knee: Cause of Serious Injury?

Science.gov (United States)

... Knee and lower leg. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Mosby Elsevier; 2014. http://www.clinicalkey.com. Accessed April 24, 2015. Brooks GP, et al. Treatment of knee injuries in the young athlete. http://www.uptodate.com/ ...

Decreased Knee Joint Loading Associated With Early Knee Osteoarthritis After Anterior Cruciate Ligament Injury.

Science.gov (United States)

Wellsandt, Elizabeth; Gardinier, Emily S; Manal, Kurt; Axe, Michael J; Buchanan, Thomas S; Snyder-Mackler, Lynn

2016-01-01

Anterior cruciate ligament (ACL) injury predisposes individuals to early-onset knee joint osteoarthritis (OA). Abnormal joint loading is apparent after ACL injury and reconstruction. The relationship between altered joint biomechanics and the development of knee OA is unknown. Altered knee joint kinetics and medial compartment contact forces initially after injury and reconstruction are associated with radiographic knee OA 5 years after reconstruction. Case-control study; Level of evidence, 3. Individuals with acute, unilateral ACL injury completed gait analysis before (baseline) and after (posttraining) preoperative rehabilitation and at 6 months, 1 year, and 2 years after reconstruction. Surface electromyographic and knee biomechanical data served as inputs to an electromyographically driven musculoskeletal model to estimate knee joint contact forces. Patients completed radiographic testing 5 years after reconstruction. Differences in knee joint kinetics and contact forces were compared between patients with and those without radiographic knee OA. Patients with OA walked with greater frontal plane interlimb differences than those without OA (nonOA) at baseline (peak knee adduction moment difference: 0.00 ± 0.08 N·m/kg·m [nonOA] vs -0.15 ± 0.09 N·m/kg·m [OA], P = .014; peak knee adduction moment impulse difference: -0.001 ± 0.032 N·m·s/kg·m [nonOA] vs -0.048 ± 0.031 N·m·s/kg·m [OA], P = .042). The involved limb knee adduction moment impulse of the group with osteoarthritis was also lower than that of the group without osteoarthritis at baseline (0.087 ± 0.023 N·m·s/kg·m [nonOA] vs 0.049 ± 0.018 N·m·s/kg·m [OA], P = .023). Significant group differences were absent at posttraining but reemerged 6 months after reconstruction (peak knee adduction moment difference: 0.02 ± 0.04 N·m/kg·m [nonOA] vs -0.06 ± 0.11 N·m/kg·m [OA], P = .043). In addition, the OA group walked with lower peak medial compartment contact forces of the involved limb

Risk Factors for Knee Injuries in Children 8 to 15 Years: The CHAMPS Study DK.

Science.gov (United States)

Junge, Tina; Runge, Lisbeth; Juul-Kristensen, Birgit; Wedderkopp, Niels

2016-04-01

Knee injuries are frequent in children, with most studies reporting traumatic knee injuries. Evidence of risk factors for knee injuries in children is sparse. The purpose of this study was to report the extent of traumatic and overuse knee injuries in children and to evaluate intrinsic and extrinsic factors for risk of these injuries. Weekly musculoskeletal pain, sport participation, and sports type were reported by 1326 school children (8-15 yr). Knee injuries were classified as traumatic or overuse. Multinomial logistic regression was used for analyses. During the study period, 952 (15% traumatic and 85% overuse) knee injuries were diagnosed. Period prevalence for traumatic and overuse knee injuries were 0.8/1000 and 5.4/1000 sport participations, respectively. Participation in tumbling gymnastics was a risk factor for traumatic knee injuries (OR, 2.14). For overuse knee injuries, intrinsic risk factors were sex (girls OR, 1.38) and previous knee injury (OR, 1.78), whereas participation in soccer (OR, 1.64), handball (OR, 1.95), basket (OR, 2.07), rhythmic (OR, 1.98), and tumbling gymnastics (OR, 1.74) were additional risk factors. For both injury types, sport participation above two times per week increased odds (OR, 1.46-2.40). Overuse knee injuries were the most frequent injury type. For traumatic knee injuries, participation in tumbling gymnastics was a risk factor. Risk factors for overuse knee injuries were being a girl; previous knee injury; and participation in soccer, handball, basket, and rhythmic and tumbling gymnastics. Further risk factors for both types of injury were participation in sports above two times per week. Although growth-related overuse knee injuries are a self-limiting condition, a major part of children are affected by these injuries with unknown short- and long-term consequences.

An Investigation of Knee Injury Prevalence and its Mechanism among Premier League Soccer Referees in Iran

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Hamid Mahdavi Mohtasham

2017-03-01

Conclusion: The results of this study highlight the importance of including special training in warm-up programs such as interval training, proprioception exercises, strength training (e.g. Nordic hamstring, flexibility training, and muscular endurance training which have been designed to prevent knee injuries. The results help to design and set-up an injury prevention program for the Referees Committee of the Iranian Football Federation.

The prevention of injuries in contact flag football.

Science.gov (United States)

Kaplan, Yonatan; Myklebust, Grethe; Nyska, Meir; Palmanovich, Ezequiel; Victor, Jan; Witvrouw, Erik

2014-01-01

American flag football is a non-tackle, contact sport with many moderate to severe contact-type injuries reported. A previous prospective injury surveillance study by the authors revealed a high incidence of injuries to the fingers, face, knee, shoulder and ankle. The objectives of the study were to conduct a pilot-prospective injury prevention study in an attempt to significantly reduce the incidence and the severity of injuries as compared to a historical cohort, as well as to provide recommendations for a future prospective injury prevention study. A prospective injury prevention study was conducted involving 724 amateur male (mean age: 20.0 ± 3.1 years) and 114 female (mean age: 21.2 ± 7.2 years) players. Four prevention measures were implemented: the no-pocket rule, self-fitting mouth guards, ankle braces (for those players with recurrent ankle sprains) and an injury treatment information brochure. An injury surveillance questionnaire was administered to record all time-loss injuries sustained in game sessions. There was a statistically significant reduction in the number of injured players, the number of finger/hand injuries, the incidence rate and the incidence proportion between the two cohorts (p football. Prevention strategies for a longer, prospective, randomised-controlled injury prevention study should include the strict enforcement of the no-pocket rule, appropriate head gear, the use of comfortable-fitting ankle braces and mouth guards, and changing the blocking rules of the game.

Mechanisms, Prediction, and Prevention of ACL Injuries: Cut Risk With Three Sharpened and Validated Tools

Science.gov (United States)

Hewett, Timothy E.; Myer, Gregory D.; Ford, Kevin R.; Paterno, Mark V.; Quatman, Carmen E.

2017-01-01

Economic and societal pressures influence modern medical practice to develop and implement prevention strategies. Anterior cruciate ligament (ACL) injury devastates the knee joint leading to short term disability and long term sequelae. Due to the high risk of long term osteoarthritis in all treatment populations following ACL injury, prevention is the only effective intervention for this life-altering disruption in knee health. The “Sequence of Prevention” Model provides a framework to monitor progress towards the ultimate goal of preventing ACL injuries. Utilizing this model, our multidisciplinary collaborative research team has spent the last decade working to delineate injury mechanisms, identify injury risk factors, predict which athletes are at-risk for injury, and develop ACL injury prevention programs. Within this model of injury prevention, modifiable factors (biomechanical and neuromuscular) related to injury mechanisms likely provide the best opportunity for intervention strategies aimed to decrease the risk of ACL injury, particularly in female athletes. Knowledge advancements have led to the development of potential solutions that allow athletes to compete with lowered risk of ACL injury. Design and integration of personalized clinical assessment tools and targeted prevention strategies for athletes at high risk for ACL injury may transform current prevention practices and ultimately significantly reduce ACL injury incidence. This 2016 OREF Clinical Research Award focuses on the authors' work and contributions to the field. The author's acknowledge the many research groups who have contributed to the current state of knowledge in the fields of ACL injury mechanisms, injury risk screening and injury prevention strategies. PMID:27612195

Patella tendon injuries secondary to cement spacers used at first-stage revision of infected total knee replacement

Directory of Open Access Journals (Sweden)

Wasim S Khan

2015-04-01

Full Text Available We describe a series of three patients who sustained patella tendon injuries in infected TKAs following the use of a static cement spacer at first-stage knee revision. The patella tendon injuries resulted in significant compromise to wound healing and knee stability requiring multiple surgeries. The mid-term function was poor with an Oxford score at 24 months ranging from 12-20. Based on our experience, we advise caution in the use of static cement spacer blocks. If they are to be used, we recommend that they should be keyed in the bone to prevent patella tendon injuries.

Association between traumatic bone marrow abnormalities of the knee, the trauma mechanism and associated soft-tissue knee injuries

Energy Technology Data Exchange (ETDEWEB)

Berger, Nicole [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); University of Zurich, Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, Zurich (Switzerland); Andreisek, Gustav; Karer, Anissja T.; Manoliu, Andrei; Ulbrich, Erika J. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Bouaicha, Samy [University Hospital Zurich, Department of Trauma Surgery, Zurich (Switzerland); Naraghi, Ali [University of Toronto, Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, Toronto, ON (Canada); Seifert, Burkhardt [University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Department of Biostatistics, Zurich (Switzerland)

2017-01-15

To determine the association between traumatic bone marrow abnormalities, the knee injury mechanism, and associated soft tissue injuries in a larger cohort than those in the published literature. Retrospective study including 220 patients with traumatic knee injuries. Knee MRIs were evaluated for trauma mechanism, soft tissue injury, and the location of bone marrow abnormalities. The locations of the abnormalities were correlated with trauma mechanisms and soft tissue injuries using the chi-square test with Bonferroni correction. One hundred and forty-four valgus injuries, 39 pivot shift injuries, 25 lateral patellar dislocations, 8 hyperextensions, and 4 dashboard injuries were included. Valgus and pivot shift injuries showed traumatic bone marrow abnormalities in the posterolateral regions of the tibia. Abnormalities after patellar dislocation were found in the anterolateral and centrolateral femur and patella. Hyperextension injuries were associated with abnormalities in almost all regions, and dashboard injuries were associated with changes in the anterior regions of the tibia and femur. Our study provides evidence of associations between traumatic bone marrow abnormality patterns and different trauma mechanisms in acute knee injury, and reveals some overlap, especially of the two most common trauma mechanisms (valgus and pivot shift), in a large patient cohort. (orig.)

Association between traumatic bone marrow abnormalities of the knee, the trauma mechanism and associated soft-tissue knee injuries

International Nuclear Information System (INIS)

Berger, Nicole; Andreisek, Gustav; Karer, Anissja T.; Manoliu, Andrei; Ulbrich, Erika J.; Bouaicha, Samy; Naraghi, Ali; Seifert, Burkhardt

2017-01-01

To determine the association between traumatic bone marrow abnormalities, the knee injury mechanism, and associated soft tissue injuries in a larger cohort than those in the published literature. Retrospective study including 220 patients with traumatic knee injuries. Knee MRIs were evaluated for trauma mechanism, soft tissue injury, and the location of bone marrow abnormalities. The locations of the abnormalities were correlated with trauma mechanisms and soft tissue injuries using the chi-square test with Bonferroni correction. One hundred and forty-four valgus injuries, 39 pivot shift injuries, 25 lateral patellar dislocations, 8 hyperextensions, and 4 dashboard injuries were included. Valgus and pivot shift injuries showed traumatic bone marrow abnormalities in the posterolateral regions of the tibia. Abnormalities after patellar dislocation were found in the anterolateral and centrolateral femur and patella. Hyperextension injuries were associated with abnormalities in almost all regions, and dashboard injuries were associated with changes in the anterior regions of the tibia and femur. Our study provides evidence of associations between traumatic bone marrow abnormality patterns and different trauma mechanisms in acute knee injury, and reveals some overlap, especially of the two most common trauma mechanisms (valgus and pivot shift), in a large patient cohort. (orig.)

The Knee injury and Osteoarthritis Outcome Score (KOOS: from joint injury to osteoarthritis

Directory of Open Access Journals (Sweden)

Roos Ewa M

2003-11-01

Full Text Available Abstract The Knee injury and Osteoarthritis Outcome Score (KOOS was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and long-term symptoms and function in subjects with knee injury and osteoarthritis. The KOOS holds five separately scored subscales: Pain, other Symptoms, Function in daily living (ADL, Function in Sport and Recreation (Sport/Rec, and knee-related Quality of Life (QOL. The KOOS has been validated for several orthopaedic interventions such as anterior cruciate ligament reconstruction, meniscectomy and total knee replacement. In addition the instrument has been used to evaluate physical therapy, nutritional supplementation and glucosamine supplementation. The effect size is generally largest for the subscale QOL followed by the subscale Pain. The KOOS is a valid, reliable and responsive self-administered instrument that can be used for short-term and long-term follow-up of several types of knee injury including osteoarthritis. The measure is relatively new and further use of the instrument will add knowledge and suggest areas that need to be further explored and improved.

The impact of previous knee injury on force plate and field-based measures of balance.

Science.gov (United States)

Baltich, Jennifer; Whittaker, Jackie; Von Tscharner, Vinzenz; Nettel-Aguirre, Alberto; Nigg, Benno M; Emery, Carolyn

2015-10-01

Individuals with post-traumatic osteoarthritis demonstrate increased sway during quiet stance. The prospective association between balance and disease onset is unknown. Improved understanding of balance in the period between joint injury and disease onset could inform secondary prevention strategies to prevent or delay the disease. This study examines the association between youth sport-related knee injury and balance, 3-10years post-injury. Participants included 50 individuals (ages 15-26years) with a sport-related intra-articular knee injury sustained 3-10years previously and 50 uninjured age-, sex- and sport-matched controls. Force-plate measures during single-limb stance (center-of-pressure 95% ellipse-area, path length, excursion, entropic half-life) and field-based balance scores (triple single-leg hop, star-excursion, unipedal dynamic balance) were collected. Descriptive statistics (mean within-pair difference; 95% confidence intervals) were used to compare groups. Linear regression (adjusted for injury history) was used to assess the relationship between ellipse-area and field-based scores. Injured participants on average demonstrated greater medio-lateral excursion [mean within-pair difference (95% confidence interval); 2.8mm (1.0, 4.5)], more regular medio-lateral position [10ms (2, 18)], and shorter triple single-leg hop distances [-30.9% (-8.1, -53.7)] than controls, while no between group differences existed for the remaining outcomes. After taking into consideration injury history, triple single leg hop scores demonstrated a linear association with ellipse area (β=0.52, 95% confidence interval 0.01, 1.01). On average the injured participants adjusted their position less frequently and demonstrated a larger magnitude of movement during single-limb stance compared to controls. These findings support the evaluation of balance outcomes in the period between knee injury and post-traumatic osteoarthritis onset. Copyright © 2015 Elsevier Ltd. All rights

Balance index score as a predictive factor for lower sports results or anterior cruciate ligament knee injuries in Croatian female athletes--preliminary study.

Science.gov (United States)

Vrbanić, Tea Schnurrer-Luke; Ravlić-Gulan, Jagoda; Gulan, Gordan; Matovinović, Damir

2007-03-01

Female athletes participating in high-risk sports suffer anterior cruciate ligament (ACL) knee injury at a 4- to 6-fold greater rate than do male athletes. ACL injuries result either from contact mechanisms or from certain unexplained non-contact mechanisms occurring during daily professional sports activities. The occurrence of non-contact injuries points to the existence of certain factors intrinsic to the knee that can lead to ACL rupture. When knee joint movement overcomes the static and the dynamic constraint systems, non-contact ACL injury may occur. Certain recent results suggest that balance and neuromuscular control play a central role in knee joint stability, protection and prevention of ACL injuries. The purpose of this study is to evaluate balance neuromuscular skills in healthy Croatian female athletes by measuring their balance index score, as well as to estimate a possible correlation between their balance index score and balance effectiveness. This study is conducted in an effort to reduce the risk of future injuries and thus prevent female athletes from withdrawing from sports prematurely. We analysed fifty-two female athletes in the high-risk sports of handball and volleyball, measuring for their static and dynamic balance index scores, using the Sport KAT 2000 testing system. This method may be used to monitor balance and coordination systems and may help to develop simpler measurements of neuromuscular control, which can be used to estimate risk predictors in athletes who withdraw from sports due to lower sports results or ruptured anterior cruciate ligament and to direct female athletes to more effective, targeted preventive interventions. The tested Croatian female athletes with lower sports results and ACL knee injury incurred after the testing were found to have a higher balance index score compared to healthy athletes. We therefore suggest that a higher balance index score can be used as an effective risk predictor for lower sports results

Prevalence of and factors associated with hock, knee, and neck injuries on dairy cows in freestall housing in Canada.

Science.gov (United States)

Zaffino Heyerhoff, J C; LeBlanc, S J; DeVries, T J; Nash, C G R; Gibbons, J; Orsel, K; Barkema, H W; Solano, L; Rushen, J; de Passillé, A M; Haley, D B

2014-01-01

floors (OR=0.19). These results demonstrate that individual animal characteristics, as well as barn design and animal management, are associated with hock, knee, and neck injuries. These data can help to guide investigations into causes and prevention of injuries. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Lower limb fractures associated with multiligament knee injury

OpenAIRE

Stagnaro, Joaquin; Yacuzzi, Carlos; Barla, Jorge; Zicaro, Juan Pablo; Costa-Paz, Matias

2017-01-01

Objectives: Knee ligament injuries related to lower limb fractures are common and frequently unnoticed. Management of acute polytrauma is usually focused in the bone lesion and a complete physical examination might be really difficult. The purpose of this study was to analyze a series of patients who suffered multiligament knee injuries associated to a lower limb fracture. Hypothesis: The use of magnetic resonance imaging (MRI) during the initial management can lead to an early diagnosis of l...

Knee Kinematics During Noncontact Anterior Cruciate Ligament Injury as Determined From Bone Bruise Location.

Science.gov (United States)

Kim, Sophia Y; Spritzer, Charles E; Utturkar, Gangadhar M; Toth, Alison P; Garrett, William E; DeFrate, Louis E

2015-10-01

The motions causing noncontact anterior cruciate ligament (ACL) injury remain unclear. Tibiofemoral bone bruises are believed to be the result of joint impact near the time of ACL rupture. The locations and frequencies of these bone bruises have been reported, but there are limited data quantifying knee position and orientation near the time of injury based on these contusions. Knee position and orientation near the time of noncontact ACL injury include extension and anterior tibial translation. Descriptive laboratory study. Magnetic resonance images of 8 subjects with noncontact ACL injuries were acquired within 1 month of injury and were subsequently analyzed. All subjects exhibited bruises on both the femur and tibia in both medial and lateral compartments. The outer margins of bone and the bone bruise surfaces were outlined on each image to create a 3-dimensional model of each subject's knee in its position during magnetic resonance imaging (MRI position). Numerical optimization was used to maximize overlap of the bone bruises on the femur and tibia and to predict the position of injury. Flexion angle, valgus orientation, internal tibial rotation, and anterior tibial translation were measured in both the MRI position and the predicted position of injury. Differences in kinematics between the MRI position, which served as an unloaded reference, and the predicted position of injury were compared by use of paired t tests. Flexion angle was near full extension in both the MRI position and the predicted position of injury (8° vs 12°; P = .2). Statistically significant increases in valgus orientation (5°; P = .003), internal tibial rotation (15°; P = .003), and anterior tibial translation (22 mm; P injury relative to the MRI position. These results suggest that for the bone bruise pattern studied, landing on an extended knee is a high risk for ACL injury. Extension was accompanied by increased anterior tibial translation (22 mm), internal tibial rotation (15�

Arthrography in sport injuries of the knee joint

Energy Technology Data Exchange (ETDEWEB)

Schaefer, H

1983-09-01

The arthrography is one of the most important diagnostic methods of sport injuries of the knee joint. The examination must give an exact information to the surgeon; a good technique and standard X-rays are an absolute postulate. The submitted examinations are based on 6687 arthrographies during a period of 5 years. The arthrography should not be carried out before the acute symptomatology has ceased, usually after an interval of 2-3 weeks. Most frequent are the meniscus injuries by rotary traumas of the knee-joint. Football as the most popular sport is responsible for more than 50% of the injuries, followed by skiing, handball and jogging.

Arthrography in sport injuries of the knee joint

International Nuclear Information System (INIS)

Schaefer, H.

1983-01-01

The arthrography is one of the most important diagnostic methods of sport injuries of the knee joint. The examination must give an exact information to the surgeon; a good technique and standard X-rays are an absolute postulate. The submitted examinations are based on 6687 arthrographies during a period of 5 years. The arthrography should not be carried out before the acute symptomatology has ceased, usually after an interval of 2-3 weeks. Most frequently are the meniscus injuries by rotary traumas of the knee-joint. Football as the most popular sport is responsible for more than 50% of the injuries, followed by skiing, handball and jogging. (orig.)

Mechanisms for noncontact anterior cruciate ligament injuries: knee joint kinematics in 10 injury situations from female team handball and basketball.

Science.gov (United States)

Koga, Hideyuki; Nakamae, Atsuo; Shima, Yosuke; Iwasa, Junji; Myklebust, Grethe; Engebretsen, Lars; Bahr, Roald; Krosshaug, Tron

2010-11-01

The mechanism for noncontact anterior cruciate ligament injury is still a matter of controversy. Video analysis of injury tapes is the only method available to extract biomechanical information from actual anterior cruciate ligament injury cases. This article describes 3-dimensional knee joint kinematics in anterior cruciate ligament injury situations using a model-based image-matching technique. Case series; Level of evidence, 4. Ten anterior cruciate ligament injury video sequences from women's handball and basketball were analyzed using the model-based image-matching method. The mean knee flexion angle among the 10 cases was 23° (range, 11°-30°) at initial contact (IC) and had increased by 24° (95% confidence interval [CI], 19°-29°) within the following 40 milliseconds. The mean valgus angle was neutral (range, -2° to 3°) at IC, but had increased by 12° (95% CI, 10°-13°) 40 milliseconds later. The knee was externally rotated 5° (range, -5° to 12°) at IC, but rotated internally by 8° (95% CI, 2°-14°) during the first 40 milliseconds, followed by external rotation of 17° (95% CI, 13°-22°). The mean peak vertical ground-reaction force was 3.2 times body weight (95% CI, 2.7-3.7), and occurred at 40 milliseconds after IC (range, 0-83). Based on when the sudden changes in joint angular motion and the peak vertical ground-reaction force occurred, it is likely that the anterior cruciate ligament injury occurred approximately 40 milliseconds after IC. The kinematic patterns were surprisingly consistent among the 10 cases. All players had immediate valgus motion within 40 milliseconds after IC. Moreover, the tibia rotated internally during the first 40 milliseconds and then external rotation was observed, possibly after the anterior cruciate ligament had torn. These results suggest that valgus loading is a contributing factor in the anterior cruciate ligament injury mechanism and that internal tibial rotation is coupled with valgus motion. Prevention

The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review.

Science.gov (United States)

Herman, Katherine; Barton, Christian; Malliaras, Peter; Morrissey, Dylan

2012-07-19

Lower limb injuries in sport are increasingly prevalent and responsible for large economic as well as personal burdens. In this review we seek to determine which easily implemented functional neuromuscular warm-up strategies are effective in preventing lower limb injuries during sports participation and in which sporting groups they are effective. Seven electronic databases were searched from inception to January 2012 for studies investigating neuromuscular warm-up strategies and injury prevention. The quality of each included study was evaluated using a modified version of the van Tulder scale. Data were extracted from each study and used to calculate the risk of injury following application of each evaluated strategy. Nine studies were identified including six randomized controlled trials (RCT) and three controlled clinical trials (CCT). Heterogeneity in study design and warm-up strategies prevented pooling of results. Two studies investigated male and female participants, while the remaining seven investigated women only. Risk Ratio (RR) statistics indicated 'The 11+' prevention strategy significantly reduces overall (RR 0.67, confidence interval (CI) 0.54 to 0.84) and overuse (RR 0.45, CI 0.28 to 0.71) lower limb injuries as well as knee (RR 0.48, CI 0.32 to 0.72) injuries among young amateur female footballers. The 'Knee Injury Prevention Program' (KIPP) significantly reduced the risk of noncontact lower limb (RR 0.5, CI 0.33 to 0.76) and overuse (RR 0.44, CI 0.22 to 0.86) injuries in young amateur female football and basketball players. The 'Prevent Injury and Enhance Performance' (PEP) strategy reduces the incidence of anterior cruciate ligament (ACL) injuries (RR 0.18, CI 0.08 to 0.42). The 'HarmoKnee' programme reduces the risk of knee injuries (RR 0.22, CI 0.06 to 0.76) in teenage female footballers. The 'Anterior Knee Pain Prevention Training Programme' (AKP PTP) significantly reduces the incidence of anterior knee pain (RR 0.27, CI 0.14 to 0.54) in

The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review

Directory of Open Access Journals (Sweden)

Herman Katherine

2012-07-01

Full Text Available Abstract Background Lower limb injuries in sport are increasingly prevalent and responsible for large economic as well as personal burdens. In this review we seek to determine which easily implemented functional neuromuscular warm-up strategies are effective in preventing lower limb injuries during sports participation and in which sporting groups they are effective. Methods Seven electronic databases were searched from inception to January 2012 for studies investigating neuromuscular warm-up strategies and injury prevention. The quality of each included study was evaluated using a modified version of the van Tulder scale. Data were extracted from each study and used to calculate the risk of injury following application of each evaluated strategy. Results Nine studies were identified including six randomized controlled trials (RCT and three controlled clinical trials (CCT. Heterogeneity in study design and warm-up strategies prevented pooling of results. Two studies investigated male and female participants, while the remaining seven investigated women only. Risk Ratio (RR statistics indicated 'The 11+' prevention strategy significantly reduces overall (RR 0.67, confidence interval (CI 0.54 to 0.84 and overuse (RR 0.45, CI 0.28 to 0.71 lower limb injuries as well as knee (RR 0.48, CI 0.32 to 0.72 injuries among young amateur female footballers. The 'Knee Injury Prevention Program' (KIPP significantly reduced the risk of noncontact lower limb (RR 0.5, CI 0.33 to 0.76 and overuse (RR 0.44, CI 0.22 to 0.86 injuries in young amateur female football and basketball players. The 'Prevent Injury and Enhance Performance' (PEP strategy reduces the incidence of anterior cruciate ligament (ACL injuries (RR 0.18, CI 0.08 to 0.42. The 'HarmoKnee' programme reduces the risk of knee injuries (RR 0.22, CI 0.06 to 0.76 in teenage female footballers. The 'Anterior Knee Pain Prevention Training Programme' (AKP PTP significantly reduces the incidence of anterior

Is peroneal nerve injury associated with worse function after knee dislocation?

Science.gov (United States)

Krych, Aaron J; Giuseffi, Steven A; Kuzma, Scott A; Stuart, Michael J; Levy, Bruce A

2014-09-01

Peroneal nerve palsy is a frequent and potentially disabling complication of multiligament knee dislocation, but little information exists on the degree to which patients recover motor or sensory function after this injury, and whether having this nerve injury--with or without complete recovery--is a predictor of inferior patient-reported outcome scores. The purposes of this study were to (1) report on motor and sensory recovery as well as patient-reported outcomes scores of patients with peroneal nerve injury from multiligament knee dislocation; (2) compare those endpoints between patients who had partial versus complete nerve injuries; and (3) compare patient-reported outcomes among patients who sustained peroneal nerve injuries after knee dislocation with a matched cohort of multiligament knee injuries without nerve injury. Thirty-two patients were identified, but five did not have 2-year followup and are excluded (16% lost to followup). Twenty-seven patients (24 male, three female) with peroneal nerve injury underwent multiligament knee reconstruction and were followed for 6.3 years (range, 2-18 years). Motor grades were assessed by examination and outcomes by International Knee Documentation Committee (IKDC) and Lysholm scores. Retrospectively, patients were divided into complete (n = 9) and partial nerve palsy (n = 18). Treatment for complete nerve palsy included an ankle-foot orthosis for all patients, nonoperative (one), neurolysis (two), tendon transfer (three), nerve transfer (one), and combined nerve/tendon transfer (one). Treatment for partial nerve palsy included nonoperative (12), neurolysis (four), nerve transfer (one), and combined nerve/tendon transfer (one). Furthermore, patients without nerve injury were matched by Schenck classification, age, and sex. Data were analyzed using univariate and multivariate models. Overall, 18 patients (69%) regained antigravity ankle dorsiflexion after treatment (three complete nerve palsy [38%] versus 15 partial

Iatrogenic popliteal artery injury in non arthroplasty knee surgery.

Science.gov (United States)

Bernhoff, K; Björck, M

2015-02-01

We have investigated iatrogenic popliteal artery injuries (PAI) during non arthroplasty knee surgery regarding mechanism of injury, treatment and outcomes, and to identify successful strategies when injury occurs. In all, 21 iatrogenic popliteal artery injuries in 21 patients during knee surgery other than knee arthroplasty were identified from the Swedish Vascular Registry (Swedvasc) between 1987 and 2011. Prospective registry data were supplemented with case-records, including long-term follow-up. In total, 13 patients suffered PAI during elective surgery and eight during urgent surgery such as fracture fixation or tumour resection. Nine injuries were detected intra-operatively, five within 12 to 48 hours and seven > 48 hours post-operatively (two days to 23 years). There were 19 open vascular and two endovascular surgical repairs. Two patients died within six months of surgery. One patient required amputation. Only six patients had a complete recovery of whom had the vascular injury detected at time of injury and repaired by a vascular surgeon. Patients sustaining vascular injury during elective procedures are more likely to litigate (p = 0.029). We conclude that outcomes are poorer when there is a delay of diagnosis and treatment, and that orthopaedic surgeons should develop strategies to detect PAI early and ensure rapid access to vascular surgical support. ©2015 The British Editorial Society of Bone & Joint Surgery.

The iliotibial band in acute knee trauma: patterns of injury on MR imaging

Energy Technology Data Exchange (ETDEWEB)

Mansour, Ramy; Yoong, Philip; McKean, David; Teh, James L. [Oxford University Hospitals NHS Trust, Department of Radiology, Nuffield Orthopaedic Centre, Oxford (United Kingdom)

2014-10-15

To delineate the spectrum of knee injuries associated with sprains and tears of the distal iliotibial band (ITB). A retrospective review of 200 random MRI scans undertaken for acute knee trauma was performed. Scans were excluded if there was a history of injury over 4 weeks from the time of the scan, septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. In each scan, the ITB was scored as normal, minor sprain (grade 1), severe sprain (grade 2), and torn (grade 3). The menisci, ligaments, and tendons of each knee were also assessed. The mean age was 27.4 years (range, 9-69 years) and 71.5 % (n = 143) of the patients were male. The ITB was injured in 115 cases (57.5 %). The next most common soft tissue structure injured was the anterior cruciate ligament (ACL) in 53.5 % of cases (n = 107). Grade 1 ITB injury was seen in 90 of these 115 cases (45 %), grade 2 injury in 20 cases, and grade 3 injury in only five cases. There is a significant association between ITB injury and ACL rupture (p < 0.05), as well as acute patellar dislocation (p < 0.05). There were ten cases of significant posterolateral corner injury, and all were associated with ITB injury, including four ITB tears. Only two cases of isolated ITB injury were seen (1 %). ITB injury is common in acute knee trauma and is associated with significant internal derangement of the knee, especially cruciate ligament rupture, posterolateral corner injury, and patellar dislocation. (orig.)

Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors.

Science.gov (United States)

Alentorn-Geli, Eduard; Myer, Gregory D; Silvers, Holly J; Samitier, Gonzalo; Romero, Daniel; Lázaro-Haro, Cristina; Cugat, Ramón

2009-07-01

dorsiflexion of the ankle when performing sport tasks, lateral trunk displacement and hip adduction combined with increased knee abduction moments (dynamic knee valgus), and increased hip internal rotation and tibial external rotation with or without foot pronation. The identified mechanisms and risk factors for non-contact ACL injuries have been mainly studied in female soccer players; thus, further research in male players is warranted. Non-contact ACL injuries in soccer players likely has a multi-factorial etiology. The identification of those athletes at increased risk may be a salient first step before designing and implementing specific pre-season and in-season training programs aimed to modify the identified risk factors and to decrease ACL injury rates. Current evidence indicates that this crucial step to prevent ACL injury is the only option to effectively prevent the sequelae of osteoarthritis associated with this traumatic injury.

Outcomes associated with early post-traumatic osteoarthritis and other negative health consequences 3-10 years following knee joint injury in youth sport.

Science.gov (United States)

Whittaker, J L; Woodhouse, L J; Nettel-Aguirre, A; Emery, C A

2015-07-01

Post-traumatic osteoarthritis (PTOA) commonly affects the knee joint. Although the risk of PTOA substantially increases post-joint injury, there is little research examining PTOA outcomes early in the period between joint injury and disease onset. Improved understanding of this interval would inform secondary prevention strategies aimed at preventing and/or delaying PTOA progression. This study examines the association between sport-related knee injury and outcomes related to development of PTOA, 3-10 years post-injury. This preliminary analysis of the first year of a historical cohort study includes 100 (15-26 years) individuals. Fifty with a sport-related intra-articular knee injury sustained 3-10 years previously and 50 uninjured age, sex and sport matched controls. The primary outcome was the 'Symptoms' sub-scale of the Knee Osteoarthritis and Injury Outcome Score (KOOS). Secondary outcomes included; the remaining KOOS subscales, body mass index (BMI), hip abductor/adductor and knee extensor/flexor strength, estimated aerobic capacity (VO2max) and performance scores on three dynamic balance tests. Descriptive statistics (mean within-pair difference; 95% Confidence interval (CI) and conditional odds ratio (OR, 95% CI; BMI) were used to compare study groups. Injured participants demonstrated poorer KOOS outcomes [symptoms -9.4 (-13.6, -5.2), pain -4.0 (-6.8, -1.2), quality-of-life -8.0 (-11.0, -5.1), daily living -3.0 (-5.0, -1.1) and sport/recreation -6.9 (-9.9, -3.8)], were 3.75 times (95% CI 1.24, 11.3) more likely to be overweight/obese and had lower triple single leg hop scores compared to controls. No significant group differences existed for remaining balance scores, estimated VO2max, hip or knee strength ratios or side-to-side difference in hip abductor/adductor or quadricep/hamstring strength. This study provides preliminary evidence that youth/young adults following sport-related knee injury report more symptoms and poorer function, and are at

Knee injury and Osteoarthritis Outcome Score (KOOS – validation and comparison to the WOMAC in total knee replacement

Directory of Open Access Journals (Sweden)

Roos Ewa M

2003-05-01

Full Text Available Abstract Background The Knee injury and Osteoarthritis Outcome Score (KOOS is an extension of the Western Ontario and McMaster Universities Osteoarthrtis Index (WOMAC, the most commonly used outcome instrument for assessment of patient-relevant treatment effects in osteoarthritis. KOOS was developed for younger and/or more active patients with knee injury and knee osteoarthritis and has in previous studies on these groups been the more responsive instrument compared to the WOMAC. Some patients eligible for total knee replacement have expectations of more demanding physical functions than required for daily living. This encouraged us to study the use of the Knee injury and Osteoarthritis Outcome Score (KOOS to assess the outcome of total knee replacement. Methods We studied the test-retest reliability, validity and responsiveness of the Swedish version LK 1.0 of the KOOS when used to prospectively evaluate the outcome of 105 patients (mean age 71.3, 66 women after total knee replacement. The follow-up rates at 6 and 12 months were 92% and 86%, respectively. Results The intraclass correlation coefficients were over 0.75 for all subscales indicating sufficient test-retest reliability. Bland-Altman plots confirmed this finding. Over 90% of the patients regarded improvement in the subscales Pain, Symptoms, Activities of Daily Living, and knee-related Quality of Life to be extremely or very important when deciding to have their knee operated on indicating good content validity. The correlations found in comparison to the SF-36 indicated the KOOS measured expected constructs. The most responsive subscale was knee-related Quality of Life. The effect sizes of the five KOOS subscales at 12 months ranged from 1.08 to 3.54 and for the WOMAC from 1.65 to 2.56. Conclusion The Knee injury and Osteoarthritis Outcome Score (KOOS is a valid, reliable, and responsive outcome measure in total joint replacement. In comparison to the WOMAC, the KOOS improved validity

The Impact of Knee Injury History on Health-Related Quality of Life in Adolescent Athletes.

Science.gov (United States)

Lam, Kenneth C; Markbreiter, Jessica G

2017-10-16

Current evidence suggests that, despite returning to full participation, physically active adults with a previous knee injury experience lower health-related quality of life (HRQOL) than those with no knee injury history. It is unknown if this relationship is present in adolescent athletes. To determine the impact of knee injury history on HRQOL in adolescent athletes who were medically cleared for full participation. Cross-sectional. Athletic training clinics. A convenience sample of 183 adolescent athletes, who were medically cleared for full participation, were grouped by self-report of a previous knee injury: positive knee injury history [HIS] (n=36, age=15.7+1.35 years, height=168.0+11.9 cm; weight=71.8+11.9 kg) and no knee injury history [NO-HIS] (n=147, age=15.5+1.4 years, height=166.0+10.5 cm, weight=67.6+14.6 kg). Participants completed the pediatric version of the International Knee Documentation Committee form (Pedi-IKDC) and Pediatric Quality of Life Inventory (PedsQL) during their preparticipation examination. Generalized linear models were used to compare group differences for the total and subscale scores of the Pedi-IKDC and PedsQL. Main effects of injury group indicated that the HIS group reported significantly lower scores than the NO-HIS group for the Pedi-IKDC total score (p.05). Our findings suggest that, despite returning to full sport participation, adolescent athletes with a previous knee injury generally experience lower HRQOL than their peers with no knee injury history, specifically for knee-specific HRQOL, physical functioning, school functioning and social functioning. Our results are similar to previous findings reported in collegiate athletes and military cadets.

Modification of Knee Flexion Angle Has Patient-Specific Effects on Anterior Cruciate Ligament Injury Risk Factors During Jump Landing.

Science.gov (United States)

Favre, Julien; Clancy, Caitlin; Dowling, Ariel V; Andriacchi, Thomas P

2016-06-01

landed in an adducted position suggests that the selection of interventions to prevent ACL injuries should account for patient-specific characteristics. The study helps elucidate how increasing the knee flexion angle affects lower body biomechanics and provided evidence for the need to introduce patient-specific strategies for preventing ACL injuries. © 2016 The Author(s).

[Skiing and snowboarding trauma in children: epidemiology, physiopathology, prevention and main injuries].

Science.gov (United States)

Dohin, B; Kohler, R

2008-11-01

Skiing and snowboarding are leading to a risk of injuries in children. Beginners and experienced have higher risk of injuries, however, the first have less severe injuries than the latest. Risk factors of injury are: ability and experience, binding adjustment, slope characteristics, speed, collisions with objects or jumping and risky behavior of the young skiers and snowboarders. Lower limb injuries are most common in skier, especially knee sprains, conversely snowboarders present more upper limb injuries, especially wrist fractures. The frequency of head injuries does not decrease while helmet use increases but severity decreases. Despite prevention and wearing protections, the frequency of trauma does not decrease significantly, which could be in relation with higher speed and increased risky behavior. Main prevention factors are safety knowledge and safety behavior, correct binding adjustment, and use of protections.

Hyperextension injuries of the knee. Do patterns of bone bruising predict soft tissue injury?

Energy Technology Data Exchange (ETDEWEB)

Ali, A.M.; Gibbons, C.E.R. [Chelsea and Westminster Hospital, Department of Orthopaedic Surgery, London (United Kingdom); Pillai, J.K.; Roberton, B.J. [Chelsea and Westminster Hospital, Department of Radiology, London (United Kingdom); Gulati, V. [Homerton University Hospital, Department of Orthopaedic Surgery, London (United Kingdom)

2018-02-15

To establish whether patterns of soft tissue injury following knee hyperextension are associated with post-traumatic 'bone bruise' distribution. Patients with a knee MRI within one year of hyperextension injury were identified at our institution over a 7 year period. MRIs, plain radiographs and clinical details of these patients were reviewed. Twenty-five patients were identified (median time from injury to MRI = 24 days). The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). There were high rates of injury to the posterior capsule (52%), ACL (40%) and PCL (40%) but lower rates of injury to the menisci (20%), medial and lateral collateral ligaments (16%) and posterolateral corner (16%). Anterior tibial plateau oedema and rupture of the posterior capsule predicted cruciate ligament injury [OR = 10.5 (p = 0.02) and 24.0 (p = 0.001) respectively]. Whilst anterolateral tibial plateau oedema strongly predicted PCL injury [OR = 26.0, p = 0.003], ACL injury was associated with a variable pattern of bone bruising. Meniscal injury was unrelated to the extent or pattern of bone bruising. 5 out of 8 patients with a 'double sulcus' on the lateral radiograph had ACL injury. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. Other structures are injured less frequently and have weaker associations with bone bruise distribution. The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. (orig.)

MR imaging of medial collateral ligament injury and associated internal knee joint injury

International Nuclear Information System (INIS)

Lim, Chae Ha; Lee, Sun Kyoung; Lim, Dong Hun; Kim, Young Sook; Byun, Ju Nam; Kim, Young Chul; Oh, Jae Hee

1996-01-01

To assess the value of MR imaging in the diagnosis of medial collateral ligament injury of the knee, we used MR imaging to evaluate the characteristic findings in MCL tears and the frequency of associated knee joint injury. We retrospectively reviewed 26 patients within four weeks of MCL injury, analysed MR findings and correlated them with surgical findings. We evaluated discontinuity, heterogeneous signal intensity of MCL, thin band- like low signal intensity at MCL, facial edema, loss of clear demarcation of adjacent fat also combined bone injury, meniscus injury and other ligament injury. Complete MCL tears were present in 14 patients and partial tears in 12. Complete tears showed discontinuity of MCL, fascial edema and loss of clear demarcation from adjacent fat in 11 patients(79%);proximal MCL tears are more common than distal tears. Partial tears showed thin band-like low signal intensity within MCL, fascial edema and loss of clear demarcation from adjacent fat in seven patients (58%);all patient s with MCL injury showed fascial edema;in 12 patients there was loss of clear demarcation from adjacent fat. We could not, however, distinguish between complete tears and partial tears when MCL showed heterogeneous high signal intensity. Combined bone injury in MCL tears was found in eight patients(62%);the most common sites of this were the lateral femoral condyle and lateral tibial plateau. There was associated injury involving other ligaments(ACL:50%;PCL:27%). Combined meniscus injury in MCL tears was present in 17 patients and the most common meniscus site(50%) is the posterior horn of the medial meniscus. Complete MCL tears showed discontinuity of MCL and partial tears showed a thin band-like low signal intensity within MCL. All patients with MCL injury showed fascial edema, and loss of clear demarcation from adjacent fat. Various other injuries combine with MCL tears. MR imaging is therefore useful in the evaluation of medial collateral ligament injury and

The extent and risk of knee injuries in children aged 9-14 with Generalised Joint Hypermobility and knee joint hypermobility

DEFF Research Database (Denmark)

Junge, Tina; Runge, Lisbeth; Juul-Kristensen, Birgit

2015-01-01

BACKGROUND: Generalised Joint Hypermobility (GJH) is suggested as an aetiological factor for knee injuries in adolescents and adults. It is presumed that GJH causes decreased joint stability, thereby increasing the risk of knee injuries during challenging situations like jumping and landing. The ...

associated injuries and complications in floating knee management

African Journals Online (AJOL)

Materials and Methods: The investigation lasted ten years from 1st January, 2000 to ... hemarthrosis, 2 paralysis of fibular nerve associated to a displaced fracture of neck of ... Keywords: Associated injuries, complications, Floating knee, Management ... Road traffic accidents were responsible for 51 cases ... cerebral injuries.

Anterior cruciate ligament injuries in soccer: Loading mechanisms, risk factors, and prevention programs

Directory of Open Access Journals (Sweden)

Boyi Dai

2014-12-01

Full Text Available Anterior cruciate ligament (ACL injuries are common in soccer. Understanding ACL loading mechanisms and risk factors for ACL injury is critical for designing effective prevention programs. The purpose of this review is to summarize the relevant literature on ACL loading mechanisms, ACL injury risk factors, and current ACL injury prevention programs for soccer players. Literature has shown that tibial anterior translation due to shear force at the proximal end of tibia is the primary ACL loading mechanism. No evidence has been found showing that knee valgus moment is the primary ACL loading mechanism. ACL loading mechanisms are largely ignored in previous studies on risk factors for ACL injury. Identified risk factors have little connections to ACL loading mechanisms. The results of studies on ACL injury prevention programs for soccer players are inconsistent. Current ACL injury prevention programs for soccer players are clinically ineffective due to low compliance. Future studies are urgently needed to identify risk factors for ACL injury in soccer that are connected to ACL loading mechanisms and have cause-and-effect relationships with injury rate, and to develop new prevention programs to improve compliance.

Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis.

Science.gov (United States)

Emery, Carolyn A; Roy, Thierry-Olivier; Whittaker, Jackie L; Nettel-Aguirre, Alberto; van Mechelen, Willem

2015-07-01

Youth have very high participation and injury rates in sport. Sport is the leading cause of injury in youth. Sport injury reduces future participation in physical activity which adversely affects future health. Sport injury may lead to overweight/obesity and post-traumatic osteoarthritis. The objective of the systematic review and meta-analysis was to evaluate the efficacy of injury prevention neuromuscular training strategies in youth sport. Three electronic databases were systematically searched up to September 2014. Studies selected met the following criteria: original data; analytic prospective design; investigated a neuromuscular training prevention strategy intervention(s) and included outcomes for injury sustained during sport participation. Two authors assessed the quality of evidence using Downs and Black (DB) criteria. Meta-analyses including randomised controlled trials only (RCTs) to ensure study design homogeneity were completed for lower extremity and knee injury outcomes. Of 2504 potentially relevant studies, 25 were included. Meta-analysis revealed a combined preventative effect of neuromuscular training in reducing the risk of lower extremity injury (incidence rate ratio: IRR=0.64 (95% CI 0.49 to 0.84)). Though not statistically significant, the point estimate suggests a protective effect of such programmes in reducing the risk of knee injury (IRR=0.74 (95% CI 0.51 to 1.07)). There is evidence for the effectiveness of neuromuscular training strategies in the reduction of injury in numerous team sports. Lack of uptake and ongoing maintenance of such programmes is an ongoing concern. A focus on implementation is critical to influence knowledge, behaviour change and sustainability of evidence informed injury prevention practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Atraumatic patellar prosthesis dislocation with patellar tendon injury following a total knee arthroplasty: a case report

Directory of Open Access Journals (Sweden)

Singh Alka

2010-01-01

Full Text Available Abstract Introduction Total knee arthroplasty is a well-established procedure with gratifying results. There is no consensus in the literature whether to routinely resurface the patella while performing total knee arthroplasty or not. Although an extremely rare occurrence in clinical practice, patellar prosthesis dislocation is a possible complication resulting from total knee arthroplasty. Case presentation We report a rare case of atraumatic spontaneous dislocation of patellar prosthesis in a 63-year-old Caucasian man of British origin with patellar tendon injury. The patient was treated successfully through a revision of the patellar component and tendon repair. In two years follow-up the patient is asymptomatic with no sign of loosening of his patellar prosthesis. Conclusions A thorough understanding of knee biomechanics is imperative in performing total knee arthroplasty in order to achieve a better functional outcome and to prevent early prosthetic failure.

Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times. Data from the osteoarthritis initiative

Energy Technology Data Exchange (ETDEWEB)

Hofmann, Felix C. [University of California San Francisco, Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Technical University of Munich, Department of Radiology, Munich (Germany); Neumann, Jan; Heilmeier, Ursula; Joseph, Gabby B.; Link, Thomas M. [University of California San Francisco, Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Nevitt, Michael C.; McCulloch, Charles E. [University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

2018-01-15

To investigate the association of cartilage degeneration with previous knee injuries not undergoing surgery, determined by morphologic and quantitative 3-T magnetic resonance imaging (MRI). We performed a nested cross-sectional study of right knee MRIs from participants in the Osteoarthritis Initiative (OAI) aged 45-79 with baseline Kellgren-Lawrence score of 0-2. Cases were 142 right knees of patients with self-reported history of injury limiting the ability to walk for at least 2 days. Controls were 426 right knees without history of injury, frequency-matched to cases on age, BMI, gender, KL scores and race (1:3 ratio). Cases and controls were compared using covariate-adjusted linear regression analysis, with the outcomes of region-specific T2 mean, laminar analysis and heterogeneity measured by texture analysis to investigate early cartilage matrix abnormalities and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) to investigate morphologic knee lesions. Compared to control subjects, we found significantly higher mean T2 values in the injury [lateral tibia (28.10 ms vs. 29.11 ms, p = 0.001), medial tibia (29.70 ms vs. 30.40 ms, p = 0.014) and global knee cartilage (32.73 ms vs. 33.29 ms, p = 0.005)]. Injury subjects also had more heterogeneous cartilage as measured by GLCM texture contrast, variance and entropy (p < 0.05 in 14 out of 18 texture parameters). WORMS gradings were not significantly different between the two groups (p > 0.05). A history of knee injury not treated surgically is associated with higher and more heterogeneous T2 values, but not with morphologic knee abnormalities. Our findings suggest that significant, conservatively treated knee injuries are associated with permanent cartilage matrix abnormalities. (orig.)

Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times. Data from the osteoarthritis initiative

International Nuclear Information System (INIS)

Hofmann, Felix C.; Neumann, Jan; Heilmeier, Ursula; Joseph, Gabby B.; Link, Thomas M.; Nevitt, Michael C.; McCulloch, Charles E.

2018-01-01

To investigate the association of cartilage degeneration with previous knee injuries not undergoing surgery, determined by morphologic and quantitative 3-T magnetic resonance imaging (MRI). We performed a nested cross-sectional study of right knee MRIs from participants in the Osteoarthritis Initiative (OAI) aged 45-79 with baseline Kellgren-Lawrence score of 0-2. Cases were 142 right knees of patients with self-reported history of injury limiting the ability to walk for at least 2 days. Controls were 426 right knees without history of injury, frequency-matched to cases on age, BMI, gender, KL scores and race (1:3 ratio). Cases and controls were compared using covariate-adjusted linear regression analysis, with the outcomes of region-specific T2 mean, laminar analysis and heterogeneity measured by texture analysis to investigate early cartilage matrix abnormalities and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) to investigate morphologic knee lesions. Compared to control subjects, we found significantly higher mean T2 values in the injury [lateral tibia (28.10 ms vs. 29.11 ms, p = 0.001), medial tibia (29.70 ms vs. 30.40 ms, p = 0.014) and global knee cartilage (32.73 ms vs. 33.29 ms, p = 0.005)]. Injury subjects also had more heterogeneous cartilage as measured by GLCM texture contrast, variance and entropy (p < 0.05 in 14 out of 18 texture parameters). WORMS gradings were not significantly different between the two groups (p > 0.05). A history of knee injury not treated surgically is associated with higher and more heterogeneous T2 values, but not with morphologic knee abnormalities. Our findings suggest that significant, conservatively treated knee injuries are associated with permanent cartilage matrix abnormalities. (orig.)

The popliteal fibular ligament in acute knee trauma: patterns of injury on MR imaging

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McKean, D.; Thomee, E.; Grant, D.; Teh, J.L.; Mansour, R. [Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Headington, Oxford (United Kingdom); Yoong, P. [Royal Berkshire NHS Foundation Trust, Royal Berkshire Hospital, Reading (United Kingdom); Yanny, S. [Buckinghamshire Healthcare NHS Trust, Stoke Mandeville Hospital, Aylesbury (United Kingdom)

2015-10-15

To describe the patterns of injury associated with injury to the popliteofibular ligament injury. A retrospective review was performed of 180 MRI scans undertaken for acute knee trauma. Scans were excluded if the time of injury was over 4 weeks from the time of the scan, or if there was a history of septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. An agreed criterion for assessing the structures of the posterolateral ligamentous complex was defined and in each scan, the popliteofibular ligament (PFL) was scored as normal or injured. The menisci, ligaments, and tendons of each knee were also assessed. The mean age was 25.7 years (range, 9-65 years) and 72.2 % (n = 130) patients were male. The PFL was injured in 36 cases (20 %). There is a significant association between PFL injury and ACL rupture (p = 0.0001), ITB injury (p = 0.0001), PCL injury (p = 0.0373), in addition to associations with injury to other posterolateral corner structures including the lateral collateral ligament (p = 0.0001), biceps femoris tendon (p = 0.0014), and popliteus tendon (p = 0.0014). Of our series of PFL injuries, nine cases (25 %) were associated with further injuries of posterolateral corner structures and in 27 cases (75 %) the PFL was the only posterolateral corner structure torn. PFL injury is not uncommon in acute knee trauma and is associated with significant internal derangement of the knee, especially anterior cruciate ligament rupture, ITB sprain, and injury to other structures within the posterolateral corner. (orig.)

A controlled intervention study assessing the relation between hip abductor strength and knee valgus

OpenAIRE

Grytdal, Are

2015-01-01

Background: Anterior cruciate ligament (ACL) injury is a common and severe lower limb injury. Knee abduction moment has been associated with risk of non-contact ACL injury, and knee valgus angle has been reported as part of the non-contact ACL injury mechanism. Fatigued and weak hip abductors have been correlated with increased knee abduction moment and knee valgus angle. Strengthening the hip abductor muscles might play an important role in ACL injury prevention. Purpose: T...

MRI evaluation of acute articular cartilage injury of knee

International Nuclear Information System (INIS)

Zhang Jun; Wu Zhenhua; Fan Guoguang; Pan Shinong; Guo Qiyong

2003-01-01

Objective: To study the MRI manifestation of acute articular cartilage injury of knee for evaluating the extension and degree of the injury and guiding treatment. Methods: MRI of 34 patients with acute articular cartilage injury of knee within one day to fifteen days confirmed by arthroscopy and arthrotomy was reviewed and analyzed, with emphasis on articular cartilage and subchondral lesion. And every manifestation on MRI and that of arthroscopy and operation was compared. Results: The articular cartilage injury was diagnosed on MRI in 29 of 34 cases. Cartilage signal changes were found only in 4. The changes of cartilage shape were variable. Thinning of focal cartilage was showed in 3, osteochondral impaction in 3, creases of cartilage in 3, disrupted cartilage with fissuring in 13, cracks cartilage in 2, and cracks cartilage with displaced fragment in 1. Bone bruise and occult fracture were found only on MRI. Conclusion: The assessment of MRI and arthroscopy in acute articular cartilage injury are consistent. Combined with arthroscopy, MRI can succeed in assessing the extension and degree of acute articular injury and allowing treatment planning

Correlation between bone contusion and ligament, menisci injury of knee joint

International Nuclear Information System (INIS)

Zhang Lijuan; Li Pei; Tu Changzhuo; Wu Guangren; Qi Yuliang; Yan Xiaoqun

2004-01-01

Objective: To evaluate the correlation between bone contusion and ligament, meniscus injury of knee joint with MR imaging. Methods: Thirty-five patients with acute trauma of knee joint were studied retrospectively. All eases showed negative on X-ray and bone cont, -sion on MR imaging. Results: in all patients, ligament and meniscus injury were seen in 25 cases (71%), incorporate anterior cruciate ligament injury in 12 cases, posterior cruciate ligament in 6, tibial collateral ligament in 8 cases, fibular collateral ligament in 6 cases, medial meniscus tear in 4 cases, lateral meniscus tear in 5 cases, and hydrops in 29 cases. There were only 3 patients with ligament or meniscus injury but no bone contusion during the same period. Conclusion: It is necessary to check by MR for the patients with acute trauma of knee joint, who have clinical symptom such as ache, swelling, move un-freely showing bone contusion on MR Imaging but without any abnormality on X-ray in order to avoid failure in diagnosing injury of ligament and meniscus. (authors)

Segmentation of knee injury swelling on infrared images

Science.gov (United States)

Puentes, John; Langet, Hélène; Herry, Christophe; Frize, Monique

2011-03-01

Interpretation of medical infrared images is complex due to thermal noise, absence of texture, and small temperature differences in pathological zones. Acute inflammatory response is a characteristic symptom of some knee injuries like anterior cruciate ligament sprains, muscle or tendons strains, and meniscus tear. Whereas artificial coloring of the original grey level images may allow to visually assess the extent inflammation in the area, their automated segmentation remains a challenging problem. This paper presents a hybrid segmentation algorithm to evaluate the extent of inflammation after knee injury, in terms of temperature variations and surface shape. It is based on the intersection of rapid color segmentation and homogeneous region segmentation, to which a Laplacian of a Gaussian filter is applied. While rapid color segmentation enables to properly detect the observed core of swollen area, homogeneous region segmentation identifies possible inflammation zones, combining homogeneous grey level and hue area segmentation. The hybrid segmentation algorithm compares the potential inflammation regions partially detected by each method to identify overlapping areas. Noise filtering and edge segmentation are then applied to common zones in order to segment the swelling surfaces of the injury. Experimental results on images of a patient with anterior cruciate ligament sprain show the improved performance of the hybrid algorithm with respect to its separated components. The main contribution of this work is a meaningful automatic segmentation of abnormal skin temperature variations on infrared thermography images of knee injury swelling.

Do exercises used in injury prevention programmes modify cutting task biomechanics? A systematic review with meta-analysis.

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Pappas, Evangelos; Nightingale, Elizabeth J; Simic, Milena; Ford, Kevin R; Hewett, Timothy E; Myer, Gregory D

2015-05-01

Some injury prevention programmes aim to reduce the risk of ACL rupture. Although the most common athletic task leading to ACL rupture is cutting, there is currently no consensus on how injury prevention programmes influence cutting task biomechanics. To systematically review and synthesise the scientific literature regarding the influence of injury prevention programme exercises on cutting task biomechanics. The three largest databases (Medline, EMBASE and CINAHL) were searched for studies that investigated the effect of injury prevention programmes on cutting task biomechanics. When possible meta-analyses were performed. Seven studies met the inclusion criteria. Across all studies, a total of 100 participants received exercises that are part of ACL injury prevention programmes and 76 participants served in control groups. Most studies evaluated variables associated with the quadriceps dominance theory. The meta-analysis revealed decreased lateral hamstrings electromyography activity (p ≤ 0.05) while single studies revealed decreased quadriceps and increased medial hamstrings activity and decreased peak knee flexion moment. Findings from single studies reported that ACL injury prevention exercises reduce neuromuscular deficits (knee valgus moment, lateral trunk leaning) associated with the ligament and trunk dominance theories, respectively. The programmes we analysed appear most effective when they emphasise individualised biomechanical technique correction and target postpubertal women. The exercises used in injury prevention programmes have the potential to improve cutting task biomechanics by ameliorating neuromuscular deficits linked to ACL rupture, especially when they emphasise individualised biomechanical technique correction and target postpubertal female athletes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Weaker lower extremity muscle strength predicts traumatic knee injury in youth female but not male athletes.

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Ryman Augustsson, Sofia; Ageberg, Eva

2017-01-01

The role of lower extremity (LE) muscle strength for predicting traumatic knee injury in youth athletes is largely unknown. The aim was to investigate the influence of LE muscle strength on traumatic knee injury in youth female and male athletes. 225 athletes (40% females) from sport senior high schools in Sweden were included in this case-control study. The athletes recorded any traumatic knee injury that had occurred during their high-school period in a web-based injury form. A one repetition maximum (1RM) barbell squat test was used to measure LE muscle strength. The 1RM was dichotomised to analyse 'weak' versus 'strong' athletes according to the median (weak median vs strong median ). 63 traumatic knee injuries, including 18 ACL injuries, were registered. The majority of injured female athletes were in the weak group compared with the strong group (p=0.0001). The odds of sustaining a traumatic knee injury and an ACL injury was 9.5 times higher and 7 times higher, respectively, in the weak median group compared with the strong median group in females (p ≤0.011). A relative 1RM squat ≤1.05 kg (105% of bodyweight) was established as the best cut-off value to distinguish high versus low risk of injury in female athletes. No strength-injury relationships were observed for the male athletes (p ≥0.348). Weaker LE muscle strength predicted traumatic knee injury in youth female athletes, but not in males. This suggests that LE muscle strength should be included in injury screening in youth female athletes.

Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial.

Science.gov (United States)

Finch, Caroline F; Twomey, Dara M; Fortington, Lauren V; Doyle, Tim L A; Elliott, Bruce C; Akram, Muhammad; Lloyd, David G

2016-04-01

Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

A non-contact complete knee dislocation with popliteal artery disruption, a rare martial arts injury.

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Viswanath, Y K; Rogers, I M

1999-09-01

Complete knee dislocation is a rare injury and an associated incidence of popliteal artery damage ranges from 16-60% of cases. It occurs commonly in road traffic accidents and in high velocity trauma where significant contact remains as the usual mode of injury. We describe a rare case of non-contact knee dislocation with popliteal artery injury sustained while practising Aikido, a type of martial art. This patient successfully underwent closed reduction of the knee with an emergency vein bypass graft. Similar injury in association with Aikido has not been described in the English literature previously. Various martial art injuries are briefly discussed and safety recommendations made.

Structure and function, injury, pathology, and treatment of the medial collateral ligament of the knee.

Science.gov (United States)

Schein, Aaron; Matcuk, George; Patel, Dakshesh; Gottsegen, Christopher J; Hartshorn, Timothy; Forrester, Deborah; White, Eric

2012-12-01

The medial collateral ligament (MCL) is the most commonly injured ligament of the knee. There is a spectrum of injury severity, and injuries may be acute or chronic. The MCL is also frequently injured in conjunction with other knee structures. Clinical evaluation of the knee is important to assess the degree of surgical acuity, but magnetic resonance imaging can provide details about the injury that may not be obvious clinically. In addition to injury, MCL bursitis can occur and may be treated with needle aspiration and corticosteroid injection. This review article covers the anatomy and biomechanics of the MCL, its injury patterns and approach to management, and MCL bursitis.

The quadriceps angle and the incidence of knee injury in indian ...

African Journals Online (AJOL)

a stronger vastus medialis pulls the patella medially resulting in a smaller ... T Puckree (Bsc Physio, Ms (exercise science), Med, PhD (exercise Physiology))1 a govender (B Physio) ... runners into 2 groups with and without knee injuries. Knee.

A non-contact complete knee dislocation with popliteal artery disruption, a rare martial arts injury

OpenAIRE

Viswanath, Y; Rogers, I

1999-01-01

Complete knee dislocation is a rare injury and an associated incidence of popliteal artery damage ranges from 16-60% of cases. It occurs commonly in road traffic accidents and in high velocity trauma where significant contact remains as the usual mode of injury. We describe a rare case of non-contact knee dislocation with popliteal artery injury sustained while practising Aikido, a type of martial art. This patient successfully underwent closed reduction of the knee with an emergency vein byp...

Contribution of mechanical unloading to trabecular bone loss following non-invasive knee injury in mice.

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Anderson, Matthew J; Diko, Sindi; Baehr, Leslie M; Baar, Keith; Bodine, Sue C; Christiansen, Blaine A

2016-10-01

Development of osteoarthritis commonly involves degeneration of epiphyseal trabecular bone. In previous studies, we observed 30-44% loss of epiphyseal trabecular bone (BV/TV) from the distal femur within 1 week following non-invasive knee injury in mice. Mechanical unloading (disuse) may contribute to this bone loss; however, it is unclear to what extent the injured limb is unloaded following injury, and whether disuse can fully account for the observed magnitude of bone loss. In this study, we investigated the contribution of mechanical unloading to trabecular bone changes observed following non-invasive knee injury in mice (female C57BL/6N). We investigated changes in gait during treadmill walking, and changes in voluntary activity level using Open Field analysis at 4, 14, 28, and 42 days post-injury. We also quantified epiphyseal trabecular bone using μCT and weighed lower-limb muscles to quantify atrophy following knee injury in both ground control and hindlimb unloaded (HLU) mice. Gait analysis revealed a slightly altered stride pattern in the injured limb, with a decreased stance phase and increased swing phase. However, Open Field analysis revealed no differences in voluntary movement between injured and sham mice at any time point. Both knee injury and HLU resulted in comparable magnitudes of trabecular bone loss; however, HLU resulted in considerably more muscle loss than knee injury, suggesting another mechanism contributing to bone loss following injury. Altogether, these data suggest that mechanical unloading likely contributes to trabecular bone loss following non-invasive knee injury, but the magnitude of this bone loss cannot be fully explained by disuse. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1680-1687, 2016. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Effects of knee extension constraint training on knee flexion angle and peak impact ground-reaction force.

Science.gov (United States)

Liu, Hui; Wu, Will; Yao, Wanxiang; Spang, Jeffrey T; Creighton, R Alexander; Garrett, William E; Yu, Bing

2014-04-01

Low compliance with training programs is likely to be one of the major reasons for inconsistency of the data regarding the effectiveness of current anterior cruciate ligament (ACL) injury prevention programs. Training methods that reduce training time and cost could favorably influence the effectiveness of ACL injury prevention programs. A newly designed knee extension constraint training device may serve this purpose. (1) Knee extension constraint training for 4 weeks would significantly increase the knee flexion angle at the time of peak impact posterior ground-reaction force and decrease peak impact ground-reaction forces during landing of a stop-jump task and a side-cutting task, and (2) the training effects would be retained 4 weeks after completion of the training program. Controlled laboratory study. Twenty-four recreational athletes were randomly assigned to group A or B. Participants in group A played sports without wearing a knee extension constraint device for 4 weeks and then played sports while wearing the device for 4 weeks, while participants in group B underwent a reversed protocol. Both groups were tested at the beginning of week 1 and at the ends of weeks 4 and 8 without wearing the device. Knee joint angles were obtained from 3-dimensional videographic data, while ground-reaction forces were measured simultaneously using force plates. Analyses of variance were performed to determine the training effects and the retention of training effects. Participants in group A significantly increased knee flexion angles and decreased ground-reaction forces at the end of week 8 (P ≤ .012). Participants in group B significantly increased knee flexion angles and decreased ground-reaction forces at the ends of weeks 4 and 8 (P ≤ .007). However, participants in group B decreased knee flexion angles and increased ground-reaction forces at the end of week 8 in comparison with the end of week 4 (P ≤ .009). Knee extension constraint training for 4 weeks

Bilateral Floating Hip and Floating Knee: a Rare Complex Injury ...

African Journals Online (AJOL)

We report a rare complex injury of a 45-year-old man who sustained a bilateral floating hip and floating knee and hospitalised in our service six days after a traffic accident. The floating knees were open type III and II of Cauchoix score in phase of suppuration. He also presented with a floating ankle on the right side.

Self-reported activity level and knee function in amateur football players: the influence of age, gender, history of knee injury and level of competition.

Science.gov (United States)

Frobell, R B; Svensson, E; Göthrick, M; Roos, E M

2008-07-01

The aim of this study is to investigate if self-reported activity level or knee functions are influenced by subject characteristics, level of competition and history of knee injury. Cross-Sectional study using questionnaires distributed at a personal visit. One hundred and eighty-eight (65 women) amateur football players in 10 football clubs from each division below national level participated in the study. Self-reported Tegner Activity Scale, and the Knee injury and Osteoarthritis Outcome Score (KOOS) are the main outcome measures. Older age, female gender and lower level of competition (football division) were independently associated with lower self-reported Tegner Activity Scale (P history of knee injury had significantly worse KOOS scores (P football players, KOOS scores do not need adjustment for age and gender.

Evaluation of functional outcome of the floating knee injury using multivariate analysis.

Science.gov (United States)

Yokoyama, Kazuhiko; Tsukamoto, Tatsuro; Aoki, Shinichi; Wakita, Ryuji; Uchino, Masataka; Noumi, Takashi; Fukushima, Nobuaki; Itoman, Moritoshi

2002-11-01

The objective of this study is to evaluate significant contributing factors affecting the functional prognosis of floating knee injuries using multivariate analysis. A total of 68 floating knee injuries (67 patients) were treated at Kitasato University Hospital from 1986 to 1999. Both the femoral fractures and the tibial fractures were managed surgically by various methods. The functional results of these injuries were evaluated using the grading system of Karlström and Olerud. Follow-up periods ranged from 2 to 19 years (mean 50.2 months) after the original injury. We defined satisfactory (S) outcomes as those cases with excellent or good results and unsatisfactory (US) outcomes as those cases with acceptable or poor results. Logistic regression analysis was used as a multivariate analysis, and the dependent variables were defined as a satisfactory outcome or as an unsatisfactory outcome. The explanatory variables were predicting factors influencing the functional outcome such as age at trauma, gender, severity of soft-tissue injury in the femur and the tibia, AO fracture grade in the femur and the tibia, Fraser type (type I or type II), Injury Severity Score (ISS), and fixation time after injury (less than 1 week or more than 1 week) in the femur and the tibia. The final functional results were as follows: 25 cases had excellent results, 15 cases good results, 16 cases acceptable results, and 12 cases poor results. The predictive logistic regression equation was as follows: Log 1-p/p = 3.12-1.52 x Fraser type - 1.65 x severity of soft-tissue injury in the tibia - 1.31 x fixation time after injury in the tibia - 0.821 x AO fracture grade in the tibia + 1.025 x fixation time after injury in the femur - 0.687 x AO fracture grade in the femur ( p=0.01). Among the variables, Fraser type and the severity of soft-tissue injury in the tibia were significantly related to the final result. The multivariate analysis showed that both the involvement of the knee joint and

The effect of knee brace and knee sleeve on the proprioception of the knee in young non-professional healthy sportsmen.

Science.gov (United States)

Bottoni, G; Herten, A; Kofler, P; Hasler, M; Nachbauer, W

2013-12-01

Proprioception has been defined as the capacity to feel the position of a joint in space as sensed by the central nervous system. Prophylactic knee braces are supposed to help in knee injury prevention not just with a mechanical support of the joint but also improving proprioception. The main aim of this study was to determine the effects of a knee brace and a knee sleeve on knee proprioception. The secondary aim was to determine if different starting angles of the knee and different movement directions influence knee proprioception. We tested a group of twenty healthy male sport students without knee injuries. They were tested with the brace, with the sleeve and without support. The threshold of detection of passive knee movement with a starting knee angle of 30° and 60°, both in flexion and extension was determined. We did not find any statistically significant change in the threshold of detection of passive knee movement wearing the brace or the sleeve compared to the unsupported condition (p=0.462, α=0.05). We found a significantly lower proprioceptive sensitivity starting at the more flexed knee angle (p=0.005, α=0.05) and moving in extension than in the other test situations (p=0.001, α=0.05). Movement direction and starting position appear to influence the threshold of detection of passive knee movement. The results of this study also suggest that knee supports do not influence either positively or negatively knee proprioception of uninjured active subjects. Copyright © 2013 Elsevier B.V. All rights reserved.

Preventing musculoskeletal injuries among recreational adult volleyball players: design of a randomised prospective controlled trial.

Science.gov (United States)

Gouttebarge, Vincent; Zwerver, Johannes; Verhagen, Evert

2017-08-02

Both acute and overuse injuries are common among recreational volleyball players, especially finger/wrist, ankle, shoulder and knee injuries. Consequently, an intervention ('VolleyVeilig') was developed to prevent or reduce the occurrence of finger/wrist, shoulder, knee and ankle injuries among recreational volleyball players. This article describes the design of a study evaluating the effectiveness of the developed intervention on the one-season occurrence of finger/wrist, shoulder, knee and ankle injuries among recreational adult volleyball players. A randomized prospective controlled trial with a follow-up period of one volleyball season will be conducted. Participants will be healthy recreational adult volleyball players (18 years of age or older) practicing volleyball (training and/or match) at least twice a week. The intervention ('VolleyVeilig') consists of a warm-up program based on more than 50 distinct exercises (with different variations and levels). The effect of the intervention programme on the occurrence of injuries will be compared to volleyball as usual. Outcome measures will be incidence of acute injury (expressed as number of injuries per 1000 h of play) and prevalence of overuse injuries (expressed as percentage). This study will be one of the first randomized prospective controlled trials evaluating the effectiveness of an intervention on the occurrence of both acute and overuse injuries among recreational adult volleyball players. Outcome of this study could possibly lead to the nationwide implementation of the intervention in all volleyball clubs in The Netherlands, ultimately resulting in less injuries. Dutch Trial Registration NTR6202 , registered February 1st 2017. Version 3, February 2017.

ETHIOLOGY AND MECHANISMS OF INJURIES OF KNEE ANTERIOR CRUCIATE LIGAMENT IN ATHLETES

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Nikola Bulatović

2011-08-01

Full Text Available The examined group was composed of 60 patients with injuries of Anterior Cruciate Ligament (ACL treated at the Clinical Center of Montenegro from 2006- 2010. Among general population the frequency is 1:3000, and around 70% of ACL injuries occur as a consequence of sports activity. These traumas represent 15-30% of all sports injuries. Normal kinematics of a knee joint means intact ligament. The purpose of our work was to determine the risk factors of injury, regarding training and competing process, daily activity and their connection with the mechanism of injury. In our inquiry, recreational athletes represented 70% of patients.The most common mechanism of injury is a non-contact, deceleration, valgus angulation with an external rotation as a consequence of landing, sudden change of direction, running rhythm, or fall. The largest number of injuries occurs in training, recreation, tournaments, and everyday activities. In diagnostics we employed clinical tests, ECHO finding, NMR and arthroscopy. Sports activity during which our patients obtained most of their injuries is soccer. Traumas were frequently followed by damages to their joint structures (meniscus, cartilage. Injuries of ACL are multifactorial etiologies, but through external and internal factors, adequate communication, and sports culture of partakers (athletes, trainers and physicians can be acted preventively on decreasing injury incidence and timely and adequate treatment

Injury prevalence of netball players in South Africa: The need for in jury prevention

Directory of Open Access Journals (Sweden)

T. Pillay

2012-12-01

Full Text Available This study aimed to establish baseline data for injury prevalence,mechanism of injury, injury severity and management of injuries in netball playersin South Africa. A cross sectional descriptive design was employed to collect databy means of a questionnaire in 2010. Participants consisted of 254 netball playerswho participated in a netball tournament. Permission was obtained from all therelevant organizations and informed consent obtained from the participants. Thegeneral injury rate was 61.8% with an injury rate of 1.9 injuries per player forthe past season. The most commonly injured structures were the ankle 37.5 % andthe knee 28.6% with the most common mechanism of injury being landing, 19% and 29% respectively. Of those whosustained injuries, 86 (44% of the injured athletes’ sustained severe injuries, 31(16% sustained moderate injuriesand 78 (40% sustained mild injuries. 67% of players reported they were able to continue with the game and 33%received medical assistance losing game and training time. The most common form of management accessed wasphysiotherapy, which accounted for 31%. It is evident that the ankle and knee injury rates amongst South Africannetball players are high in comparison to other netball playing nations. Injury surveillance is an integral part ofdeveloping preventative measures. The article lays a platform for developing these strategies against the backdrop ofits findings and comparison with other authors.

Effects of a low volume injury prevention program on the hamstring torque angle relationship

OpenAIRE

Naclerio Ayllón, Fernando José; Faigenbaum, Avery D.; Larumbe Zabala, Eneko; Goss-Sampson, Mark; Pérez-Bilbao, Txomin; Jiménez Gutiérrez, Alfonso; Beedie, Chris

2013-01-01

The effects of a 4-week lower body injury prevention program on knee muscle torque-angle relationship were examined in soccer players. Twenty men were randomly allocated to either a control (n = 10) or training group (n = 10). The training group underwent three training sessions per week, comprising 3 sets of 8 repetitions of one open-chain exercise (Nordic curl) and two closed-chain exercises-forward lunges on a Bosu balance trainer and eccentric single leg dead lifts. Maximal peak knee flex...

Common rugby league injuries. Recommendations for treatment and preventative measures.

Science.gov (United States)

Gibbs, N

1994-12-01

Rugby league is the main professional team sport played in Eastern Australia. It is also very popular at a junior and amateur level. However, injuries are common because of the amount of body contact that occurs and the amount of running that is required to participate in the game. Injuries to the lower limbs account for over 50% of all injuries. The most common specific injuries are ankle lateral ligament tears, knee medial collateral and anterior cruciate ligament tears, groin musculotendinous tears, hamstring and calf muscle tears, and quadriceps muscle contusions. Head injuries are common and consist of varying degrees of concussion as well as lacerations and facial fractures. Serious head injury is rare. Some of the more common upper limb injuries are to the acromioclavicular and glenohumeral joints. Accurate diagnosis of these common injuries using appropriate history, examination and investigations is critical in organising a treatment and rehabilitation plan that will return the player to competition as soon as possible. An understanding of the mechanism of injury is also important in order to develop preventative strategies.

Differences in injury pattern and prevalence of cartilage lesions in knee and ankle joints: a retrospective cohort study

Directory of Open Access Journals (Sweden)

Matthias Aurich

2014-12-01

Full Text Available Osteoarthritis (OA is more common in the knee compared to the ankle joint. This can not be explained exclusively by anatomical and biomechanical differences. The aim of this study is to analyze and compare the injury pattern (clinically and the cartilage lesions (arthroscopically of knee and ankle joints in a cohort of patients from the same catchment area. A retrospective study of the clinical data of 3122 patients (2139 outpatients and 983 inpatients was performed, who were treated due to an injury of the knee and ankle joint. Statistical analysis was performed using SigmaStat 3.0 (SPSS Inc, Chicago, USA. There is a higher prevalence of injuries in the ankle as compared to the knee joint in this population from the same catchment area. In contrast, high-grade cartilage lesions are more prevalent in the knee, whereas low grade cartilage lesions are equally distributed between knee and ankle. From this data it can be concluded that the frequency of injuries and the injury pattern of knee versus ankle joints do not correlate with the severity of cartilage lesions and may therefore have no direct influence on the differential incidence of OA in those two joints.

A Prospective Study of Overuse Knee Injuries Among Female Athletes With Muscle Imbalances and Structural Abnormalities.

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Devan, Michelle R; Pescatello, Linda S; Faghri, Pouran; Anderson, Jeffrey

2004-09-01

OBJECTIVE: To prospectively examine the influence of hamstring-to-quadriceps (H:Q) ratio and structural abnormalities on the prevalence of overuse knee injuries among female collegiate athletes. DESIGN AND SETTING: We used chi-square 2 x 2 contingency tables and the Fischer exact test to examine associations among H:Q ratios, structural abnormalities, and overuse knee injuries. SUBJECTS: Fifty-three apparently healthy women (age = 19.4 +/- 1.3 years, height = 167.6 +/- 10.1 cm, mass = 65.0 +/- 10.0 kg) from National Collegiate Athletic Association Division I women's field hockey (n = 23), soccer (n = 20), and basketball teams (n = 10) volunteered. MEASUREMENTS: The H:Q ratio was determined from a preseason isokinetic test on a Biodex system at 60 degrees /s and 300 degrees /s. We measured athletes for genu recurvatum and Q-angles with a 14-in (35.56-cm) goniometer. Iliotibial band flexibility was assessed via the Ober test. RESULTS: Ten overuse knee injuries (iliotibial band friction syndromes = 5, patellar tendinitis = 3, patellofemoral syndrome = 1, pes anserine tendinitis = 1) occurred in 9 athletes. The H:Q ratio below the normal range at 300 degrees /s (P = 0.047) was associated with overuse knee injuries, as was the presence of genu recurvatum (P = 0.004). In addition, athletes possessing lower H:Q ratios at 300 degrees /s and genu recurvatum incurred more overuse knee injuries than athletes without these abnormalities (P = 0.001). CONCLUSIONS: The presence of genu recurvatum and an H: Q ratio below normal range was associated with an increased prevalence of overuse knee injuries among female collegiate athletes. Further investigation is needed to clarify which preseason screening procedures may identify collegiate athletes who are susceptible to overuse knee injuries.

Non-Traumatic Anterior Dislocation of a Total Knee Replacement Associated with Neurovascular Injury

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Aderinto, Joseph; Gross, Allan E; Rittenhouse, Bryan

2009-01-01

Prosthetic total knee replacements rarely dislocate. When dislocation does occur, it is usually in a posterior direction in association with a posterior stabilised, cruciate-sacrificing prosthesis. Neurovascular injury is unusual. In this report, we describe a case of anterior dislocation of a cruciate-retaining total knee replacement in a 67-year-old woman. The dislocation occurred in the absence of overt trauma and resulted in severe neurovascular injury. PMID:19686618

Knee Injuries in Wrestlers: A Prospective Study from the Indian Subcontinent

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Agarwal; Mann

2016-01-01

Background Wrestling is a very popular sport the world over and its popularity is rapidly increasing in India. However, due to its arduous nature it is associated with a high incidence of injuries. Out of all the injuries, those to the knee are one of the commonest injuries reported. Objectives Our aim was to study the pattern of these injuries in the Indian wrestlers. Methods A pr...

Sport injuries of the knee in young people

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Kainz, L; Brezina, K

1981-12-01

The largest number of injuries of the knee occurrs in athletes. The portion of girls has reached 30%. More than 50% of all injuries regard the ligaments and the menisci. Especially in these cases and in combined lesions, arthrography gives good results. All possibilities of investigations should be used for acutely injured sportsmen because of the specific risks and the dissimulation of young sportspeople and because of the danger of late established diagnosis and within those of late damages.

Epidemiology and history of knee injury and its impact on activity limitation among football premier league professional referees.

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Mahdavi Mohtasham, Hamid; Shahrbanian, Shahnaz; Khoshroo, Fatemeh

2018-01-01

The purpose of this study was to determine the epidemiology and history of knee injury and its impact on activity limitation among football premier league professional referees in Iran. This was a descriptive study. 59 Football Premier League professional referees participated in the study. The knee injury related information such as injury history and mechanism was recorded. Injury related symptoms and their impacts on the activity limitation, ability to perform activities of daily living as well participation in sports and recreational activities was obtained through the Knee Outcome Survey (KOS). The results indicated that 31 out of 59 participants reported the history of knee injury. In addition, 18.6%, 22.4% and 81% of the referees reported that they had been injured during the last 6 months of the last year, and at some point in their refereeing careers, respectively. Results further indicated that 48.8% of the injuries occurred in the non-dominant leg and they occurred more frequently during training sessions (52%). Furthermore, the value of KOS was 85 ± 13 for Activities of Daily Living subscale and 90 ± 9 for Sports and Recreational Activities subscale of the KOS. Knee injury was quite common among the Football Premier League professional referees. It was also indicated that the injuries occurred mainly due to insufficient physical fitness. Therefore, it is suggested that football referees undergo the proper warm-up program to avoid knee injury.

Bone signal abnormality, as seen on knee joint MRI : relationship between its location and associated injury

International Nuclear Information System (INIS)

Kim, Young Nam; Kim, Baek Hyun; Jung, Hoe Seok; Na, Eui Sung; Seol, Hye Young; Cha, In Ho; Lim, Hong Chul

1998-01-01

The purpose of the study was to evaluate the relationship between the location of bone signal abnormality and associated injury, as seen on MR, in patients with acute knee joint injury. Materials and Methods: Thirty-six patients with acute knee injury and bone signal abnormalities on MR were included in this study. The femur and tibia were each divided into six compartments, namely the anteromedial, medial, posteromedial,anterolateral, lateral, and posterolateral ; these were obtained in each knee joint. We evaluated the location of bone signal abnormality and the corresponding arthroscopic or operative findings of injury to ligaments and menisci. Cases with signal abnormalities involving more than three compartments were excluded. Results : Bone signal abnormalities were demonstrated in 51 compartments. Most(84%, 43/51) were noted in the lateral half of the knee joint, the most common location being the tibio- posterolateral compartment(13/51). The femoro-lateral(11/51) and tibio- anterolateral compartment(8/51) were the next most common locations. All cases(13/13)with bone signal abnormality in the tibio- posterolateral compartment had tears at the anterior cruciate ligament,while 9 of 11 cases(81%) with abnormality in the femoro- lateral compartment had tears at the anterior cruciate ligament. Six of eight cases(75%) with signal abnormality in the tibio- anterolateral compartment had tears at the posterior cruciate ligament ; 31 of 43 cases (72%) with abnormality in the lateral half of the knee joint had tears at the medial collateral ligament. Six of eight cases(75%) with signal abnormality in the medial half of the knee joint had tears at the medial meniscus, but no lateral meniscal tear was found. Among patients with signal abnormality in the lateral half of the knee joint, the tear was lateral meniscal in nine of 43 cases(21%) and medial meniscal in six of 43(14%). Conclusion : The location of bone signal abnormality, as seen on knee MR, inpatients with

Strategies for the prevention of knee osteoarthritis

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Roos, Ewa M.; Arden, Nigel K

2016-01-01

, interfering with activities of daily living and the ability to work. Many patients tolerate pain, and many health-care providers accept pain and disability as inevitable corollaries of OA and ageing. Too often, health-care providers passively await final 'joint death', necessitating knee and hip replacements......-the regimes. Now is the time to begin the era of personalized prevention for knee OA....

Floating knee injury associated with patellar tendon rupture: a case report and review of literature.

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Vaidyanathan, Singaravadivelu; Panchanathan Ganesan, Jagannath; Moongilpatti Sengodan, Mugundhan

2012-01-01

Floating knee injuries are frequently associated with other concomitant injuries to the ipsilateral limb or other parts of body of which injury to the ipsilateral knee ligaments carries significance for various reasons. A middle-aged man sustained a floating knee injury following RTA. DCS fixation by bridge plating technique for the distal femur and lateral buttress plating by MIPO technique for proximal tibia were planned and executed under spinal anesthesia with image intensifier. In addition, there were patellar tendon rupture along with avulsion of VMO from the medial border of patella and torn MPFL, which we have missed initially. To the best of our knowledge no similar case has been reported in English literature so far. We have reviewed the literature and proposed a different interpretation of Blake and McBride classification.

Floating Knee Injury Associated with Patellar Tendon Rupture: A Case Report and Review of Literature

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Singaravadivelu Vaidyanathan

2012-01-01

Full Text Available Floating knee injuries are frequently associated with other concomitant injuries to the ipsilateral limb or other parts of body of which injury to the ipsilateral knee ligaments carries significance for various reasons. A middle-aged man sustained a floating knee injury following RTA. DCS fixation by bridge plating technique for the distal femur and lateral buttress plating by MIPO technique for proximal tibia were planned and executed under spinal anesthesia with image intensifier. In addition, there were patellar tendon rupture along with avulsion of VMO from the medial border of patella and torn MPFL, which we have missed initially. To the best of our knowledge no similar case has been reported in English literature so far. We have reviewed the literature and proposed a different interpretation of Blake and McBride classification.

Knee Injury and Osteoarthritis Outcome Score (KOOS): systematic review and meta-analysis of measurement properties.

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Collins, N J; Prinsen, C A C; Christensen, R; Bartels, E M; Terwee, C B; Roos, E M

2016-08-01

To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties in participants with knee injuries and/or osteoarthritis (OA). Methodological quality was evaluated using the COSMIN checklist. Where possible, meta-analysis of extracted data was conducted for all studies and stratified by age and knee condition; otherwise narrative synthesis was performed. KOOS has adequate internal consistency, test-retest reliability and construct validity in young and old adults with knee injuries and/or OA. The ADL subscale has better content validity for older patients and Sport/Rec for younger patients with knee injuries, while the Pain subscale is more relevant for painful knee conditions. The five-factor structure of the original KOOS is unclear. There is some evidence that the KOOS subscales demonstrate sufficient unidimensionality, but this requires confirmation. Although measurement error requires further evaluation, the minimal detectable change for KOOS subscales ranges from 14.3 to 19.6 for younger individuals, and ≥20 for older individuals. Evidence of responsiveness comes from larger effect sizes following surgical (especially total knee replacement) than non-surgical interventions. KOOS demonstrates adequate content validity, internal consistency, test-retest reliability, construct validity and responsiveness for age- and condition-relevant subscales. Structural validity, cross-cultural validity and measurement error require further evaluation, as well as construct validity of KOOS Physical function Short form. Suggested order of subscales for different knee conditions can be applied in hierarchical testing of endpoints in clinical trials. PROSPERO (CRD42011001603). Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All

Knee Ligament Injury and the Clinical Application of Tissue Engineering Techniques: A Systematic Review.

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Riley, Thomas C; Mafi, Reza; Mafi, Pouya; Khan, Wasim S

2018-02-23

The incidence of knee ligament injury is increasing and represents a significant cost to healthcare providers. Current interventions include tissue grafts, suture repair and non-surgical management. These techniques have demonstrated good patient outcomes but have been associated graft rejection, infection, long term immobilization and reduced joint function. The limitations of traditional management strategies have prompted research into tissue engineering of knee ligaments. This paper aims to evaluate whether tissue engineering of knee ligaments offers a viable alternative in the clinical management of knee ligament injuries. A search of existing literature was performed using OVID Medline, Embase, AMED, PubMed and Google Scholar, and a manual review of citations identified within these papers. Silk, polymer and extracellular matrix based scaffolds can all improve graft healing and collagen production. Fibroblasts and stem cells demonstrate compatibility with scaffolds, and have been shown to increase organized collagen production. These effects can be augmented using growth factors and extracellular matrix derivatives. Animal studies have shown tissue engineered ligaments can provide the biomechanical characteristics required for effective treatment of knee ligament injuries. There is a growing clinical demand for a tissue engineered alternative to traditional management strategies. Currently, there is limited consensus regarding material selection for use in tissue engineered ligaments. Further research is required to optimize tissue engineered ligament production before clinical application. Controlled clinical trials comparing the use of tissue engineered ligaments and traditional management in patients with knee ligament injury could determine whether they can provide a cost-effective alternative. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Hip joint biomechanics in those with and without post-traumatic knee osteoarthritis after anterior cruciate ligament injury.

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Wellsandt, E; Zeni, J A; Axe, M J; Snyder-Mackler, L

2017-12-01

Anterior cruciate ligament injury results in altered kinematics and kinetics in the knee and hip joints that persist despite surgical reconstruction and rehabilitation. Abnormal movement patterns and a history of osteoarthritis are risk factors for articular cartilage degeneration in additional joints. The purpose of this study was to determine if hip joint biomechanics early after anterior cruciate ligament injury and reconstruction differ between patients with and without post-traumatic knee osteoarthritis 5years after reconstruction. The study's rationale was that individuals who develop knee osteoarthritis after anterior cruciate ligament injury may also demonstrate large alterations in hip joint biomechanics. Nineteen athletes with anterior cruciate ligament injury completed standard gait analysis before (baseline) and after (post-training) extended pre-operative rehabilitation and at 6months, 1year, and 2years after reconstruction. Weightbearing knee radiographs were completed 5years after reconstruction to identify medial compartment osteoarthritis. Five of 19 patients had knee osteoarthritis at 5years after anterior cruciate ligament reconstruction. Patients with knee osteoarthritis at 5years walked with smaller sagittal plane hip angles (P: 0.043) and lower sagittal (P: 0.021) and frontal plane (P: 0.042) external hip moments in the injured limb before and after reconstruction compared to those without knee osteoarthritis. The current findings suggest hip joint biomechanics may be altered in patients who develop post-traumatic knee osteoarthritis. Further study is needed to confirm whether the risk of non-traumatic hip pathology is increased after anterior cruciate ligament injury and if hip joint biomechanics influence its development. Copyright © 2017 Elsevier Ltd. All rights reserved.

Common Peroneal Nerve Palsy with Multiple-Ligament Knee Injury and Distal Avulsion of the Biceps Femoris Tendon

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Takeshi Oshima

2015-01-01

Full Text Available A multiple-ligament knee injury that includes posterolateral corner (PLC disruption often causes palsy of the common peroneal nerve (CPN, which occurs in 44% of cases with PLC injury and biceps femoris tendon rupture or avulsion of the fibular head. Approximately half of these cases do not show functional recovery. This case report aims to present a criteria-based approach to the operation and postoperative management of CPN palsy that resulted from a multiple-ligament knee injury in a 22-year-old man that occurred during judo. We performed a two-staged surgery. The first stage was to repair the injuries to the PLC and biceps femoris. The second stage involved anterior cruciate ligament reconstruction. The outcomes were excellent, with a stable knee, excellent range of motion, and improvement in the palsy. The patient was able to return to judo competition 27 weeks after the injury. To the best of our knowledge, this is the first case report describing a return to sports following CPN palsy with multiple-ligament knee injury.

Knee Muscular Control During Jump Landing in Multidirections.

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Sinsurin, Komsak; Vachalathiti, Roongtiwa; Jalayondeja, Wattana; Limroongreungrat, Weerawat

2016-06-01

Jump landing is a complex movement in sports. While competing and practicing, athletes frequently perform multi-planar jump landing. Anticipatory muscle activity could influence the amount of knee flexion and prepare the knee for dynamic weight bearing such as landing tasks. The aim of the present study was to examine knee muscle function and knee flexion excursion as athletes naturally performed multi-direction jump landing. Eighteen male athletes performed the jump-landing test in four directions: forward (0°), 30° diagonal, 60° diagonal, and lateral (90°). Muscles tested were vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF), semitendinosus (ST), and biceps femoris (BF). A Vicon(TM) 612 workstation collected the kinematic data. An electromyography was synchronized with the Vicon(TM) Motion system to quantify dynamic muscle function. Repeated measure ANOVA was used to analyze the data. Jump-landing direction significantly influenced (P jump landing. A higher risk of knee injury might occur during lateral jump landing than forward and diagonal directions. Athletes should have more practice in jump landing in lateral direction to avoid injury. Landing technique with high knee flexion in multi-directions should be taught to jumpers for knee injury prevention.

Avulsion fractures and chronic avulsion injuries of the knee: role of MR imaging

International Nuclear Information System (INIS)

Mellado, J.M.; Ramos, A.; Salvado, E.; Camins, A.; Sauri, A.; Calmet, J.

2002-01-01

Avulsion fractures and chronic avulsion injuries of the knee are common lesions in sports-related trauma, especially among adolescents. Magnetic resonance imaging may prove useful in detecting and characterizing such lesions, and has several advantages with regard to other imaging modalities. We review, illustrate, and discuss the MR imaging features of some of the more frequent avulsion fractures and chronic avulsion injuries of the knee, including avulsion fractures of the cruciate ligaments, avulsion fractures of lateral and medial stabilizers, avulsion fractures and chronic avulsion injuries of the extensor mechanism, and avulsive cortical irregularities of the distal femur. The role of MR imaging in evaluating such lesions is emphasized. (orig.)

Real-time feedback on knee abduction moment does not improve frontal-plane knee mechanics during jump landings.

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Beaulieu, M L; Palmieri-Smith, R M

2014-08-01

Excessive knee abduction loading is a contributing factor to anterior cruciate ligament (ACL) injury risk. The purpose of this study was to determine whether a double-leg landing training program with real-time visual feedback improves frontal-plane mechanics during double- and single-leg landings. Knee abduction angles and moments and vertical ground reaction forces (GRF) of 21 recreationally active women were quantified for double- and single-leg landings before and after the training program. This program consisted of two sessions of double-leg jump landings with real-time visual feedback on knee abduction moments for the experimental group and without real-time feedback for the control group. No significant differences were found between training groups. In comparison with pre-training data, peak knee abduction moments decreased 12% post-training for both double- and single-leg landings; whereas peak vertical GRF decreased 8% post-training for double-leg landings only, irrespective of training group. Real-time feedback on knee abduction moments, therefore, did not significantly improve frontal-plane knee mechanics during landings. The effect of the training program on knee abduction moments, however, transferred from the double-leg landings (simple task) to single-leg landings (more complex task). Consequently, ACL injury prevention efforts may not need to focus on complex tasks during which injury occurs. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Sport injuries of the knee in young people

International Nuclear Information System (INIS)

Kainz, L.; Brezina, K.

1981-01-01

The biggest number of injuries of the knee are in highly result interested sportsmen. The portion of girls has reached 30%. More than 50% of all injuries regard the ligaments and the menisci. Especially in these cases and in combined lesions gives the arthrography good results. All possibilities of investigations should be used for acute injured sportsmen, because of the specific readiness of risks and the dissimulation of young sportspeople and because of the danger of too late established diagnosis and within those of late damages. (orig.) [de

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?

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Myer, Gregory D; Ford, Kevin R; Di Stasi, Stephanie L; Foss, Kim D Barber; Micheli, Lyle J; Hewett, Timothy E

2015-01-01

Identifying risk factors for knee pain and anterior cruciate ligament (ACL) injury can be an important step in the injury prevention cycle. We evaluated two unique prospective cohorts with similar populations and methodologies to compare the incidence rates and risk factors associated with patellofemoral pain (PFP) and ACL injury. The 'PFP cohort' consisted of 240 middle and high school female athletes. They were evaluated by a physician and underwent anthropometric assessment, strength testing and three-dimensional landing biomechanical analyses prior to their basketball season. 145 of these athletes met inclusion for surveillance of incident (new) PFP by certified athletic trainers during their competitive season. The 'ACL cohort' included 205 high school female volleyball, soccer and basketball athletes who underwent the same anthropometric, strength and biomechanical assessment prior to their competitive season and were subsequently followed up for incidence of ACL injury. A one-way analysis of variance was used to evaluate potential group (incident PFP vs ACL injured) differences in anthropometrics, strength and landing biomechanics. Knee abduction moment (KAM) cut-scores that provided the maximal sensitivity and specificity for prediction of PFP or ACL injury risk were also compared between the cohorts. KAM during landing above 15.4 Nm was associated with a 6.8% risk to develop PFP compared to a 2.9% risk if below the PFP risk threshold in our sample. Likewise, a KAM above 25.3 Nm was associated with a 6.8% risk for subsequent ACL injury compared to a 0.4% risk if below the established ACL risk threshold. The ACL-injured athletes initiated landing with a greater knee abduction angle and a reduced hamstrings-to-quadriceps strength ratio relative to the incident PFP group. Also, when comparing across cohorts, the athletes who suffered ACL injury also had lower hamstring/quadriceps ratio than the players in the PFP sample (p15 Nm of knee abduction load

Epidemiology of Knee Sprains in Youth, High School, and Collegiate American Football Players.

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Clifton, Daniel R; Onate, James A; Schussler, Eric; Djoko, Aristarque; Dompier, Thomas P; Kerr, Zachary Y

2017-05-01

  Variations in knee-sprain incidence among competition levels are unclear but may help inform prevention strategies in American football players.   To describe the epidemiology of knee sprains in youth, high school, and collegiate football players.   Descriptive epidemiology study.   Injury and athlete-exposure (AE) data were collected from 3 injury-surveillance programs at the youth, high school, and collegiate competition levels.   Data from 310 youth, 184 high school, and 71 collegiate football team-seasons were collected during the 2012 through 2014 seasons.   Knee-sprain rates and risks were calculated for each competition level. Injury rate ratios (IRRs) and risk ratios (RRs) compared knee-sprain rates by competition level. Injury proportion ratios (IPRs) compared differences in surgery needs, recurrence, injury mechanism, and injury activity by competition level.   Knee-sprain rates in youth, high school, and collegiate football were 0.16/1000 AEs, 0.25/1000 AEs, and 0.69/1000 AEs, respectively. Knee-sprain rates increased as the competition level increased (high school versus youth: IRR = 1.60; 95% confidence interval [CI] = 1.12, 2.30; collegiate versus high school: IRR = 2.73; 95% CI = 2.38, 3.96). Knee-sprain risk was highest in collegiate (4.3%), followed by high school (2.0%) and youth (0.5%) athletes. Knee-sprain risk increased as the competition level increased (high school versus youth: RR = 3.73; 95% CI = 2.60, 5.34; collegiate versus high school: RR = 2.14; 95% CI = 1.83, 2.51). Collegiate football had the lowest proportion of knee sprains that were noncontact injuries (collegiate versus youth: IPR = 0.54; 95% CI = 0.31, 0.95; collegiate versus high school: IPR = 0.59; 95% CI = 0.44, 0.79) and the lowest proportion that occurred while being tackled (collegiate versus youth: IPR = 0.44; 95% CI = 0.26, 0.76; collegiate versus high school: IPR = 0.71; 95% CI = 0.51, 0.98).   Knee-sprain incidence was highest in collegiate football

Disruption of the proximal tibiofibular joint in the setting of multi-ligament knee injury

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Porrino, Jack A. [University of Washington, Department of Radiology, 4245 Roosevelt Way NE, Box 354755, Seattle, WA (United States)

2015-08-15

Instability of the proximal tibiofibular joint is a relatively uncommon condition when in isolation; however, instability of the proximal tibiofibular joint is far more frequent in those presenting with a severe multi-ligament injury of the knee. If this joint is left unstable, repair of a co-existent injury of the posterolateral corner may fail, regardless of the proficiency of the technique. We present two patients with disruption of the proximal tibiofibular joint, including the MRI appearance, who initially presented to our hospital for management of significant polytrauma, as well as multi-ligament injury of the ipsilateral knee. (orig.)

Disruption of the proximal tibiofibular joint in the setting of multi-ligament knee injury

International Nuclear Information System (INIS)

Porrino, Jack A.

2015-01-01

Instability of the proximal tibiofibular joint is a relatively uncommon condition when in isolation; however, instability of the proximal tibiofibular joint is far more frequent in those presenting with a severe multi-ligament injury of the knee. If this joint is left unstable, repair of a co-existent injury of the posterolateral corner may fail, regardless of the proficiency of the technique. We present two patients with disruption of the proximal tibiofibular joint, including the MRI appearance, who initially presented to our hospital for management of significant polytrauma, as well as multi-ligament injury of the ipsilateral knee. (orig.)

The Effects of Injury Prevention Programs on the Biomechanics of Landing Tasks: A Systematic Review With Meta-analysis.

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Lopes, Thiago Jambo Alves; Simic, Milena; Myer, Gregory D; Ford, Kevin R; Hewett, Timothy E; Pappas, Evangelos

2018-05-01

Anterior cruciate ligament (ACL) tear is a common injury in sports and often occurs during landing from a jump. To synthesize the evidence on the effects of injury prevention programs (IPPs) on landing biomechanics as they relate to the ligament, quadriceps, trunk, and leg dominance theories associated with ACL injury risk. Meta-analysis. Six electronic databases were searched for studies that investigated the effect of IPPs on landing task biomechanics. Prospective studies that reported landing biomechanics at baseline and post-IPP were included. Results from trunk, hip, and knee kinematics and kinetics related to the ACL injury theories were extracted, and meta-analyses were performed when possible. The criteria were met by 28 studies with a total of 466 participants. Most studies evaluated young females, bilateral landing tasks, and recreational athletes, while most variables were related to the ligament and quadriceps dominance theories. An important predictor of ACL injury, peak knee abduction moment, decreased ( P = .01) after the IPPs while other variables related to the ligament dominance theory did not change. Regarding the quadriceps dominance theory, after the IPPs, angles of hip flexion at initial contact ( P = .009), peak hip flexion ( P = .002), and peak knee flexion ( P = .007) increased, while knee flexion at initial contact did not change ( P = .18). Moreover, peak knee flexion moment decreased ( P = .005) and peak vertical ground-reaction force did not change ( P = .10). The exercises used in IPPs might have the potential to improve landing task biomechanics related to the quadriceps dominance theory, especially increasing peak knee and hip flexion angles. Importantly, peak knee abduction moment decreased, which indicates that IPPs influence a desired movement strategy to help athletes overcome dangerous ligament dominance loads arising from lack of frontal plane control during dynamic tasks. The lack of findings for some biomechanical variables

Biomechanical and neuromuscular characteristics of male athletes: implications for the development of anterior cruciate ligament injury prevention programs.

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Sugimoto, Dai; Alentorn-Geli, Eduard; Mendiguchía, Jurdan; Samuelsson, Kristian; Karlsson, Jon; Myer, Gregory D

2015-06-01

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.

Proprioceptive Training and Injury Prevention in a Professional Men's Basketball Team: A Six-Year Prospective Study.

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Riva, Dario; Bianchi, Roberto; Rocca, Flavio; Mamo, Carlo

2016-02-01

Single limb stance instability is a risk factor for lower extremity injuries. Therefore, the development of proprioception may play an important role in injury prevention. This investigation considered a professional basketball team for 6 years, integrating systematic proprioceptive activity in the training routine. The purpose was to assess the effectiveness of proprioceptive training programs based on quantifiable instability, to reduce ankle sprains, knee sprains, and low back pain through developing refined and long-lasting proprioceptive control. Fifty-five subjects were studied. In the first biennium (2004-2006), the preventive program consisted of classic proprioceptive exercises. In the second biennium (2006-2008), the proprioceptive training became quantifiable and interactive by means of electronic proprioceptive stations. In the third biennium (2008-2010), the intensity and the training volume increased while the session duration became shorter. Analysis of variance was used to analyze the differences in proprioceptive control between groups, years, and bienniums. Injury rates and rate ratios of injury during practices and games were estimated. The results showed a statistically significant reduction in the occurrence of ankle sprains by 81% from the first to the third biennium (p < 0.001). Low back pain showed similar results with a reduction of 77.8% (p < 0.005). The reduction in knee sprains was 64.5% (not significant). Comparing the third biennium with the level of all new entry players, proprioceptive control improved significantly by 72.2% (p < 0.001). These findings indicate that improvements in proprioceptive control in single stance may be a key factor for an effective reduction in ankle sprains, knee sprains, and low back pain.

Association between frontal plane knee control and lower extremity injuries: a prospective study on young team sport athletes

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Pasanen, Kati; Krosshaug, Tron; Vasankari, Tommi; Kannus, Pekka; Heinonen, Ari; Kujala, Urho M; Avela, Janne; Perttunen, Jarmo; Parkkari, Jari

2018-01-01

Background/aim Poor frontal plane knee control can manifest as increased dynamic knee valgus during athletic tasks. The purpose of this study was to investigate the association between frontal plane knee control and the risk of acute lower extremity injuries. In addition, we wanted to study if the single-leg squat (SLS) test can be used as a screening tool to identify athletes with an increased injury risk. Methods A total of 306 basketball and floorball players participated in the baseline SLS test and a 12-month injury registration follow-up. Acute lower extremity time-loss injuries were registered. Frontal plane knee projection angles (FPKPA) during the SLS were calculated using a two-dimensional video analysis. Results Athletes displaying a high FPKPA were 2.7 times more likely to sustain a lower extremity injury (adjusted OR 2.67, 95% CI 1.23 to 5.83) and 2.4 times more likely to sustain an ankle injury (OR 2.37, 95% CI 1.13 to 4.98). There was no statistically significant association between FPKPA and knee injury (OR 1.49, 95% CI 0.56 to 3.98). The receiver operating characteristic curve analyses indicated poor combined sensitivity and specificity when FPKPA was used as a screening test for lower extremity injuries (area under the curve of 0.59) and ankle injuries (area under the curve of 0.58). Conclusions Athletes displaying a large FPKPA in the SLS test had an elevated risk of acute lower extremity and ankle injuries. However, the SLS test is not sensitive and specific enough to be used as a screening tool for future injury risk. PMID:29387448

Geometric Characteristics of the Knee Are Associated With a Noncontact ACL Injury to the Contralateral Knee After Unilateral ACL Injury in Young Female Athletes.

Science.gov (United States)

Levins, James G; Argentieri, Erin C; Sturnick, Daniel R; Gardner-Morse, Mack; Vacek, Pamela M; Tourville, Timothy W; Johnson, Robert J; Slauterbeck, James R; Beynnon, Bruce D

2017-12-01

Contralateral anterior cruciate ligament (CACL) injury after recovery from a first-time ACL rupture occurs at a high rate in young females; however, little is known about the risk factors associated with bilateral ACL trauma. The geometric characteristics of the contralateral knee at the time of the initial ACL injury are associated with risk of suffering a CACL injury in these female athletes. Case-control study; Level of evidence, 3. Sixty-two female athletes who suffered their first noncontact ACL injury while participating in sports at the high school or college level were identified, and geometry of the femoral notch, ACL, tibial spines, tibial subchondral bone, articular cartilage surfaces, and menisci of the contralateral, uninjured, knee was characterized in 3 dimensions. We were unable to contact 7 subjects and followed the remaining 55 until either a CACL injury or an ACL graft injury occurred or, if they were not injured, until the date of last contact (mean, 34 months after their first ACL injury). Cox regression was used to identify risk factors for CACL injury. Ten (18.2%) females suffered a CACL injury. Decreases of 1 SD in femoral intercondylar notch width (measured at its outlet and anterior attachment of the ACL) were associated with increases in the risk of suffering a CACL injury (hazard ratio = 1.88 and 2.05, respectively). Likewise, 1 SD decreases in medial-lateral width of the lateral tibial spine, height of the medial tibial spine, and thickness of the articular cartilage located at the posterior region of the medial tibial compartment were associated with 3.59-, 1.75-, and 2.15-fold increases in the risk of CACL injury, respectively. After ACL injury, subsequent injury to the CACL is influenced by geometry of the structures that surround the ACL (the femoral notch and tibial spines). This information can be used to identify individuals at increased risk for CACL trauma, who might benefit from targeted risk-reduction interventions.

The "sequence of prevention" for musculoskeletal injuries among adult recreational footballers: A systematic review of the scientific literature.

Science.gov (United States)

Kilic, Ozgur; Kemler, Ellen; Gouttebarge, Vincent

2018-02-02

To gather epidemiological information related to all steps of Van Mechelen's "sequence of prevention" for musculoskeletal injuries among adult recreational football players. A systematic review of the scientific literature was conducted in Medline via Pubmed. Therefore, two highly sensitive search strategies based on three groups of keywords (and related search terms) were used. In total, 33 relevant original studies were included in our systematic review. The results of our systematic review showed that the incidence of musculoskeletal injuries among recreational adult football players ranged from 9.6 to 15.8 injuries per 1000 exposure hours. These injuries are especially located in the ankle, knee, groin and hamstring, being associated with previous injury and match exposure. The FIFA11 + injury prevention programme and the Nordic Hamstring Exercise (NHE) were found to be effective for the reduction or prevention of musculoskeletal injuries among adult recreational football players. Our systematic review showed that musculoskeletal injuries are common among recreational adult football players, while effective preventive programmes are available. Further studies should focus on the identification and understanding of the key factors responsible for the optimal adoption, implementation and maintenance of these measures. Copyright © 2018 Elsevier Ltd. All rights reserved.

Knee Injuries and Disorders

Science.gov (United States)

Your knee joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the knee joint move. When any of these structures is hurt or diseased, you have knee problems. Knee problems can cause pain and difficulty ...

Knee function among elite handball and football players 1-6 years after anterior cruciate ligament injury.

Science.gov (United States)

Myklebust, G; Bahr, R; Nilstad, A; Steffen, K

2017-05-01

The aim of the study was to describe objective and self-reported knee function for athletes who have returned to elite handball and football play after an ACL injury, comparing these to non-injured players at the same level. A total of 414 handball and 444 football players completed baseline tests from 2007 through 2014, examining lower extremity strength, dynamic balance, knee laxity, and knee function (KOOS questionnaire). Measures were compared between injured and non-injured legs and between injured legs and legs of controls. Eighty (9.3%) of the 858 players reported a previous ACL injury, 1-6 years post-injury (3.5±2.5 years), 49 handball (61.3%) and 31 football players (38.7%). We found no difference in strength or dynamic balance between previously ACL-injured (N=80) and non-injured players legs (N=1556). However, lower quadriceps (6.3%, 95% CI: 3.2-9.2) and hamstrings muscle strength (6.1%, 95% CI: 3.3-8.1) were observed in previously ACL-injured legs compared to the non-injured contralateral side (N=80). ACL-injured knees displayed greater joint laxity than the contralateral knee (N=80, 17%, 95% CI: 8-26) and healthy knees (N=1556, 23%, 95% CI: 14-33). KOOS scores were significantly lower for injured knees compared to knees of non-injured players. ACL-injured players who have successfully returned to elite sport have comparable strength and balance measures as their non-injured teammates. Subjective perception of knee function is strongly affected by injury history, with clinically relevant lower scores for the KOOS subscores Pain, Function, Sport, and Quality Of Life. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Biomechanical factors associated with the risk of knee injury when ...

African Journals Online (AJOL)

Objectives. To systematically assess the literature investigating biomechanical knee injury risk factors when an individual lands from a jump. Data sources. Four electronic databases were searched for peer-reviewed English journals containing landing biomechanical studies published over 14 years (1990 - 2003).

Isokinetic strength effects of FIFA'a "The 11+" injury prevention training programme

DEFF Research Database (Denmark)

Brito, João; Figueiredo, Pedro; Fernandes, Luís

2010-01-01

The purpose of this study was to evaluate whether FIFA's Medical Assessment and Research Centre (F-MARC) injury prevention programme, "The 11+", improves isokinetic strength of the knee extensor and flexor muscles in sub-elite soccer players. Twenty players aged 22.3 ± 4.2 yr performed "The 11+" 3...... significantly improved the conventional H/Q ratio at 60°/s by 14.8{\\%} and the DCR by 13.8% in the non-dominant limb (pknee joint....

Sports Related Injuries: Incidence, Management and Prevention

OpenAIRE

Stanger, Michael A.

1982-01-01

The incidence of injury related to various sports is reviewed according to sport, area of injury, number of participants and hours per week spent at the sport. Organized sports accounted for fewer injuries than unsupervised recreational activities like tree climbing, skateboarding and running. The knee is the most commonly injured site. Sensitivity to patients' commitment to their sport is necessary: sometimes instead of rest, they can substitute a less hazardous form of exercise. Principles ...

2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries

Science.gov (United States)

Ekås, Guri Ranum; Grindem, Hege; Moksnes, Håvard; Anderson, Allen F; Chotel, Franck; Cohen, Moises; Forssblad, Magnus; Ganley, Theodore J; Feller, Julian A; Karlsson, Jón; Kocher, Minider S; LaPrade, Robert F; McNamee, Michael; Mandelbaum, Bert; Micheli, Lyle; Mohtadi, Nicholas; Reider, Bruce; Roe, Justin; Seil, Romain; Siebold, Rainer; Witvrouw, Erik; Engebretsen, Lars

2018-01-01

In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions. PMID:29478021

A lower extremity strength-based profile of NCAA Division I women's basketball and gymnastics athletes: implications for knee joint injury risk assessment.

Science.gov (United States)

Thompson, Brennan J; Cazier, Curtis S; Bressel, Eadric; Dolny, Dennis G

2018-08-01

This study aimed to provide a comprehensive strength-based physiological profile of women's NCAA Division I basketball and gymnastic athletes; and to make sport-specific comparisons for various strength characteristics of the knee flexor and extensor muscles. A focus on antagonist muscle balance (hamstrings-to-quadriceps ratios, H:Q) was used to elucidate vulnerabilities in these at-risk female athletes. Fourteen NCAA Division I women's basketball and 13 gymnastics athletes performed strength testing of the knee extensors and flexors. Outcome measures included absolute and relative (body mass normalised) peak torque (PT), rate of torque development at 50, 100, 200 ms (RTD50 etc.) and H:Q ratios of all variables. The basketball athletes had greater absolute strength for all variables except for isokinetic PT at 240°s -1 and isometric RTD50 for the knee extensors. Gymnasts showed ~20% weaker body mass relative concentric PT for the knee flexors at 60 and 120°·s -1 , and decreased conventional H:Q ratios at 60 and 240°·s -1 (~15%). These findings suggest that collegiate level gymnastics athletes may be prone to increased ACL injury risk due to deficient knee flexor strength and H:Q strength imbalance. Coaches may use these findings when implementing injury prevention screening and/or for individualised strength training programming centered around an athletes strength-related deficits.

A HYPOTHESIS: COULD PORTABLE NATURAL GRASS BE A RISK FACTOR FOR KNEE INJURIES?

Directory of Open Access Journals (Sweden)

John Orchard

2008-03-01

Full Text Available Previous study has shown a likely link between increased shoe- surface traction and risk of knee Anterior Cruciate Ligament (ACL injury. Portable natural grass systems are being used more often in sport, but no study to date has investigated their relative safety. By their nature, they must have high resistance to falling apart and therefore newly laid systems may be at risk of creating excessive shoe-surface traction. This study describes two clusters of knee injuries (particularly non-contact ACL injuries, each occurring to players of one professional football team at single venue, using portable grass, in a short space of time. The first series included two ACL injuries, one posterolateral complex disruption and one lateral ligament tear occurring in two rugby league games on a portable bermudagrass surface in Brisbane, Australia. The second series included four non-contact ACL injuries over a period of ten weeks in professional soccer games on a portable Kentucky bluegrass/perennial ryegrass surface in Barcelona, Spain. Possible intrinsic risk factors are discussed but there was no common risk shared by the players. Although no measures of traction were made at the Brisbane venue, average rotational traction was measured towards the end of the injury cluster at Camp Nou, Barcelona, to be 48 Nm. Chance undoubtedly had a part to play in these clusters, but the only obvious common risk factor was play on a portable natural grass surface soon after it was laid. Further study is required to determine whether portable natural grass systems may exhibit high shoe-surface traction soon after being laid and whether this could be a risk factor for knee injury

Management of Medial Collateral Ligament Injury During Primary Total Knee Arthroplasty: A Systematic Review

Directory of Open Access Journals (Sweden)

Paul Della Torre, MD

2014-07-01

Full Text Available Medial collateral ligament injury during primary total knee arthroplasty is a recognised complication potentially resulting in valgus instability, suboptimal patient outcomes and a higher rate of revision or reoperation. Options for management include primary repair with or without augmentation, reconstruction or immediate conversion to prosthesis with greater constraint, in conjunction with various postoperative rehabilitation protocols. Inconsistent recommendations throughout the orthopaedic literature have made the approach to managing this complication problematic. The objective of this study was to review the available literature to date comparing intraoperative and postoperative management options for primary total knee arthroplasty complicated by recognised injury to the medial collateral ligament. This systematic literature review was prospectively registered with PROSPERO (#CRD42014008866 and performed in accordance with PRISMA guidelines including a PRISMA flow diagram. Five articles satisfied the inclusion criteria. Each was a retrospective, observational cohort or case series with small numbers reported, inconsistent methodology and incompletely reported outcomes. Four of the five studies managing medial collateral ligament injury during total knee arthroplasty (47/84 patients with direct repair with or without autograft augmentation reported good outcomes with no revision or reoperation required for symptomatic instability over a follow-up period of 16 months to almost 8 years. The fifth study with a follow-up to 10 years and a high rate of conversion to unlinked semi constrained total knee arthroplasty implant (30/37 patients reported a greater incidence of revision due to instability, in patients in whom the medial collateral ligament injury was directly repaired without added constraint. Overall balance of evidence is in favour of satisfactory outcomes without symptomatic instability following direct repair with or without

Risk factors for acute nerve injury after total knee arthroplasty.

Science.gov (United States)

Shetty, Teena; Nguyen, Joseph T; Sasaki, Mayu; Wu, Anita; Bogner, Eric; Burge, Alissa; Cogsil, Taylor; Dalal, Aashka; Halvorsen, Kristin; Cummings, Kelianne; Su, Edwin P; Lyman, Stephen

2018-06-01

In this we study identified potential risk factors for post-total knee arthroplasty (TKA) nerve injury, a catastrophic complication with a reported incidence of 0.3%-1.3%. Patients who developed post-TKA nerve injury from 1998 to 2013 were identified, and each was matched with 2 controls. A multivariable logistic regression model was built to calculate odds ratios (ORs). Sixty-five nerve injury cases were identified in 39,990 TKAs (0.16%). Females (OR 3.28, P = 0.003) and patients with history of lumbar pathology (OR 6.12, P = 0.026) were associated with increased risk of nerve injury. Tourniquet pressure nerve injury was unexpected and requires further investigation. Muscle Nerve 57: 946-950, 2018. © 2017 Wiley Periodicals, Inc.

Sex differences in proximal control of the knee joint.

Science.gov (United States)

Mendiguchia, Jurdan; Ford, Kevin R; Quatman, Carmen E; Alentorn-Geli, Eduard; Hewett, Timothy E

2011-07-01

Following the onset of maturation, female athletes have a significantly higher risk for anterior cruciate ligament (ACL) injury compared with male athletes. While multiple sex differences in lower-extremity neuromuscular control and biomechanics have been identified as potential risk factors for ACL injury in females, the majority of these studies have focused specifically on the knee joint. However, increasing evidence in the literature indicates that lumbo-pelvic (core) control may have a large effect on knee-joint control and injury risk. This review examines the published evidence on the contributions of the trunk and hip to knee-joint control. Specifically, the sex differences in potential proximal controllers of the knee as risk factors for ACL injury are identified and discussed. Sex differences in trunk and hip biomechanics have been identified in all planes of motion (sagittal, coronal and transverse). Essentially, female athletes show greater lateral trunk displacement, altered trunk and hip flexion angles, greater ranges of trunk motion, and increased hip adduction and internal rotation during sport manoeuvres, compared with their male counterparts. These differences may increase the risk of ACL injury among female athletes. Prevention programmes targeted towards trunk and hip neuromuscular control may decrease the risk for ACL injuries.

Sex Differences in Proximal Control of the Knee Joint

Science.gov (United States)

Mendiguchia, Jurdan; Ford, Kevin R.; Quatman, Carmen E.; Alentorn-Geli, Eduard; Hewett, Timothy E.

2014-01-01

Following the onset of maturation, female athletes have a significantly higher risk for anterior cruciate ligament (ACL) injury compared with male athletes. While multiple sex differences in lower-extremity neuromuscular control and biomechanics have been identified as potential risk factors for ACL injury in females, the majority of these studies have focused specifically on the knee joint. However, increasing evidence in the literature indicates that lumbopelvic (core) control may have a large effect on knee-joint control and injury risk. This review examines the published evidence on the contributions of the trunk and hip to knee-joint control. Specifically, the sex differences in potential proximal controllers of the knee as risk factors for ACL injury are identified and discussed. Sex differences in trunk and hip biomechanics have been identified in all planes of motion (sagittal, coronal and transverse). Essentially, female athletes show greater lateral trunk displacement, altered trunk and hip flexion angles, greater ranges of trunk motion, and increased hip adduction and internal rotation during sport manoeuvres, compared with their male counterparts. These differences may increase the risk of ACL injury among female athletes. Prevention programmes targeted towards trunk and hip neuromuscular control may decrease the risk for ACL injuries. PMID:21688868

Delay in surgery predisposes to meniscal and chondral injuries in anterior cruciate ligament deficient knees

Directory of Open Access Journals (Sweden)

Ravi Gupta

2016-01-01

Conclusion: Surgical delay predicts an increase in medial meniscal and lateral articular injuries justifying early rather than delayed reconstruction in ACL deficient knees. Increasing age is positively related to intraarticular injuries while females are more susceptible to lateral articular injuries.

Impact of treatment strategy and physical performance on future knee-related self-efficacy in individuals with ACL injury

DEFF Research Database (Denmark)

Flosadottir, Vala; Frobell, Richard; Roos, Ewa M

2018-01-01

BACKGROUND: In people with anterior cruciate ligament (ACL) injury, high self-efficacy facilitates recovery, indicated by improved muscle function, reduced knee symptoms and increased physical activity. Impact of treatment on future self-efficacy is however not well investigated. The aims...... of the study were to 1) investigate knee-related self-efficacy 6 years after acute ACL injury in patients treated with exercise therapy alone or in combination with either early or the option of delayed ACL reconstruction (ACLR), and 2) to investigate associations between single-leg physical performance...... at various time points after ACL injury and knee self-efficacy at 6 years after injury. METHODS: Participants (n = 121) originated from the KANON-study (ISRCTN84752559), a treatment RCT including active adults with acute ACL injury treated with structured exercise therapy combined with early or the option...

Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure

DEFF Research Database (Denmark)

Roos, Ewa M.; Roos, H P; Lohmander, L S

1998-01-01

There is broad consensus that good outcome measures are needed to distinguish interventions that are effective from those that are not. This task requires standardized, patient-centered measures that can be administered at a low cost. We developed a questionnaire to assess short- and long......-term patient-relevant outcomes following knee injury, based on the WOMAC Osteoarthritis Index, a literature review, an expert panel, and a pilot study. The Knee injury and Osteoarthritis Outcome Score (KOOS) is self-administered and assesses five outcomes: pain, symptoms, activities of daily living, sport...

Jumper's Knee or Lander's Knee? : A Systematic Review of the Relation between Jump Biomechanics and Patellar Tendinopathy

NARCIS (Netherlands)

van der Worp, Henk; de Poel, H. J.; Diercks, R. L.; van den Akker-Scheek, I.; Zwerver, J.

Patellar tendinopathy (jumper's knee) is a common injury in sports that comprise jump actions. This article systematically reviews the literature examining the relation between patellar tendinopathy and take-off and landing kinematics in order to uncover risk factors and potential prevention

2018 International Olympic Committee Consensus Statement on Prevention, Diagnosis, and Management of Pediatric Anterior Cruciate Ligament Injuries

Science.gov (United States)

Ardern, Clare L.; Ekås, Guri; Grindem, Hege; Moksnes, Håvard; Anderson, Allen F.; Chotel, Franck; Cohen, Moises; Forssblad, Magnus; Ganley, Theodore J.; Feller, Julian A.; Karlsson, Jón; Kocher, Mininder S.; LaPrade, Robert F.; McNamee, Mike; Mandelbaum, Bert; Micheli, Lyle; Mohtadi, Nicholas G.H.; Reider, Bruce; Roe, Justin P.; Seil, Romain; Siebold, Rainer; Silvers-Granelli, Holly J.; Soligard, Torbjørn; Witvrouw, Erik; Engebretsen, Lars

2018-01-01

In October 2017, the International Olympic Committee hosted an international expert group of physical therapists and orthopaedic surgeons who specialize in treating and researching pediatric anterior cruciate ligament (ACL) injuries. The purpose of this meeting was to provide a comprehensive, evidence-informed summary to support the clinician and help children with ACL injury and their parents/guardians make the best possible decisions. Representatives from the following societies attended: American Orthopaedic Society for Sports Medicine; European Paediatric Orthopaedic Society; European Society for Sports Traumatology, Knee Surgery, and Arthroscopy; International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine; Pediatric Orthopaedic Society of North America; and Sociedad Latinoamericana de Artroscopia, Rodilla, y Deporte. Physical therapists and orthopaedic surgeons with clinical and research experience in the field and an ethics expert with substantial experience in the area of sports injuries also participated. This consensus statement addresses 6 fundamental clinical questions regarding the prevention, diagnosis, and management of pediatric ACL injuries. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision making with children and the potential long-term ramifications of the injury. PMID:29594177

Injuries to posterolateral corner of the knee: a comprehensive review from anatomy to surgical treatment☆

Science.gov (United States)

Crespo, Bernardo; James, Evan W.; Metsavaht, Leonardo; LaPrade, Robert F.

2014-01-01

Although injuries to the posterolateral corner of the knee were previously considered to be a rare condition, they have been shown to be present in almost 16% of all knee injuries and are responsible for sustained instability and failure of concomitant reconstructions if not properly recognized. Although also once considered to be the “dark side of the knee”, increased knowledge of the posterolateral corner anatomy and biomechanics has led to improved diagnostic ability with better understanding of physical and imaging examinations. The management of posterolateral corner injuries has also evolved and good outcomes have been reported after operative treatment following anatomical reconstruction principles. PMID:26401495

Knee complaints vary with age and gender in the adult population. Population-based reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS)

DEFF Research Database (Denmark)

Paradowski, Przemyslaw T; Bergman, Stefan; Sundén-Lundius, Anne

2006-01-01

Self-reported knee complaints may vary with age and gender. Reference data from the adult population would help to better interpret the outcome of interventions due to knee complaints. The objectives of the present study were to describe the variation of self-reported knee pain, function and qual......Self-reported knee complaints may vary with age and gender. Reference data from the adult population would help to better interpret the outcome of interventions due to knee complaints. The objectives of the present study were to describe the variation of self-reported knee pain, function...... and quality of life with age and gender in the adult population and to establish population-based reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS)....

Anterior cruciate ligament injury/reinjury in alpine ski racing: a narrative review

Directory of Open Access Journals (Sweden)

Jordan MJ

2017-03-01

Full Text Available Matthew J Jordan,1 Per Aagaard,2 Walter Herzog1 1Human Performance Laboratory, The University of Calgary, Calgary, AB, Canada; 2Department of Sports Science and Clinical Biomechanics, SDU Muscle Research Cluster (SMRC, University of Southern Denmark, Odense M, Denmark Abstract: The purpose of the present review was to: 1 provide an overview of the current understanding on the epidemiology, etiology, risk factors, and prevention methods for anterior cruciate ligament (ACL injury in alpine ski racing; and 2 provide an overview of what is known pertaining to ACL reinjury and return to sport after ACL injury in alpine ski racing. Given that most of the scientific studies on ACL injuries in alpine ski racing have been descriptive, and that very few studies contributed higher level scientific evidence, a nonsystematic narrative review was employed. Three scholarly databases were searched for articles on ACL injury or knee injury in alpine ski racing. Studies were classified according to their relevance in relation to epidemiology, etiology, risk factors, and return to sport/reinjury prevention. Alpine ski racers (skiers were found to be at high risk for knee injuries, and ACL tears were the most frequent diagnosis. Three primary ACL injury mechanism were identified that involved tibial internal rotation and anteriorly directed shear forces from ski equipment and the environment. While trunk muscle strength imbalance and genetics were found to be predictive of ACL injuries in development-level skiers, there was limited scientific data on ACL injury risk factors among elite skiers. Based on expert opinion, research on injury risk factors should focus on equipment design, course settings/speed, and athlete factors (eg, fitness. While skiers seem to make a successful recovery following ACL injury, there may be persistent neuromuscular deficits. Future research efforts should be directed toward prospective studies on ACL injury/reinjury prevention in both

A conceptual framework for a sports knee injury performance profile (SKIPP) and return to activity criteria (RTAC)

OpenAIRE

Logerstedt, David; Arundale, Amelia; Lynch, Andrew; Snyder-Mackler, Lynn

2015-01-01

ABSTRACTInjuries to the knee, including intra-articular fractures, ligamentous ruptures, and meniscal and articular cartilage lesions, are commonplace within sports. Despite advancements in surgical techniques and enhanced rehabilitation, athletes returning to cutting, pivoting, and jumping sports after a knee injury are at greater risk of sustaining a second injury. The clinical utility of objective criteria presents a decision-making challenge to ensure athletes are fully rehabilitated and ...

MR diagnosis of articular cartilage injury in the knee: compared with arthroscopy

International Nuclear Information System (INIS)

Zhang Min; Li Shiling; Guo Zhiping; Zhang Wei; Ma Xiaohui; Cai Pengli; Wei Peijian; Peng Zhigang; Sun Yingcai; Zhang Zekun

2005-01-01

Objective: To assess the efficacy of FS-3D-FISP, FS-2D-FLASH and SE-T 1 WI sequences in the detection of articular cartilage injury of the knee. Methods: 34 consecutive patients with persistent symptoms of knee pain who were scheduled for arthroscopy underwent MR examination of the knee on a 1.5 TMR unit prior to arthroscopy. The 2D MR images were transferred to a workstation and processed tow-dimensional and three-dimensional reconstruction. Results: Compared with the arthroscopy, the sensitivity, specificity, and Kappa were 91.4%, 97%, and 0.818, respectively with FS-3D-F ISP sequence, 77.1%, 98%, and 0.531, respectively with FS-2D-FLASH sequence, 70%, 99%, and 0.518, respectively with SE-T 1 WI sequence. In the cases that had no acute trauma, 77.6% lesions were shown lower SI on T 1 -WI in the region of the subchondral bone and marrow near the lesions, and higher SI on FS-3D-FISP and FS-2D-FLASH sequences. Conclusion: Comparing with arthroscopy, the diagnosis accuracy of FS-3D-FISP sequence is obviously better than that of FS-2D-FLASH and SE-T 1 WI sequences. Correlation between FS-3D-FISP sequence and arthroscopy in detecting articular cartilage injury is remarkeble. Abnormal signal in the subchondral bone and marrow is an important indirect sign of articular cartilage injury. Three-dimensional reconstruction of articular cartilage is helpful for localization of the lesions after injury. (authors)

Symptoms of Knee Instability as Risk Factors for Recurrent Falls.

Science.gov (United States)

Nevitt, Michael C; Tolstykh, Irina; Shakoor, Najia; Nguyen, Uyen-Sa D T; Segal, Neil A; Lewis, Cora; Felson, David T

2016-08-01

Whether knee instability contributes to the increased risk of falls and fractures observed in persons with knee osteoarthritis (OA) has not been studied. We examined the association of knee buckling with the risk of falling and fall-related consequences in older adults with, or at high risk for, knee OA. At the 60-month visit of the Multicenter Osteoarthritis Study, men and women ages 55-84 years were asked about knee buckling in the past 3 months and whether they fell when a knee buckled. Falls and fall-related injuries in the past 12 months and balance confidence were assessed at 60 and 84 months. Multivariate logistic regression was used to assess the association of knee buckling with falls and their consequences. A total of 1,842 subjects (59% women, mean ± SD age 66.9 ± 7.8 years, and body mass index 30.3 ± 5.7) were included. At 60 months 16.8% reported buckling and at 84 months 14.1% had recurrent (≥2) falls. Bucklers at 60 months had a 1.6- to 2.5-fold greater odds of recurrent falls, fear of falling, and poor balance confidence at 84 months. Those who fell when a knee buckled at baseline had a 4.5-fold, 2-fold, and 3-fold increased odds 2 years later of recurrent falls, significant fall injuries, and fall injuries that limited activity, respectively, and were 4 times more likely to have poor balance confidence. Interventions that reduce knee buckling may help prevent falls, fall-related injuries, and adverse psychological consequences of falls in persons with knee OA. © 2016, American College of Rheumatology.

Symptoms of Knee Instability are Risk Factors for Recurrent Falls

Science.gov (United States)

Nevitt, Michael C; Tolstykh, Irina; Shakoor, Najia; Nguyen, Uyen-Sa D.T.; Segal, Neil A; Lewis, Cora; Felson, David T

2016-01-01

Objectives Whether knee instability contributes to the increased risk of falls and fractures observed in persons with knee osteoarthritis (OA) has not been studied. We examined the association of knee buckling with the risk of falling and fall-related consequences in older adults with, or at high risk for, knee OA. Methods At the 60 month visit of the Multicenter Osteoarthritis Study, men and women ages 55 to 84 were asked about knee buckling in the past 3 months and whether they fell when a knee buckled. Falls and fall-related injuries in the past 12 months and balance confidence were assessed at 60 and 84 months. Multivariate logistic regression was used to assess the association of knee buckling with falls and their consequences. Results 1,842 subjects (59% women, mean [SD] age= 66.9 [7.8] and BMI= 30.3 [5.7]) were included. At 60 months 16.8% reported buckling and at 84 months 14.1% had recurrent (≥2) falls. Bucklers at 60 months had a 1.6 to 2.5-fold greater odds of recurrent falls, fear of falling and poor balance confidence at 84 months. Those who fell when a knee buckled at baseline had a 4.5-fold, 2-fold and 3-fold increased odds two years later of recurrent falls, significant fall injuries and fall injuries that limited activity, respectively, and were 4 times more likely to have poor balance confidence. Conclusion Interventions that reduce knee buckling may help prevent falls, fall-related injuries and adverse psychological consequences of falls in persons with knee OA. PMID:26853236

MRI diagnosis of knee joint injury: the clinical application with a report of 35 cases

International Nuclear Information System (INIS)

Zhao Quan; Tang Ni; Wu Xiaoyong; Zhao Ping; Guan Huanwen

2006-01-01

Objective: To study the MRI findings of knee joint injury and the pathalogical basis and clinical significance. Methods: MR images of the knee joint injury were investigated in 35 cases. Results: In 23 cases of meniscus damage, lesions were nodular, linear or radioactive fissure with hyperintense signal within the dark meniscus, extending to or beneath the articular cartilage surface. In 9 cases of cruciate ligament injury, the disorder was a hyperintense shadow which was hyperintense on T 1 WI and hypointense on T 2 WI within the stripe-like, hypointense ligament, accompanying with the alteration of the ligament, which was in a wave shape or discontinued. Dislocation of the tibia was also revealed. In 5 cases of the bilateral collateral ligament damage. The involved thickened ligament had increased signal and blurred edge. In 4 cases of obscure bone fracture, the lesion was located in the metaphysic, manifested a hypo-intense shadow on T 1 WI, diverse on T 2 WI. Conclusion: MRI plays an important role in the diagnosis of the injury of menicus, ligament, and the obscure fracture of knee joint, and provides detailed information for the clinical management. (authors)

Complex pelvic ring injuries associated with floating knee in a poly-trauma patient

OpenAIRE

Zhou, Yuebin; Guo, Honggang; Cai, Zhiwei; Zhang, Yuan

2017-01-01

Abstract Rationale: Complex pelvic ring fracture associated with floating knee is comparatively rare which usually results from high-energy trauma including vehicle-related accidence, falls from height, and earthquake-related injury. To our knowledge, few literatures have documented such injuries in the individual patient. Management of both injuries present challenges for surgical management and postoperative care. The purpose of this study is to prove the feasibility and benefits of damage ...

Elastic Bandaging for Orthopedic- and Sports-Injury Prevention and Rehabilitation: A Systematic Review.

Science.gov (United States)

Fousekis, Konstantinos; Billis, Evdokia; Matzaroglou, Charalampos; Mylonas, Konstantinos; Koutsojannis, Constantinos; Tsepis, Elias

2017-05-01

Elastic bandages are commonly used in sports to treat and prevent sport injuries. To conduct a systematic review assessing the effectiveness of elastic bandaging in orthopedic- and sports-injury prevention and rehabilitation. The researchers searched the electronic databases MEDLINE, CINAHL, SPORTDiscus, EMBASE, and Physiotherapy Evidence Database (PEDro) with keywords elastic bandaging in combination, respectively, with first aid, sports injuries, orthopedic injuries, and sports injuries prevention and rehabilitation. Research studies were selected based on the use of the term elastic bandaging in the abstract. Final selection was made by applying inclusion and exclusion criteria to the full text. Studies were included if they were peer-reviewed clinical trials written in English on the effects of elastic bandaging for orthopedic-injury prevention and rehabilitation. Twelve studies met the criteria and were included in the final analysis. Data collected included number of participants, condition being treated, treatment used, control group, outcome measures, and results. Studies were critically analyzed using the PEDro scale. The studies in this review fell into 2 categories: studies in athletes (n = 2) and nonathletes (n = 10). All included trials had moderate to high quality, scoring ≥5 on the PEDro scale. The PEDro scores for the studies in athletes and nonathletes ranged from 5 to 6 out of 10 and from 5 to 8 out of 10, respectively. The quality of studies was mixed, ranging from higher- to moderate-quality methodological clinical trials. Overall, elastic bandaging can assist proprioceptive function of knee and ankle joint. Because of the moderate methodological quality and insufficient number of clinical trials, further effects of elastic bandaging could not be confirmed.

Eccentric Knee Flexor Strength and Risk of Hamstring Injuries in Rugby Union: A Prospective Study.

Science.gov (United States)

Bourne, Matthew N; Opar, David A; Williams, Morgan D; Shield, Anthony J

2015-11-01

Hamstring strain injuries (HSIs) represent the most common cause of lost playing time in rugby union. Eccentric knee flexor weakness and between-limb imbalance in eccentric knee flexor strength are associated with a heightened risk of HSIs in other sports; however, these variables have not been explored in rugby union. To determine if lower levels of eccentric knee flexor strength or greater between-limb imbalance in this parameter during the Nordic hamstring exercise are risk factors for HSIs in rugby union. Cohort study; Level of evidence, 2. This prospective study was conducted over the 2014 Super Rugby and Queensland Rugby Union seasons. In total, 178 rugby union players (mean age, 22.6 ± 3.8 years; mean height, 185.0 ± 6.8 cm; mean weight, 96.5 ± 13.1 kg) had their eccentric knee flexor strength assessed using a custom-made device during the preseason. Reports of previous hamstring, quadriceps, groin, calf, and anterior cruciate ligament injuries were also obtained. The main outcome measure was the prospective occurrence of HSIs. Twenty players suffered at least 1 HSI during the study period. Players with a history of HSIs had a 4.1-fold (95% CI, 1.9-8.9; P = .001) greater risk of subsequent HSIs than players without such a history. Between-limb imbalance in eccentric knee flexor strength of ≥15% and ≥20% increased the risk of HSIs by 2.4-fold (95% CI, 1.1-5.5; P = .033) and 3.4-fold (95% CI, 1.5-7.6; P = .003), respectively. Lower eccentric knee flexor strength and other prior injuries were not associated with an increased risk of future HSIs. Multivariate logistic regression revealed that the risk of reinjuries was augmented in players with strength imbalances. Previous HSIs and between-limb imbalance in eccentric knee flexor strength were associated with an increased risk of future HSIs in rugby union. These results support the rationale for reducing imbalance, particularly in players who have suffered a prior HSI, to mitigate the risk of future

Peroneal nerve injury in three patients with knee trauma: MR imaging and correlation with anatomic findings in volunteers and anatomic specimens

Energy Technology Data Exchange (ETDEWEB)

Trappeniers, Laurence; Osteaux, Michel [Department of Radiology, Vrije Universiteit Brussels, Brussels (Belgium); De Maeseneer, Michel [Department of Radiology, Vrije Universiteit Brussels, Brussels (Belgium); Department of Radiology, AZ VUB, Laarbeeklaan 101, 1090, Jette (Belgium); Van Roy, Peter [Department of Experimental Anatomy, Vrije Universiteit Brussels, Brussels (Belgium); Chaskis, Christo [Department of Neurosurgery, Vrije Universiteit Brussels, Brussels (Belgium)

2003-07-01

The aim of this article is to report on three patients with injuries of the peroneal nerve along the posterolateral aspect of the knee. Injuries in this area are less common than the injuries occurring at the level of the fibular head. In this article we report on three patients with posterolateral knee trauma who had peroneal nerve dysfunction. To better understand the precise location of the nerve on MR images, we performed MR imaging in five volunteers, and studied the position of the nerve on anatomic dissection (n=1) and anatomic slices (n=1). The common peroneal nerve is easily depicted on MR images and has a typical location along the posterior margin of the biceps tendon. Non-visualisation of the peroneal nerve at the posterolateral aspect of the knee, as seen on MR images, is consistent with nerve injury. Scar tissue at the posterolateral aspect of the knee indicates injury of this specific area, and involvement of the peroneal nerve is likely. (orig.)

A CLINICAL STUDY OF ARTHROSCOPIC MANAGEMENT OF ANTERIOR C RUCIATE LIGAMENT INJURIES OF KNEE JOINT

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Paragjyoti

2015-09-01

Full Text Available BACKGROUND : Anterior C ruciate L igament (ACL tear is a common sports injury of the knee. There are a lot of controversies related to the management of this injury and more than 2000 papers have been published on the various aspects of the topic. Arthroscopic reconstruction of the ACL with autogenous graft material is widely used nowadays. The two most commonly used grafts are the central one - third of the patellar ligament (bone - tendon - bone, BTB and the hamstring tendon ( S emitendinosus - gracilis, STG construct but the former graft leads to increased donor site morbidity & hurdles in postoperative rehab & pain. The aim of the study is to study the Arthroscopic management of anterior cruciate ligament injury of knee joint using quadrupled hamstring graft. METHOD: The study was carried out on 30 cases of anterior cruciate ligament injury of knee joint attending the OPD and emergency of department of Orthopaedics, Silchar Medical College & Hospital who met the inclusion criteria. An informed consent was obtained from each patient prior to participation in the study. All the patients were examined in detail and worked up to obtain pre - anaesthetic clearance. X - rays and MRI were done routinely in all the cases. Clinical and radiological parameters were recorded. Arthroscopic anterior cruciate ligament reconstruction with quadrupled hamstring graft was done in all the patients. Concomitant meniscal inju ries were treated according to the merit of the injury. Patients were followed up at regular intervals and outcome variables were assessed and recorded. RESULTS: Results of our study clearly showed that arthroscopic ACL reconstruction using quadrupled hamstring graft is a safe, effective and reproducible procedure in restoring knee function with minimal donor site morbidity. At follow up evaluation, all patients had good outcomes in terms of clinical stability, range of motion and general symptoms. CONCLUSION: From the results in this study

Impact of treatment strategy and physical performance on future knee-related self-efficacy in individuals with ACL injury

DEFF Research Database (Denmark)

Flosadottir, Vala; Frobell, Richard; Roos, Ewa M

2018-01-01

of the study were to 1) investigate knee-related self-efficacy 6 years after acute ACL injury in patients treated with exercise therapy alone or in combination with either early or the option of delayed ACL reconstruction (ACLR), and 2) to investigate associations between single-leg physical performance...... at various time points after ACL injury and knee self-efficacy at 6 years after injury. METHODS: Participants (n = 121) originated from the KANON-study (ISRCTN84752559), a treatment RCT including active adults with acute ACL injury treated with structured exercise therapy combined with early or the option...... of delayed ACLR. In this ancillary study, participants with knee self-efficacy data at 6 years (n = 89) were analyzed as treated; exercise therapy alone (n = 20), exercise therapy plus early ACLR (n = 46), and exercise therapy plus delayed ACLR (n = 23). The participants performed physical performance tests...

Knee kinematics and kinetics in former soccer players with a 16-year-old ACL injury – the effects of twelve weeks of knee-specific training

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Holmström Eva

2007-04-01

Full Text Available Abstract Background Training of neuromuscular control has become increasingly important and plays a major role in rehabilitation of subjects with an injury to the anterior cruciate ligament (ACL. Little is known, however, of the influence of this training on knee stiffness during loading. Increased knee stiffness occurs as a loading strategy of ACL-injured subjects and is associated with increased joint contact forces. Increased or altered joint loads contribute to the development of osteoarthritis. The aim of the study was to determine if knee stiffness, defined by changes in knee kinetics and kinematics of gait, step activity and cross-over hop could be reduced through a knee-specific 12-week training programme. Methods A 3-dimensional motion analysis system (VICON and a force plate (AMTI were used to calculate knee kinetics and kinematics before and after 12 weeks of knee-specific training in 12 males recruited from a cohort with ACL injury 16 years earlier. Twelve uninjured males matched for age, sex, BMI and activity level served as a reference group. Self-reported patient-relevant data were obtained by the KOOS questionnaire. Results There were no significant changes in knee stiffness during gait and step activity after training. For the cross-over hop, increased peak knee flexion during landing (from 44 to 48 degrees, p = 0.031 and increased internal knee extensor moment (1.28 to 1.55 Nm/kg, p = 0.017 were seen after training, indicating reduced knee stiffness. The KOOS sport and recreation score improved from 70 to 77 (p = 0.005 and was significantly correlated with the changes in knee flexion during landing for the cross-over hop (r = 0.6, p = 0.039. Conclusion Knee-specific training improved lower extremity kinetics and kinematics, indicating reduced knee stiffness during demanding hop activity. Self-reported sport and recreational function correlated positively with the biomechanical changes supporting a clinical importance of the

Injuries in Spanish female soccer players

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Juan Del Coso

2018-04-01

Full Text Available Background: Epidemiologic research to learn the incidence, type, location, and severity of female soccer injuries and the risk factors for sustaining a sport injury is the first step in developing preventive policies. The aim of this study was to analyze the incidence of injuries in the population of female soccer players in Spain. Methods: The injuries incurred by 25,397 female soccer players were registered by the medical staff of the Spanish Football Federation during 1 season. A standardized medical questionnaire was used to classify the injury according to type, severity, location, and injury mechanism. A total of 2108 injuries was reported with an incidence of 0.083 injuries per player per season. Most injuries were in the lower limbs (74.0%, mainly affecting knee (30.4% and ankle joints (17.9%. Results: The proportion of injuries derived from contact with another player was higher during matches (33.7% than during training (11.4%; p  0.05. Conclusion: Most female soccer injuries were located at the knee and ankle; the injury mechanism determined the playing time lost; and the player's age did not affect injury characteristics. Keywords: Ankle, Epidemiology, Knee, Sport injuries, Women

Naval Special Warfare Injury Prevention and Human Performance Initiative

Science.gov (United States)

2012-06-30

or tactical training when the injury occurred. In 13.6% of the injuries, Operators were engaged in recreational activity/ sports when the injury...Collegiate Athletic Association (NCAA) and World Anti- Doping Agency (WADA) supplement list. Based on self-reported dietary intake, the current data indicate...knee tendonitis/ITBS (11%), and biceps and supraspinatus tendonopathy (11%) • Command PT and recreational/ sports activities accounted for 70% of

Magnetic resonance imaging of acute joint injuries of the knee

International Nuclear Information System (INIS)

Pinto, R.; Ragozzino, A.; Romano, L.; Del Vecchio, E.; Accarino, B.; Barile, V.

1988-01-01

Magnetic Resonance (MR) imaging was employed to evaluate muscoloskeletal pathoanathomy, and proved to be extremely useful in characterizing knee pathology. Between October 1986 and Novembre 1987, 24 patients with suspected traumatic ligament injuries were examined with high resolution MR imaging in the RMRC diagnostic center, Naples, with a 0.5T superconducting magnet ( 5000 Magniscan CGR) using a surface coil and a 500/28 (repetition time: TR: ms/echo time: TE-ms), 1200-1600/35-105 spin-echo pulse sequence. Nineteen patients with positive MR imaging exams underwent diagnostic and/or therapeutic arthroscopy. Arthroscopy confirmed MR diagnosis in the whole of cases. In 6 patients with negative MR findings no arthroscopy followed and the patients' successful outcome confirmed the accuracy of MR negative predictive value. Such results prove MR imaging to have a high diagnostic accuracy in the evaluation of acute joint injuries of the knee.Moreover, MR imaging-an uninvasive screening technique-appears to have high potentials for the evaluation of those cases where diagnostic arthroscopy is not required

Tears of anterior cruciate ligament and associated injury in the knee joint: MR imaging

International Nuclear Information System (INIS)

Kim, Eui Jong; Ryu, Kyung Nam; Ahn, Jin Whan; Yoon, Yup

1994-01-01

The objective of the study was to evaluate the characteristic findings in tears of the anterior cruciate ligament(ACL) and associated injury at MR imaging. We reviewed the findings of MR images and the corresponding arthroscopic results of 32 patients with ACL tears. We evaluated the signal intensity and contour of ACL surrounding bony structures, menisci and associated injury of the knee joint. Complete ACL tears were present in 25 patients and partial ACL tears were in 7 patients. Complete ACL tears showed heterogenously increased signal intensity with contour bulging of the ACL in 14 patients (56%) and without bulging or absence in 11 patients(44%). Most patients torn ACL with contour bulging(12/14) had bone bruise, but only one patient torn ACL without bulging contour had bone bruise. ACL with thin continuous low signal band surrounding heterogenously increased signal intensity suggests partial tear which was seen in three patients of seven proved partial ACL tears. Combined bone injury in ACL tear were in 23 patients (73%) and most of these(22/23) were at midportion of lateral notch of femur and/or posterior portion of lateral tibial plateu. Deepening of lateral notch of femur were noted in 17 patients(53%). Associated injuries of the other ligaments of knee joint were buckling of the posterior cruciate ligament(16/32, 50%) and tears of the medial collateral ligament(11/32, 34%). Posterior horns of menisci were more frequent site of combined injury within menisci in patients with ACL tear. Acute tearing of ACL in MRI is seen as heterogenously increased signal intensity with contour bulging of ACL and combined bone bruises. Patients with torn ACL frequently have various combined injury. In patient with knee injury, these associated or ancillary findings suggest that ACL tear is present

Cross-cultural adaptation and validation of the French version of the Knee injury and Osteoarthritis Outcome Score (KOOS) in knee osteoarthritis patients

DEFF Research Database (Denmark)

Ornetti, P; Parratte, S; Gossec, L

2008-01-01

OBJECTIVE: To adapt the Knee injury and Osteoarthritis Outcome Score (KOOS) into French and to evaluate the psychometric properties of this new version. METHODS: The French version of the KOOS was developed according to cross-cultural guidelines by using the "translation-back translation" method...... to ensure content validity. KOOS data were then obtained in patients with symptomatic knee osteoarthritis (OA). The translated questionnaire was evaluated in two knee OA population groups, one with no indication for joint replacement (medicine), and the other waiting for joint replacement (surgery......). The psychometric properties evaluated were feasibility: percentage of responses, floor and ceiling effects; construct validity: internal consistency using Cronbach's alpha, correlations with osteoarthritis knee and hip quality of life domains using Spearman's rank test, and known group comparison between medicine...

Priorities for injury prevention in women's Australian football: a compilation of national data from different sources.

Science.gov (United States)

Fortington, Lauren V; Finch, Caroline F

2016-01-01

Participation in Australian football (AF) has traditionally been male dominated and current understanding of injury and priorities for prevention are based solely on reports of injuries in male players. There is evidence in other sports that indicates that injury types differ between males and females. With increasing participation in AF by females, it is important to consider their specific injury and prevention needs. This study aimed to provide a first injury profile from existing sources for female AF. Compilation of injury data from four prospectively recorded data sets relating to female AF: (1) hospital admissions in Victoria, 2008/09-13/14, n=500 injuries; (2) emergency department (ED) presentations in Victoria, 2008/09-2012/13, n=1,879 injuries; (3) insurance claims across Australia 2004-2013, n=522 injuries; (4) West Australian Women's Football League (WAWFL), 2014 season club data, n=49 injuries. Descriptive results are presented as injury frequencies, injury types and injury to body parts. Hospital admissions and ED presentations were dominated by upper limb injuries, representing 47% and 51% of all injuries, respectively, primarily to the wrist/hand at 32% and 40%. Most (65%) insurance claim injuries involved the lower limb, 27% of which were for knee ligament damage. A high proportion of concussions (33%) were reported in the club-collected data. The results provide the first compilation of existing data sets of women's AF injuries and highlight the need for a rigorous and systematic injury surveillance system to be instituted.

Recognizing Movement Injuries in Children.

Science.gov (United States)

Williams, Biff; Marston, Rip

2001-01-01

Describes five common youth sport injuries: Little League elbow, swimmer's shoulder, shin splints, Osgood's Schlatters disease, and jumper's knee, also noting their corresponding causes, behavioral symptoms, treatment techniques, and prevention strategies. The information is intended to help teachers identify sports injuries more readily and…

The Analysis of Knee Joint Movement During Golf Swing in Professional and Amateur Golfers

OpenAIRE

M.Somjarod; V. Tanawat; l. Weerawat

2011-01-01

The understanding of knee movement during swing importance for golf swing improving and preventing injury. Thirty male professional and amateur golfers were assigned to swing time by time for 3 times. Data from a vedio-based motion capture were used to compute knee joint movement variables. The results showed that professional and amateur golfers were significantly in left knee flexion angle at the impact point and mid follow through phase. Nevertheless, left knee externa...

Subchondral insufficiency fracture of the knee: a non-traumatic injury with prolonged recovery time.

Science.gov (United States)

Gourlay, Margaret L; Renner, Jordan B; Spang, Jeffrey T; Rubin, Janet E

2015-06-08

Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Although low bone density may be present concurrently, it is not the underlying cause of subchondral insufficiency fractures in the majority of patients. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow oedema and subchondral bone collapse. This article presents a 51-year-old postmenopausal woman, a physician, who had subchondral insufficiency fractures of the knee associated with prolonged standing during clinical work. She was treated with partial weight bearing on crutches until 14 months after the injury, viscosupplementation at 4 months to treat osteoarthritis and teriparatide treatment to improve bone healing at 7 months. By 26 months after the injury, she tolerated independent walking with a fabric knee support but still experienced mild posterolateral knee pain and numbness on prolonged standing. 2015 BMJ Publishing Group Ltd.

Effect of Mulligan's and Kinesio knee taping on adolescent ballet dancers knee and hip biomechanics during landing.

Science.gov (United States)

Hendry, D; Campbell, A; Ng, L; Grisbrook, T L; Hopper, D M

2015-12-01

Taping is often used to manage the high rate of knee injuries in ballet dancers; however, little is known about the effect of taping on lower-limb biomechanics during ballet landings in the turnout position. This study investigated the effects of Kinesiotape (KT), Mulligan's tape (MT) and no tape (NT) on knee and hip kinetics during landing in three turnout positions. The effect of taping on the esthetic execution of ballet jumps was also assessed. Eighteen pain-free 12-15-year-old female ballet dancers performed ballet jumps in three turnout positions, under the three knee taping conditions. A Vicon Motion Analysis system (Vicon Oxford, Oxford, UK) and Advanced Mechanical Technology, Inc. (Watertown, Massa chusetts, USA) force plate collected lower-limb mechanics. The results demonstrated that MT significantly reduced peak posterior knee shear forces (P = 0.025) and peak posterior (P = 0.005), medial (P = 0.022) and lateral (P = 0.014) hip shear forces compared with NT when landing in first position. KT had no effect on knee or hip forces. No significant differences existed between taping conditions in all landing positions for the esthetic measures. MT was able to reduce knee and the hip forces without affecting the esthetic performance of ballet jumps, which may have implications for preventing and managing knee injuries in ballet dancers. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Intra-articular injection of hyaluronic acid for the reduction in joint adhesion formation in a rabbit model of knee injury.

Science.gov (United States)

Wang, Min; Liu, Chao; Xiao, Wei

2014-07-01

Our purpose was to evaluate the effectiveness of intra-articular injections of hyaluronic acid (HA) into immobilized joints for reducing rigidity and formation of joint adhesions following surgery and prolonged joint immobilization. Twenty-four New Zealand white rabbits were randomly divided into experimental (n = 12) and control groups (n = 12). A model of knee injury was created in the right hind leg, and external plaster fixation was performed for 8 weeks. The experimental and control groups received weekly intra-articular injections of 0.3 mL HA solution or normal saline, respectively, in the knee joint. The degree of adhesions, range of motion (ROM), and collagen content of the synovium of the knee joint were observed after 8 weeks. At the end of 8 weeks, the experimental compared with control group had significantly higher mean ROM (70.3° ± 11.1° vs. 54.6° ± 11.2°, respectively; P = 0.002) and mean adhesion score. The experimental group compared with the control group had significantly lower mean adhesion score (2.2 ± 0.9 vs. 3.1 ± 0.7, respectively; P = 0.012) and collagen content (32.4 ± 4.7 vs. 39.0 ± 4.2 μg/mg, P = 0.001). In a rabbit model of knee injury, intra-articular injection of HA decreased adhesion formation and collagen content and increased ROM after prolonged immobilization. These results indicate that HA may be clinically useful to prevent adhesions and improve joint mobility in patients who require joint immobilization for up to 8 weeks.

Biomechanical characteristics of an anterior cruciate ligament injury in javelin throwing

Directory of Open Access Journals (Sweden)

Boyi Dai

2015-12-01

Conclusion: The ACL injury in this study occurred during the first 30% of the delivery phase, most likely during the first 25% of the delivery phase. A stiff landing of the left leg with a small knee flexion angle was the primary contributor to this injury. Javelin throwers may have a soft left leg landing with a flexed knee, which may help them prevent ACL injuries without compromising performance.

Novel magnetic resonance imaging evaluation for valgus instability of the knee caused by medial collateral ligament injury

International Nuclear Information System (INIS)

Ikuma, Hisanori; Abe, Nobuhiro; Furumatsu, Takayuki; Uchida, Youichiro; Fujiwara, Kazuo; Nishida, Keiichiro; Ozaki, Toshifumi

2008-01-01

Instability of the knee after the medial collateral ligament (MCL) injury is usually assessed with the manual valgus stress test, even though, in recent years, it has become possible to apply magnetic resonance imaging (MRI) to the assessment of the damage of the ligament. The valgus instability of 24 patients (12 isolated injuries and 12 multiple ligament injuries) who suffered MCL injury between 1993 and 1998 was evaluated with the Hughston and Eilers classification, which involves radiographic assessment under manual valgus stress to the injured knees. We developed a novel system for classifying the degree of injury to the MCL by calculating the percentage of injured area based on MRI and investigated the relationship between this novel MRI classification and the magnitude of valgus instability by the Hughston and Eilers classification. There was a significant correlation between the 2 classifications (p=0.0006). On the other hand, the results using other MRI based classification systems, such as the Mink and Deutsch classification and the Petermann classification, were not correlated with the findings by the Hughston and Eilers classification in these cases (p>0.05). Since MRI is capable of assessing the injured ligament in clinical practice, this novel classification system would be useful for evaluating the stability of the knee and choosing an appropriate treatment following MCL injury. (author)

Injury Prevention in Youth Sports.

Science.gov (United States)

Stracciolini, Andrea; Sugimoto, Dai; Howell, David R

2017-03-01

Children and adolescents are now participating in competitive sports at younger ages and with increasing intensity. As a result, increasing numbers of young athletes are presenting to pediatricians for care of sports-related injuries and advice about prevention. Understanding and identifying modifiable risk factors for injury in the young athletic population is a critical first step in injury prevention. Risk factors vary by sport, age, and sex. This article reviews the most common risk factors for injury and the evidence to support proposed strategies for prevention. [Pediatr Ann. 2017;46(3):e99-e105.]. Copyright 2017, SLACK Incorporated.

Motor learning strategies in basketball players and its implications for ACL injury prevention: a randomized controlled trial.

Science.gov (United States)

Benjaminse, Anne; Otten, Bert; Gokeler, Alli; Diercks, Ron L; Lemmink, Koen A P M

2017-08-01

Adding external focus of attention (EF, focus on the movement effect) may optimize current anterior cruciate ligament (ACL) injury prevention programmes. The purpose of the current study was to investigate the effects of an EF, by a visual stimulus and an internal focus, by a verbal stimulus during unexpected sidestep cutting in female and male athletes and how these effects remained over time. Ninety experienced basketball athletes performed sidestep cutting manoeuvres in three sessions (S1, S2 and S3). In this randomized controlled trial, athletes were allocated to three groups: visual (VIS), verbal (VER) and control (CTRL). Kinematics and kinetics were collected at the time of peak knee frontal plane moment. Males in the VIS group showed a larger vertical ground reaction force (S1: 25.4 ± 3.1 N/kg, S2: 25.8 ± 2.9 N/kg, S3: 25.2 ± 3.2 N/kg) and knee flexion moments (S1: -3.8 ± 0.9 Nm/kg, S2: -4.0 ± 1.2 Nm/kg, S3: -3.9 ± 1.3 Nm/kg) compared to the males in the VER and CTRL groups and to the females in the VIS group (p knee valgus moment and the females in the VER group reduced knee varus moment over time (n.s.). Male subjects clearly benefit from visual feedback. Females may need different feedback modes to learn a correct movement pattern. Sex-specific learning preferences may have to be acknowledged in day by day practice. Adding video instruction or feedback to regular training regimens when teaching athletes safe movement patterns and providing individual feedback might target suboptimal long-term results and optimize ACL injury prevention programmes. I.

Lessons learned from the last 20 years of ACL-related in vivo-biomechanics research of the knee joint.

Science.gov (United States)

Pappas, Evangelos; Zampeli, Franceska; Xergia, Sofia A; Georgoulis, Anastasios D

2013-04-01

Technological advances in recent years have allowed the easy and accurate assessment of knee motion during athletic activities. Subsequently, thousands of studies have been published that greatly improved our understanding of the aetiology, surgical reconstruction techniques and prevention of anterior cruciate ligament (ACL) injuries. The purpose of this review is to summarize the evidence from biomechanical studies on ACL-related research. High-impact articles that enhanced understanding of ACL injury aetiology, rehabilitation, prevention and adaptations after reconstruction were selected. The importance of restoring internal tibial rotation after ACL reconstruction has emerged in several studies. Criteria-based, individualized rehabilitation protocols have replaced the traditional time-based protocols. Excessive knee valgus, poor trunk control, excessive quadriceps forces and leg asymmetries have been identified as potential high risk biomechanical factors for ACL tear. Injury prevention programmes have emerged as low cost and effective means of preventing ACL injuries, particularly in female athletes. As a result of biomechanical research, clinicians have a better understanding of ACL injury aetiology, prevention and rehabilitation. Athletes exhibiting neuromuscular deficits predisposing them to ACL injury can be identified and enrolled into prevention programmes. Clinicians should assess ACL-reconstructed patients for excessive internal tibial rotation that may lead to poor outcomes.

Complex pelvic ring injuries associated with floating knee in a poly-trauma patient: A case report.

Science.gov (United States)

Zhou, Yuebin; Guo, Honggang; Cai, Zhiwei; Zhang, Yuan

2017-12-01

Complex pelvic ring fracture associated with floating knee is comparatively rare which usually results from high-energy trauma including vehicle-related accidence, falls from height, and earthquake-related injury. To our knowledge, few literatures have documented such injuries in the individual patient. Management of both injuries present challenges for surgical management and postoperative care. The purpose of this study is to prove the feasibility and benefits of damage control orthopedics (DCO). Our case involved a 45-year-old lady who was hit by a dilapidated building. The patient was anxious, pale and hemodynamically stable at the initial examination. The pelvis was unstable and there were obvious deformities in the left lower extremities. Significant degloved injuries in the left leg were noted. Her radiographs and physical examination verified the above signs. Unstable pelvic fractures, multiple fractures of bilateral lower limbs with floating knee injury, multiple pelvic and rib fractures and multiple degloving injuries and soft tissue contusion formed the characteristics of the multiple-injury. The algorithm of DCO was determined as the treatment. Early simplified procedures such as wound debridement, pelvis fixation, closed reduction and EF of the right shoulder joint, and chest wall fixation were conducted as soon as possible. After a period of time, internal fixations were applied to the fracture sites. The subsequent functional exercise was also conducted in accordance with this algorithm. This patient got recovery after the treatments which were guided by the criterion of DCO. The restoration of limb functional and the quality of life greatly improved. The DCO plays a decisive role in the first aid and follow-up treatment of this patient. The guidelines of management of complex pelvic ring injuries and floating knee should be established by authorities.

Prevention of groin injuries in sports

DEFF Research Database (Denmark)

Esteve, E; Rathleff, M S; Bagur-Calafat, C

2015-01-01

performed in Review Manager 5.3. RESULTS: Seven trials were included: six on football players (four male and two female populations) and one on male handball players. In total there were 4191 participants with a total of 157 injuries. The primary analysis, including all participants, did not show...... a significant reduction in the number of groin injuries after completing a groin injury prevention programme (relative risk (RR) 0.81; 95% CI 0.60 to 1.09). Subgroup analysis based on type of sports, gender and type of prevention programme showed similar non-significant estimates with RR ranging from 0.48 to 0......BACKGROUND/AIM: Groin injuries are common in football and ice hockey, and previous groin injury is a strong risk factor for future groin injuries, which calls for primary prevention. The aim of this systematic review was to evaluate the effect of specific groin-injury prevention programmes...

Injury prevention in football

African Journals Online (AJOL)

other sports,[1,2] and youth football players are no exception to this. ... at risk of sports injury because of high levels of exposure at a time of major physiological change.[4] The ..... As part of injury prevention, adequate injury management and.

Prevention of Eye Injuries

OpenAIRE

Pashby, Tom

1981-01-01

In Canada 30,000 people are registered as blind; in one third of these, blindness might have been avoided. Prevention is the key to reducing the number of eye injuries and blind eyes. The role of the family physician in early identification of treatable conditions and in the education of patients is discussed, but responsibility for prevention belongs to all physicians. The success of prevention is seen in the great reduction in eye injuries in industry and sports since eye protectors have be...

Assessment of knee laxity using a robotic testing device: a comparison to the manual clinical knee examination.

Science.gov (United States)

Branch, T P; Stinton, S K; Siebold, R; Freedberg, H I; Jacobs, C A; Hutton, W C

2017-08-01

The purpose of this study was to collect knee laxity data using a robotic testing device. The data collected were then compared to the results obtained from manual clinical examination. Two human cadavers were studied. A medial collateral ligament (MCL) tear was simulated in the left knee of cadaver 1, and a posterolateral corner (PLC) injury was simulated in the right knee of cadaver 2. Contralateral knees were left intact. Five blinded examiners carried out manual clinical examination on the knees. Laxity grades and a diagnosis were recorded. Using a robotic knee device which can measure knee laxity in three planes of motion: anterior-posterior, internal-external tibia rotation, and varus-valgus, quantitative data were obtained to document tibial motion relative to the femur. One of the five examiners correctly diagnosed the MCL injury. Robotic testing showed a 1.7° larger valgus angle, 3° greater tibial internal rotation, and lower endpoint stiffness (11.1 vs. 24.6 Nm/°) in the MCL-injured knee during varus-valgus testing when compared to the intact knee and 4.9 mm greater medial tibial translation during rotational testing. Two of the five examiners correctly diagnosed the PLC injury, while the other examiners diagnosed an MCL tear. The PLC-injured knee demonstrated 4.1 mm more lateral tibial translation and 2.2 mm more posterior tibial translation during varus-valgus testing when compared to the intact knee. The robotic testing device was able to provide objective numerical data that reflected differences between the injured knees and the uninjured knees in both cadavers. The examiners that performed the manual clinical examination on the cadaver knees proved to be poor at diagnosing the injuries. Robotic testing could act as an adjunct to the manual clinical examination by supplying numbers that could improve diagnosis of knee injury. Level II.

Knee Confidence as it Relates to Self-Reported and Objective Correlates of Knee Osteoarthritis

DEFF Research Database (Denmark)

Skou, Søren T; Rasmussen, Sten; Simonsen, Ole

2015-01-01

osteoarthritis (OA). Background Lack of knee confidence is a frequent symptom in patients with knee OA, but little is known of associations between knee confidence and other common correlates of knee OA. Methods Baseline data from 220 patients with knee OA were applied in ordinal regression analyses, with knee...... confidence, assessed using item Q3 of the Knee injury and Osteoarthritis Outcome Score, as the dependent variable and self-reported (pain on walking, general health, fear of movement, self-efficacy, function, and previous serious injury) and objective measures (muscle strength, 20-m walk time.......21; 95% CI: 1.09, 1.34), and general health (OR = 0.024; 95% CI: 0.002, 0.259) explained 19% of the variance in knee confidence (Pcommon finding in individuals with knee OA. Pain on walking was confirmed as a correlate of knee confidence, whereas...

ACL-reconstructed and ACL-deficient individuals show differentiated trunk, hip, and knee kinematics during vertical hops more than 20 years post-injury.

Science.gov (United States)

Markström, Jonas L; Tengman, Eva; Häger, Charlotte K

2018-02-01

Little is known regarding movement strategies in the long term following injury of the anterior cruciate ligament (ACL), and even less about comparisons of reconstructed and deficient knees in relation to healthy controls. The present purpose was to compare trunk, hip, and knee kinematics during a one-leg vertical hop (VH) ~20 years post-ACL injury between persons treated with surgery and physiotherapy (ACL R ), solely physiotherapy (ACL PT ), and controls (CTRL). Between-leg kinematic differences within groups were also investigated. Sixty-six persons who suffered unilateral ACL injury on average 23 ± 2 years ago (32 ACL R , 34 ACL PT ) and 33 controls performed the VH. Peak trunk, hip, and knee angles during Take-off and Landing phases recorded with a 3D motion capture system were analysed with multivariate statistics. Significant group effects during both Take-off and Landing were found, with ACL PT differing from CTRL in Take-off with a combination of less knee flexion and knee internal rotation, and from both ACL R and CTRL in Landing with less hip and knee flexion, knee internal rotation, and greater hip adduction. ACL R also presented different kinematics to ACL PT and CTRL in Take-off with a combination of greater trunk flexion, hip flexion, hip internal rotation, and less knee abduction, and in Landing with greater trunk flexion and hip internal rotation. Further, different kinematics and hop height were found between legs within groups in both Take-off and Landing for both ACL groups, but not for CTRL. Different kinematics for the injured leg for both ACL groups compared to CTRL and between treatment groups, as well as between legs within treatment groups, indicate long-term consequences of injury. Compensatory mechanisms for knee protection seem to prevail over time irrespective of initial treatment, possibly increasing the risk of re-injury and triggering the development of osteoarthritis. Detailed investigation of movement strategies during the VH

Dual-energy computed tomography of cruciate ligament injuries in acute knee trauma

Energy Technology Data Exchange (ETDEWEB)

Peltola, Erno K. [Helsinki University Hospital, Toeoeloe Trauma Center, Department of Radiology, Helsinki Medical Imaging Center, Helsinki (Finland); Koskinen, Seppo K. [Karolinska Universitetssjukhuset, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden)

2015-09-15

To examine dual-energy computed tomography (DECT) in evaluating cruciate ligament injuries. More specifically, the purpose was to assess the optimal keV level in DECT gemstone spectral imaging (GSI) images and to examine the usefulness of collagen-specific color mapping and dual-energy bone removal in the evaluation of cruciate ligaments and the popliteus tendon. At a level 1 trauma center, a 29-month period of emergency department DECT examinations for acute knee trauma was reviewed by two radiologists for presence of cruciate ligament injuries, visualization of the popliteus tendon and the optimal keV level in GSI images. Three different evaluating protocols (GSI, bone removal and collagen-specific color mapping) were rated. Subsequent MRI served as a reference standard for intraarticular injuries. A total of 18 patients who had an acute knee trauma, DECT and MRI were found. On MRI, six patients had an ACL rupture. DECT's sensitivity and specificity to detect ACL rupture were 79 % and 100 %, respectively. The DECT vs. MRI intra- and interobserver proportions of agreement for ACL rupture were excellent or good (kappa values 0.72-0.87). Only one patient had a PCL rupture. In GSI images, the optimal keV level was 63 keV. GSI of 40-140 keV was considered to be the best evaluation protocol in the majority of cases. DECT is a usable method to evaluate ACL in acute knee trauma patients with rather good sensitivity and high specificity. GSI is generally a better evaluation protocol than bone removal or collagen-specific color mapping in the evaluation of cruciate ligaments and popliteus tendon. (orig.)

Behaviour, the key factor for sports injury prevention.

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Verhagen, Evert A L M; van Stralen, Maartje M; van Mechelen, Willem

2010-11-01

Safety in sports and physical activity is an important prerequisite for continuing participation in sports, as well as for maintenance of a healthy physically active lifestyle. For this reason, prevention, reduction and control of sports injuries are important goals for society as a whole. Recent advances in sports medicine discuss the need for research on real-life injury prevention. Such views call for a more behavioural approach when it comes to actual sports injury prevention. Nevertheless, the role of behaviour in sports injury prevention remains under-researched. In order to push the field of sports injury prevention forward, this article provides an overview of the relationship between behaviour and sports injury risk. Different types of behaviour relate to injury risk factors and injury mechanisms. Behaviour that influences risk factors and injury mechanisms is not confined only to the athlete. Various types of behaviour by, for example, the coach, referee, physical therapist or sports associations, also influence risk factors and injury mechanisms. In addition, multiple behaviours often act together. Some types of behaviour may directly affect injury risk and are by definition a risk factor. Other behaviours may only affect risk factors and injury mechanisms, and influence injury risk indirectly. Recent ideas on injury prevention that call for studies on real-life injury prevention still rely heavily on preventive measures that are established through efficacy research. A serious limitation in such an approach is that one expects that proven preventive measures will be adopted if the determinants and influences of sports safety behaviours are understood. Therefore, if one truly wants to prevent sports injuries in a real-life situation, a broader research focus is needed. In trying to do so, we need to look at lessons learned from other fields of injury prevention research.

Injury prevention in Australian Indigenous communities.

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Ivers, Rebecca; Clapham, Kathleen; Senserrick, Teresa; Lyford, Marilyn; Stevenson, Mark

2008-12-01

Injury prevention in Indigenous communities in Australia is a continuing national challenge, with Indigenous fatality rates due to injury three times higher than the general population. Suicide and transport are the leading causes of injury mortality, and assault, transport and falls the primary causes of injury morbidity. Addressing the complex range of injury problems in disadvantaged Indigenous communities requires considerable work in building or enhancing existing capacity of communities to address local safety issues. Poor data, lack of funding and absence of targeted programs are some of the issues that impede injury prevention activities. Traditional approaches to injury prevention can be used to highlight key areas of need, however adaptations are needed in keeping with Indigenous peoples' holistic approach to health, linked to land and linked to community in order to address the complex spiritual, emotional and social determinants of Indigenous injury.

Occupational Injury Prevention Research in NIOSH

Directory of Open Access Journals (Sweden)

Hongwei Hsiao

2010-12-01

Full Text Available This paper provided a brief summary of the current strategic goals, activities, and impacts of the NIOSH (National Institute for Occupational Safety and Health occupational injury research program. Three primary drivers (injury database, stakeholder input, and staff capacity were used to define NIOSH research focuses to maximize relevance and impact of the NIOSH injury-prevention-research program. Injury data, strategic goals, program activities, and research impacts were presented with a focus on prevention of four leading causes of workplace injury and death in the US: motor vehicle incidents, falls, workplace violence, and machine and industrial vehicle incidents. This paper showcased selected priority goals, activities, and impacts of the NIOSH injury prevention program. The NIOSH contribution to the overall decrease in fatalities and injuries is reinforced by decreases in specific goal areas. There were also many intermediate outcomes that are on a direct path to preventing injuries, such as new safety regulations and standards, safer technology and products, and improved worker safety training. The outcomes serve as an excellent foundation to stimulate further research and worldwide partnership to address global workplace injury problems.

Cross-cultural translation of the Lysholm knee score in Chinese and its validation in patients with anterior cruciate ligament injury.

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Wang, W; Liu, L; Chang, X; Jia, Z Y; Zhao, J Z; Xu, W D

2016-10-19

The Lysholm Knee Score (LKS) is widely used and is one of the most effective questionnaires employed to assess knee injuries. Although LKS has been translated into multiple languages, there is no Chinese version even though China has the largest population of patients with knee-joint injuries. The objective of our study was to develop the Chinese version of LKS (C-LKS) and assess its reliability, validity and responsiveness in Chinese patients with anterior cruciate ligament (ACL) injuries. Study participants were mainly recruited among patients with ACL injuries scheduled for arthroscopic ACL reconstruction at our hospital. First, we developed the C-LKS in a five-step translation and cross-cultural adaptation procedure. Next, we calculated the Cronbach's alpha, intraclass correlation coefficient (ICC), Pearson's correlation coefficient (r), effect size (ES), and standardized response mean (SRM) to evaluate the reliability, validity, and responsiveness of C-LKS respectively. Overall, 126 patients with ACL injuries successfully completed the questionnaires. Acceptable internal consistency (Cronbach's alpha = 0.726) as well as excellent test-retest reliability (ICC = 0.935) was found for C-LKS. Good or moderate correlation (r = 0.514-0.837) was determined among C-LKS and International Knee Documentation Committee Subjective Knee Form (IKDC), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), physical subscales of SF-36; C-LKS also had fair or moderate correlation (r = 0.207-0.462) with the other subscales of SF-36, which adequately illustrated that good validity was included in C-LKS. In addition, good responsiveness was also observed in C-LKS (ES = 1.36,SRM = 1.26). We have shown that our developed C-LKS questionnaire is reliable, valid and responsible for the evaluation of Chinese-speaking patients with ACL injuries and it would be an effective instrument.

Sensitivity and specificity of the 'knee-up test' for estimation of the American Spinal Injury Association Impairment Scale in patients with acute motor incomplete cervical spinal cord injury.

Science.gov (United States)

Yugué, Itaru; Okada, Seiji; Maeda, Takeshi; Ueta, Takayoshi; Shiba, Keiichiro

2018-04-01

A retrospective study. Precise classification of the neurological state of patients with acute cervical spinal cord injury (CSCI) can be challenging. This study proposed a useful and simple clinical method to help classify patients with incomplete CSCI. Spinal Injuries Centre, Japan. The sensitivity and specificity of the 'knee-up test' were evaluated in patients with acute CSCI classified as American Spinal Injury Association Impairment Scale (AIS) C or D. The result is positive if the patient can lift the knee in one or both legs to an upright position, whereas the result is negative if the patient is unable to lift the knee in either leg to an upright position. The AIS of these patients was classified according to a strict computerised algorithm designed by Walden et al., and the knee-up test was tested by non-expert examiners. Among the 200 patients, 95 and 105 were classified as AIS C and AIS D, respectively. Overall, 126 and 74 patients demonstrated positive and negative results, respectively, when evaluated using the knee-up test. A total of 104 patients with positive results and 73 patients with negative results were classified as AIS D and AIS C, respectively. The sensitivity, specificity, positive predictive and negative predictive values of this test for all patients were 99.1, 76.8, 82.5 and 98.7, respectively. The knee-up test may allow easy and highly accurate estimation, without the need for special skills, of AIS classification for patients with incomplete CSCI.

Prevention of overuse injuries by a concurrent exercise program in subjects exposed to an increase in training load: a randomized controlled trial of 1020 army recruits

DEFF Research Database (Denmark)

Brushøj, Christoffer; Larsen, Klaus; Albrecht-Beste, Elisabeth

2008-01-01

on a literature review of intrinsic risk factors, and performed concurrent with an increase in physical activity, can reduce the incidence of overuse knee injuries and medial tibial stress syndrome, as well as increase running distance. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS...... no significant differences in incidence of injury between the prevention group and the placebo group (incidence, 0.22 vs 0.19; P = .162; relative risk = 1.05 [range, 0.98-1.11]). The soldiers in the prevention group had the greater improvement in running distance in 12-minute run tests (82 vs 43 m; P = .037......BACKGROUND: It is unknown whether an exercise program can prevent overuse injuries in the lower extremity. An often encountered and important risk factor for the development of lower extremity overuse injuries is an abrupt increase in activity level. HYPOTHESIS: A preventive training program based...

Anterior cruciate ligament injury/reinjury in alpine ski racing: a narrative review

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Jordan, Matthew J; Aagaard, Per; Herzog, Walter

2017-01-01

The purpose of the present review was to: 1) provide an overview of the current understanding on the epidemiology, etiology, risk factors, and prevention methods for anterior cruciate ligament (ACL) injury in alpine ski racing; and 2) provide an overview of what is known pertaining to ACL reinjury and return to sport after ACL injury in alpine ski racing. Given that most of the scientific studies on ACL injuries in alpine ski racing have been descriptive, and that very few studies contributed higher level scientific evidence, a nonsystematic narrative review was employed. Three scholarly databases were searched for articles on ACL injury or knee injury in alpine ski racing. Studies were classified according to their relevance in relation to epidemiology, etiology, risk factors, and return to sport/reinjury prevention. Alpine ski racers (skiers) were found to be at high risk for knee injuries, and ACL tears were the most frequent diagnosis. Three primary ACL injury mechanism were identified that involved tibial internal rotation and anteriorly directed shear forces from ski equipment and the environment. While trunk muscle strength imbalance and genetics were found to be predictive of ACL injuries in development-level skiers, there was limited scientific data on ACL injury risk factors among elite skiers. Based on expert opinion, research on injury risk factors should focus on equipment design, course settings/speed, and athlete factors (eg, fitness). While skiers seem to make a successful recovery following ACL injury, there may be persistent neuromuscular deficits. Future research efforts should be directed toward prospective studies on ACL injury/reinjury prevention in both male and female skiers and toward the effects of knee injury on long-term health outcomes, such as the early development of osteoarthritis. International collaborations may be necessary to generate sufficient statistical power for ACL injury/reinjury prevention research in alpine ski racing

Prevention of unintentional childhood injury.

Science.gov (United States)

Theurer, Wesley M; Bhavsar, Amit K

2013-04-01

Unintentional injury accounts for 40 percent of childhood deaths annually, most commonly from motor vehicle crashes. The proper use of child restraints is the most effective strategy to prevent injury or death. Motor vehicle restraint guidelines have recently been revised to an age-based system that delays the progression in type of restraint for most children. Strategies to prevent suffocation in children include using appropriate bedding, positioning babies on their backs to sleep, and removing items from the sleep and play environment that could potentially entrap or entangle the child. Fencing that isolates a swimming pool from the yard and surrounding area and "touch" adult supervision (i.e., an adult is in the water and able to reach and grab a child) have been shown to be most effective in preventing drownings. Swimming lessons are recommended for children older than four years. Poison prevention programs have been shown to improve prevention behavior among caregivers, but may not decrease poisoning incidence. Syrup of ipecac is not recommended. Smoke detector maintenance, a home escape plan, and educating children about how to respond during a fire emergency are effective strategies for preventing fire injuries or death. Fall injuries may be reduced by not using walkers for infants and toddlers or bunk beds for children six years and younger. Consistent helmet use while bicycling reduces head and brain injuries. Although direct counseling by physicians appears to improve some parental safety behaviors, its effect on reducing childhood injuries is uncertain. Community-based interventions can be effective in high-risk populations.

Does the FIFA 11+ Injury Prevention Program Reduce the Incidence of ACL Injury in Male Soccer Players?

Science.gov (United States)

Silvers-Granelli, Holly J; Bizzini, Mario; Arundale, Amelia; Mandelbaum, Bert R; Snyder-Mackler, Lynn

2017-10-01

The FIFA 11+ injury prevention program has been shown to decrease the risk of soccer injuries in men and women. The program has also been shown to decrease time loss resulting from injury. However, previous studies have not specifically investigated how the program might impact the rate of anterior cruciate ligament (ACL) injury in male soccer players. The purpose of this study was to examine if the FIFA 11+ injury prevention program can (1) reduce the overall number of ACL injuries in men who play competitive college soccer and whether any potential reduction in rate of ACL injuries differed based on (2) game versus practice setting; (3) player position; (4) level of play (Division I or II); or (5) field type. This study was a prospective cluster randomized controlled trial, which was conducted in 61 Division I and Division II National Collegiate Athletic Association men's soccer teams over the course of one competitive soccer season. The FIFA 11+ is a 15- to 20-minute on-the-field dynamic warm-up program used before training and games and was utilized as the intervention throughout the entire competitive season. Sixty-five teams were randomized: 34 to the control group (850 players) and 31 to the intervention group (675 players). Four intervention teams did not complete the study and did not submit their data, noting insufficient time to complete the program, reducing the number for per-protocol analysis to 61. Compliance to the FIFA 11+ program, athletic exposures, specific injuries, ACL injuries, and time loss resulting from injury were collected and recorded using a secure Internet-based system. At the end of the season, the data in the injury surveillance system were crosshatched with each individual institution's internal database. At that time, the certified athletic trainer signed off on the injury collection data to confirm their accuracy and completeness. A lower proportion of athletes in the intervention group experienced knee injuries (25% [34 of

Costs and effectiveness of a brief MRI examination of patients with acute knee injury

International Nuclear Information System (INIS)

Oei, Edwin H.G.; Nikken, Jeroen J.; Ginai, Abida Z.; Krestin, Gabriel P.; Verhaar, Jan A.N.; Vugt, Arie B. van; Hunink, M.G.M.

2009-01-01

The aim of this study was to assess the costs and effectiveness of selective short magnetic resonance imaging (MRI) in patients with acute knee injury. A model was developed to evaluate the selective use of MRI in patients with acute knee injury and no fracture on radiography based on the results of a trial in which 208 patients were randomized between radiography only and radiography plus MRI. We analyzed medical (diagnostic and therapeutic) costs, quality of life, duration of diagnostic workup, number of additional diagnostic examinations, time absent from work, and time to convalescence during a 6-month follow-up period. Quality of life was lowest (EuroQol at 6 weeks 0.61 (95% CI 0.54-0.67)); duration of diagnostic workup, absence from work, and time to convalescence were longest; and the number of diagnostic examinations was largest with radiography only. These outcomes were more favorable for both MRI strategies (EuroQol at 6 weeks 0.72 (95% CI 0.67-0.77) for both). Mean total costs were 2,593 euros (95% CI 1,815-3,372) with radiography only, 2,116 euros (95% CI 1,488-2,743) with radiography plus MRI, and 1,973 euros (95% CI 1,401-2,543) with selective MRI. The results suggest that selective use of a short MRI examination saves costs and potentially increases effectiveness in patients with acute knee injury without a fracture on radiography. (orig.)

Construct validity and reliability of the Finnish version of the Knee Injury and Osteoarthritis Outcome Score.

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Multanen, Juhani; Honkanen, Mikko; Häkkinen, Arja; Kiviranta, Ilkka

2018-05-22

The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a commonly used knee assessment and outcome tool in both clinical work and research. However, it has not been formally translated and validated in Finnish. The purpose of this study was to translate and culturally adapt the KOOS questionnaire into Finnish and to determine its validity and reliability among Finnish middle-aged patients with knee injuries. KOOS was translated and culturally adapted from English into Finnish. Subsequently, 59 patients with knee injuries completed the Finnish version of KOOS, Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form 36 Health Survey (SF-36) and Numeric Pain Rating Scale (Pain-NRS). The same KOOS questionnaire was re-administered 2 weeks later. Psychometric assessment of the Finnish KOOS was performed by testing its construct validity and reliability by using internal consistency, test-retest reliability and measurement error. The floor and ceiling effects were also examined. The cross-cultural adaptation revealed only minor cultural differences and was well received by the patients. For construct validity, high to moderate Spearman's Correlation Coefficients were found between the KOOS subscales and the WOMAC, SF-36, and Pain-NRS subscales. The Cronbach's alpha was from 0.79 to 0.96 for all subscales indicating acceptable internal consistency. The test-retest reliability was good to excellent, with Intraclass Correlation Coefficients ranging from 0.73 to 0.86 for all KOOS subscales. The minimal detectable change ranged from 17 to 34 on an individual level and from 2 to 4 on a group level. No floor or ceiling effects were observed. This study yielded an appropriately translated and culturally adapted Finnish version of KOOS which demonstrated good validity and reliability. Our data indicate that the Finnish version of KOOS is suitable for assessment of the knee status of Finnish patients with different knee complaints. Further studies are needed to

Muscle weakness, afferent sensory dysfunction and exercise in knee osteoarthritis

DEFF Research Database (Denmark)

Roos, Ewa M.; Herzog, Walter; Block, Joel A

2011-01-01

Lower-extremity muscle strength and afferent sensory dysfunction, such as reduced proprioceptive acuity, are potentially modifiable putative risk factors for knee osteoarthritis (OA). Findings from current studies suggest that muscle weakness is a predictor of knee OA onset, while there is confli...... with previous knee injuries) are easily identified, and may benefit from exercise interventions to prevent or delay OA onset....... there is conflicting evidence regarding the role of muscle weakness in OA progression. In contrast, the literature suggests a role for afferent sensory dysfunction in OA progression but not necessarily in OA onset. The few pilot exercise studies performed in patients who are at risk of incident OA indicate...... a possibility for achieving preventive structure or load modifications. In contrast, large randomized controlled trials of patients with established OA have failed to demonstrate beneficial effects of strengthening exercises. Subgroups of individuals who are at increased risk of knee OA (such as those...

Analysis of medical service use of knee osteoarthritis and knee meniscal and ligament injuries in Korea: a cross-sectional study of national patient sample data

OpenAIRE

Suh, Chang Yong; Lee, Yoon Jae; Shin, Joon-Shik; Lee, Jinho; Kim, Me-riong; Koh, Wonil; Cha, Yun-Yeop; Shin, Byung-Cheul; Hwang, Eui-Hyoung; Suhr, Kristin; Kim, Mia; Ha, In-Hyuk

2017-01-01

Background Osteoarthritis (OA) and meniscal and ligament injuries of the knee are the two most common knee disorders in Korea. The aim of this study was to analyze the demographic characteristics, medical service use and related costs for these disorders, and the results are expected to help inform practitioners, researchers, and policy-makers. Methods The present study aimed to evaluate incidence and patient characteristics, and to assess current medical service use, usual care, and medical ...

Managing dislocations of the hip, knee, and ankle in the emergency department

Science.gov (United States)

Arnold, Caylyne; Fayos, Zane; Bruner, David; Arnold, Dylan

2017-12-01

Dislocation of the major joints of the lower extremities--hip, knee, and ankle--can occur due to motor-vehicle crashes, falls, and sports injuries. Hip dislocations are the most common, and they require emergent management to prevent avascular necrosis of the femoral head. Knee dislocations are uncommon but potentially dangerous injuries that can result in amputation due to the potential for missed secondary injury, especially if they are reduced spontaneously. Isolated ankle dislocations are relatively rare, as most ankle dislocations involve an associated fracture. This review presents an algorithmic approach to management that ensures that pain relief, imaging, reduction, vascular monitoring, and emergent orthopedic consultation are carried out in a timely fashion. Copyright © 2017 EB Medicine. All rights reserved.

Ecological approaches to the prevention of unintentional injuries

Directory of Open Access Journals (Sweden)

John P. Allegrante

2010-06-01

Full Text Available

Background: Injury as a cause of significant morbidity and mortality has remained fairly stable in countries with developed economies. Although injury prevention often is conceptualised as a biomedical construct, such a reductionist perspective overlooks the importance of the psychological, environmental, and sociocultural conditions as contributing factors to injury and its consequences. This paper describes the potential of the ecological model for understanding the antecedent causes of unintentional injuries and guiding injury prevention approaches. We review the origins and conceptualise the elements of the ecological model and conclude with some examples of applications of ecological approaches to the prevention of unintentional injury and promotion of community safety.

Methods: A review of the English-language literature on the conceptualization of ecological models in public health and injury prevention, including the application of the ecological model in the prevention of falls and road traffic injuries and in the community safety promotion movement.

Results: Three dimensions are important in social-ecological systems that comprise key determinants of injuries: 1 the individual and his or her behaviour, 2 the physical environment, and 3 the social environment. Social and environmental determinants have profound impact on population health and in the causation of injuries.

Conclusions: Social and environmental determinants of injury should be studied with the same energy, urgency, and intellectual rigor as physical determinants. Application of the ecological model in injury prevention shows the most promise in falls injury prevention, road traffic injury prevention, and community safety promotion.

Prevention of Hamstring Injuries in Collegiate Sprinters

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Sugiura, Yusaku; Sakuma, Kazuhiko; Sakuraba, Keishoku; Sato, Yamato

2017-01-01

Background: No studies have been reported on how strength, agility, and flexibility training reduce the occurrence of hamstring injuries in sprinters. Therefore, a program for preventing hamstring injury in these athletes has not been established. Purpose: To document the incidence of hamstring injuries during times when different prevention strategies were employed to see whether a particular prevention program reduced their occurrence. Study Design: Descriptive epidemiology study. Methods: The study subjects were a total of 613 collegiate male sprinters trained by the same coach over 24 seasons. Tow training was used throughout the research period as a normal sprint training method. The hamstring injury prevention program evolved over time. From 1988 to 1991 (period 1), prevention focused on strength training alone; from 1992 to 1999 (period 2), a combination of strength and agility training was used; and from 2000 to 2011 (period 3), the program incorporated strength, agility, and flexibility training. The incidence of hamstring injuries was compared for each of the 3 prevention strategies. Results: The incidence of hamstring injuries per athlete-seasons was 137.9 for period 1, 60.6 for period 2, and 6.7 for period 3. A significant difference was observed in the incidence of hamstring injury according to the different prevention programs (χ2(2) = 31.78, P hamstring injuries for period 1 was significantly greater than the expected value (P hamstring injuries in sprinters decreased as agility and flexibility were added to strength training. PMID:28210652

Reference Values for the Marx Activity Rating Scale in a Young Athletic Population: History of Knee Ligament Injury Is Associated With Higher Scores.

Science.gov (United States)

Cameron, Kenneth L; Peck, Karen Y; Thompson, Brandon S; Svoboda, Steven J; Owens, Brett D; Marshall, Stephen W

2015-01-01

Activity-related patient-reported outcome measures are an important component of assessment after knee ligament injury in young and physically active patients; however, normative data for most activity scales are limited. To present reference values by sex for the Marx Activity Rating Scale (MARS) within a young and physically active population while accounting for knee ligament injury history and sex. Cross-sectional study. Level 2. All incoming freshman entering a US Service Academy in June of 2011 were recruited to participate in this study. MARS was administered to 1169 incoming freshmen (203 women) who consented to participate within the first week of matriculation. All subjects were deemed healthy and medically fit for military service on admission. Subjects also completed a baseline questionnaire that asked for basic demographic information and injury history. We calculated means with standard deviations, medians with interquartile ranges, and percentiles for ordinal and continuous variables, and frequencies and proportions for dichotomous variables. We also compared median scores by sex and history of knee ligament injury using the Kruskal-Wallis test. MARS was the primary outcome of interest. The median MARS score was significantly higher for men when compared with women (χ(2) = 13.22, df = 1, P MARS scores between men and women (χ(2) = 0.47, df = 1, P = 0.493) who reported a history of injury. Overall, median MARS scores were significantly higher among those who reported a history of knee ligament injury when compared with those who did not (χ(2) = 9.06, df = 1, P = 0.003). Assessing activity as a patient-reported outcome after knee ligament injury is important, and reference values for these instruments need to account for the influence of prior injury and sex. © 2015 The Author(s).

Artificial neural networks in knee injury risk evaluation among professional football players

Science.gov (United States)

Martyna, Michałowska; Tomasz, Walczak; Krzysztof, Grabski Jakub; Monika, Grygorowicz

2018-01-01

Lower limb injury risk assessment was proposed, based on isokinetic examination that is a part of standard athlete's biomechanical evaluation performed mainly twice a year. Information about non-contact knee injury (or lack of the injury) sustained within twelve months after isokinetic test, confirmed in USG were verified. Three the most common types of football injuries were taken into consideration: anterior cruciate ligament (ACL) rupture, hamstring and quadriceps muscles injuries. 22 parameters, obtained from isokinetic tests were divided into 4 groups and used as input parameters of five feedforward artificial neural networks (ANNs). The 5th group consisted of all considered parameters. The networks were trained with the use of Levenberg-Marquardt backpropagation algorithm to return value close to 1 for the sets of parameters corresponding injury event and close to 0 for parameters with no injury recorded within 6 - 12 months after isokinetic test. Results of this study shows that ANN might be useful tools, which simplify process of simultaneous interpretation of many numerical parameters, but the most important factor that significantly influence the results is database used for ANN training.

Brain Injury Safety Tips and Prevention

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Practice guidelines for the management of multiligamentous injuries of the knee

Directory of Open Access Journals (Sweden)

Ankit Goyal

2017-01-01

Full Text Available Background: Multiligamentous injuries of knee remain a gray area as far as guidelines for management are concerned due to absence of large-scale, prospective controlled trials. This article reviews the recent evidence-based literature and trends in treatment of multiligamentous injuries and establishes the needful protocol, keeping in view the current concepts. Materials and Methods: Two reviewers individually assessed the available data indexed on PubMed and Medline and compiled data on incidence, surgical versus nonsurgical treatment, timing of surgery, and repair versus reconstruction of multiligamentous injury. Results: Evolving trends do not clearly describe treatment, but most studies have shown increasing inclination toward an early, staged/single surgical procedure for multiligamentous injuries involving cruciate and collateral ligaments. Medial complex injuries have shown better results with conservative treatment with surgical reconstruction of concomitant injuries. Conclusion: Multiligamentous injury still remains a gray area due to unavailability of a formal guideline to treatment in the absence of large-scale, blinded prospective controlled trials. Any in multiligamentous injuries any intervention needs to be individualized by the presence of any life- or limb-threatening complication. The risks and guarded prognosis with both surgical and non-surgical modalities of treatment should be explained to patient and relations.

Gender dimorphic ACL strain in response to combined dynamic 3D knee joint loading: implications for ACL injury risk.

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Mizuno, Kiyonori; Andrish, Jack T; van den Bogert, Antonie J; McLean, Scott G

2009-12-01

While gender-based differences in knee joint anatomies/laxities are well documented, the potential for them to precipitate gender-dimorphic ACL loading and resultant injury risk has not been considered. To this end, we generated gender-specific models of ACL strain as a function of any six degrees of freedom (6DOF) knee joint load state via a combined cadaveric and analytical approach. Continuously varying joint forces and torques were applied to five male and five female cadaveric specimens and recorded along with synchronous knee flexion and ACL strain data. All data (approximately 10,000 samples) were submitted to specimen-specific regression analyses, affording ACL strain predictions as a function of the combined 6 DOF knee loads. Following individual model verifications, generalized gender-specific models were generated and subjected to 6 DOF external load scenarios consistent with both a clinical examination and a dynamic sports maneuver. The ensuing model-based strain predictions were subsequently examined for gender-based discrepancies. Male and female specimen-specific models predicted ACL strain within 0.51%+/-0.10% and 0.52%+/-0.07% of the measured data respectively, and explained more than 75% of the associated variance in each case. Predicted female ACL strains were also significantly larger than respective male values for both simulated 6 DOF load scenarios. Outcomes suggest that the female ACL will rupture in response to comparatively smaller external load applications. Future work must address the underlying anatomical/laxity contributions to knee joint mechanical and resultant ACL loading, ultimately affording prevention strategies that may cater to individual joint vulnerabilities.

Jump Landing Characteristics Predict Lower Extremity Injuries in Indoor Team Sports.

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van der Does, H T D; Brink, M S; Benjaminse, A; Visscher, C; Lemmink, K A P M

2016-03-01

The aim of this study is to investigate the predictive value of landing stability and technique to gain insight into risk factors for ankle and knee injuries in indoor team sport players. Seventy-five male and female basketball, volleyball or korfball players were screened by measuring landing stability after a single-leg jump landing and landing technique during a repeated counter movement jump by detailed 3-dimensional kinematics and kinetics. During the season 11 acute ankle injuries were reported along with 6 acute and 7 overuse knee injuries by the teams' physical therapist. Logistic regression analysis showed less landing stability in the forward and diagonal jump direction (OR 1.01-1.10, p≤0.05) in players who sustained an acute ankle injury. Furthermore landing technique with a greater ankle dorsiflexion moment increased the risk for acute ankle injury (OR 2.16, p≤0.05). A smaller knee flexion moment and greater vertical ground reaction force increased the risk of an overuse knee injury (OR 0.29 and 1.13 respectively, p≤0.05). Less one-legged landing stability and suboptimal landing technique were shown in players sustaining an acute ankle and overuse knee injury compared to healthy players. Determining both landing stability and technique may further guide injury prevention programs. © Georg Thieme Verlag KG Stuttgart · New York.

Position controlled Knee Rehabilitation Orthotic Device for Patients after Total Knee Replacement Arthroplasty

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Wannaphan, Patsiri; Chanthasopeephan, Teeranoot

2016-11-01

Knee rehabilitation after total knee replacement arthroplasty is essential for patients during their post-surgery recovery period. This study is about designing one degree of freedom knee rehabilitation equipment to assist patients for their post-surgery exercise. The equipment is designed to be used in sitting position with flexion/extension of knee in sagittal plane. The range of knee joint motion is starting from 0 to 90 degrees angle for knee rehabilitation motion. The feature includes adjustable link for different human proportions and the torque feedback control at knee joint during rehabilitation and the control of flexion/extension speed. The motion of the rehabilitation equipment was set to move at low speed (18 degrees/sec) for knee rehabilitation. The rehabilitation link without additional load took one second to move from vertical hanging up to 90° while the corresponding torque increased from 0 Nm to 2 Nm at 90°. When extra load is added, the link took 1.5 seconds to move to 90° The torque is then increased from 0 Nm to 4 Nm. After a period of time, the speed of the motion can be varied. User can adjust the motion to 40 degrees/sec during recovery activity of the knee and users can increase the level of exercise or motion up to 60 degrees/sec to strengthen the muscles during throughout their rehabilitation program depends on each patient. Torque control is included to prevent injury. Patients can use the equipment for home exercise to help reduce the number of hospital visit while the patients can receive an appropriate therapy for their knee recovery program.

THE INFLUENCE OF HIP STRENGTH ON KNEE KINEMATICS DURING A SINGLE-LEGGED MEDIAL DROP LANDING AMONG COMPETITIVE COLLEGIATE BASKETBALL PLAYERS.

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Suzuki, Hidetomo; Omori, Go; Uematsu, Daisuke; Nishino, Katsutoshi; Endo, Naoto

2015-10-01

A smaller knee flexion angle and larger knee valgus angle during weight-bearing activities have been identified as risk factors for non-contact anterior cruciate ligament (ACL) injuries. To prevent such injuries, attention has been focused on the role of hip strength in knee motion control. However, gender differences in the relationship between hip strength and knee kinematics during weight-bearing activities in the frontal plane have not been evaluated. The purpose of this study was to determine the influence of hip strength on knee kinematics in both genders during a single-legged landing task in the frontal plane. The hypotheses were that 1) subjects with a greater hip strength would demonstrate larger knee flexion and smaller knee valgus and internal rotation angles and 2) no gender differences would exist during the single-legged landing task. Forty-three Japanese collegiate basketball players (20 males, 23 females) participated in this study. Three-dimensional motion analysis was used to evaluate knee kinematics during a single-legged medial drop landing (SML). A hand-held dynamometer was used to assess hip extensor (HEXT), abductor (HAB), and external rotator (in two positions: seated position [SHER] and prone [PHER]) isometric strength. Spearman rank correlation coefficients (ρ) were determined for correlations between hip strength and knee kinematics at initial contact (IC) and peak (PK) during SML (p genders. Hip strength may, therefore, play an important role in knee motion control during sports activities, suggesting that increased hip strength may help to prevent non-contact ACL injuries in athletes of both genders. Moreover, gender-specific programs may be needed to control abnormal knee motion, as the influence of hip strength on knee kinematics may differ based on gender. 3.

Interventions for preventing lower limb soft-tissue running injuries.

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Yeung, Simon S; Yeung, Ella W; Gillespie, Lesley D

2011-07-06

evidence that a longer, more gradual increase in training reduces injuries in novice runners (one trial; 486 participants; RR 1.02, 95% CI 0.72 to 1.45). There was some evidence from a poor quality trial that additional training resulted in a significant increase in the number of naval recruits with shin splints (one trial; 1670 participants; RR 2.02, 95% CI 1.11 to 3.70). There was limited evidence that injuries were less frequent in prisoners when running duration (one trial; 69 participants; RR 0.41, 95% CI 0.21 to 0.79) or frequency (one trial; 58 participants; RR 0.19, 95% CI 0.06 to 0.66) were reduced.Patellofemoral braces appear to be effective for preventing anterior knee pain (two trials; 227 participants; RR 0.41, 95% CI 0.24 to 0.67).Custom-made biomechanical insoles may be more effective than no insoles for reducing shin splints (medial tibial stress syndrome) in military recruits (one trial; 146 participants; RR 0.24, 95% CI 0.08 to 0.69).We found no evidence in military recruits that wearing running shoes based on foot shape, rather than standard running shoes, significantly reduced rate of running injuries (2 trials; 5795 participants; Rate Ratio 1.03, 95% CI 0.93 to 1.14). Overall, the evidence base for the effectiveness of interventions to reduce soft-tissue injury after intensive running is very weak, with few trials at low risk of bias. More well-designed and reported RCTs are needed that test interventions in recreational and competitive runners.

The Effect of Upper Body Mass and Initial Knee Flexion on the Injury Outcome of Post Mortem Human Subject Pedestrian Isolated Legs.

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Petit, Philippe; Trosseille, Xavier; Dufaure, Nicolas; Dubois, Denis; Potier, Pascal; Vallancien, Guy

2014-11-01

In the ECE 127 Regulation on pedestrian leg protection, as well as in the Euro NCAP test protocol, a legform impactor hits the vehicle at the speed of 40 kph. In these tests, the knee is fully extended and the leg is not coupled to the upper body. However, the typical configuration of a pedestrian impact differs since the knee is flexed during most of the gait cycle and the hip joint applies an unknown force to the femur. This study aimed at investigating the influence of the inertia of the upper body (modelled using an upper body mass fixed at the proximal end of the femur) and the initial knee flexion angle on the lower limb injury outcome. In total, 18 tests were conducted on 18 legs from 9 Post Mortem Human Subjects (PMHS). The principle of these tests was to impact the leg at 40 kph using a sled equipped with 3 crushing steel tubes, the stiffness of which were representative of the front face of a European sedan (bonnet leading edge, bumper and spoiler). The mass of the equipped sled was 74.5 kg. The test matrix was designed to perform 4 tests in 4 configurations combining two upper body masses (either 0 or 3 kg) and two knee angles (0 or 20 degrees) at 40 kph (11 m/s) plus 2 tests at 9 m/s. Autopsies were performed on the lower limbs and an injury assessment was established. The findings of this study were first that the increase of the upper body mass resulted in more severe injuries, second that an initial flexion of the knee, corresponding to its natural position during the gait cycle, decreased the severity of the injuries, and third that based on the injury outcome, a test conducted with no upper body mass and the knee fully extended was as severe as a test conducted with a 3 kg upper body mass and an initial knee flexion of 20°.

Need for Injury Prevention Education In Medical School Curriculum

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Vaca, Federico E

2010-02-01

Full Text Available Injury is the leading cause of death and disability among the U.S. population aged 1 to 44 years. In 2006 more than 179,000 fatalities were attributed to injury. Despite increasing awareness of the global epidemic of injury and violence, a considerable gap remains between advances in injury-prevention research and prevention knowledge that is taught to medical students. This article discusses the growing need for U.S medical schools to train future physicians in the fundamentals of injury prevention and control. Teaching medical students to implement injury prevention in their future practice should help reduce injury morbidity and mortality. Deliberate efforts should be made to integrate injury-prevention education into existing curriculum. Key resources are available to do this. Emergency physicians can be essential advocates in establishing injury prevention training because of their clinical expertise in treating injury. Increasing the number of physicians with injury- and violence- prevention knowledge and skills is ultimately an important strategy to reduce the national and global burden of injury. [West J Emerg Med. 2010; 11(1:40-43].

Diagnostic criterial to differentiate medial meniscal injury from degenerative changes on 99mTc-MDP knee SPECT in patients with chronic knee pain

International Nuclear Information System (INIS)

Paeng, Jin Chul; Chung, June Key; Kang, Won Jun; So, Young; Lee, Dong Soo; Lee, Myung Chul; Yoo, Jae Ho; Lee, Myung Chul; Jeong, Hwan Jeong

2003-01-01

In patients with chronic knee pain, the diagnostic performance of 99m Tc-MDP knee SPECT for internal derangement of knee is deteriorated due to degenerative changes. In this study, we tried to establish diagnostic criteria to differentiate medial meniscal injury (MMI) from degenerative change (DC) when the uptake in increased in medial compartment. A total of 49 knee SPECT of the patients with chronic(more than 3 months) knee pain, which showed increased 99m Tc-MDP uptake in the medial compartment, were included in this study. The diagnosis was confirmed by arthroscopy. On knee SPECT, 3 diagnosic criteria for MMI were investigated. In Criterion, I, MMI was diagnosed when crescentic uptake was observed in the medial tibial plateau. In Criterion II, crescentic uptake was further classified into anterior, mid, posterior, and diffuse patterns, according to the location of maximal uptake; and only crescentic mid, posterior, and diffuse patterns were diagnosed as MMI. In Criterion III, MMI was diagnosed when medial tibial plateau showed higher activity then medial femoral condyle. The diagnostic performance of the 3 criteria was compared. The sensitivity and specificity were 93% and 14% in Criterion I, 89% and 38% in Criterion II, and 75% and 67% in Criterion III, respectively. Criterion III had significantly improve diagnostic performance, especially, specificity. In this study, we established a practical diagnostic criterion to differentiate MMI from DC on knee SPECT. The result is helpful to improve the diagnostic value of knee SPECT as a screening test for chronic knee pain

Preventing Paraffin-Related Injury

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Dehran Swart

2009-07-01

Full Text Available Paraffin (called kerosene in North America and other parts of the world is the most commonly used fuel in ‎non-electrified dwellings worldwide. It is especially popular in Africa and South Asia. Although paraffin ‎offers many advantages – especially its comparatively low cost to produce – it poses two major risks of ‎injury. First, paraffin poisoning is common, either through ingestion or through inhalation of smoke and ‎fumes. Second, paraffin is highly flammable, and poses fire risk through multiple causes. This commentary ‎discusses strategies to prevent paraffin-related injury. Prevention of paraffin-related injury must be through ‎multiple strategies, and should include policy-oriented change, changes to the safety of home environments, ‎and behavioral changes targeting how individuals store and use paraffin and paraffin appliances. We review ‎successful prevention strategies in each of these domains and discuss appropriate research and community ‎initiatives that should be implemented to improve paraffin safety among at-risk populations.‎

The floating knee: epidemiology, prognostic indicators & outcome following surgical management

OpenAIRE

Yesupalan Rajam S; Rethnam Ulfin; Nair Rajagopalan

2007-01-01

Abstract Background Floating Knee injuries are complex injuries. The type of fractures, soft tissue and associated injuries make this a challenging problem to manage. We present the outcome of these injuries after surgical management. Methods 29 patients with floating knee injuries were managed over a 3 year period. This was a prospective study were both fractures of the floating knee injury were surgically fixed using different modalities. The associated injuries were managed appropriately. ...

Managing dislocations of the hip, knee, and ankle in the emergency department [digest].

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Arnold, Caylyne; Fayos, Zane; Bruner, David; Arnold, Dylan; Gupta, Nachi; Nusbaum, Jeffrey

2017-12-20

Dislocation of the major joints of the lower extremities--hip, knee, and ankle--can occur due to motor-vehicle crashes, falls, and sports injuries. Hip dislocations are the most common, and they require emergent management to prevent avascular necrosis of the femoral head. Knee dislocations are uncommon but potentially dangerous injuries that can result in amputation due to the potential for missed secondary injury, especially if they are reduced spontaneously. Isolated ankle dislocations are relatively rare, as most ankle dislocations involve an associated fracture. This review presents an algorithmic approach to management that ensures that pain relief, imaging, reduction, vascular monitoring, and emergent orthopedic consultation are carried out in a timely fashion. [Points & Pearls is a digest of Emergency Medicine Practice.].

Anterior cruciate ligament injury/reinjury in alpine ski racing

DEFF Research Database (Denmark)

Jordan, Matthew J; Aagaard, Per; Herzog, Walter

2017-01-01

and return to sport after ACL injury in alpine ski racing. Given that most of the scientific studies on ACL injuries in alpine ski racing have been descriptive, and that very few studies contributed higher level scientific evidence, a nonsystematic narrative review was employed. Three scholarly databases...... were searched for articles on ACL injury or knee injury in alpine ski racing. Studies were classified according to their relevance in relation to epidemiology, etiology, risk factors, and return to sport/reinjury prevention. Alpine ski racers (skiers) were found to be at high risk for knee injuries...... injuries in development-level skiers, there was limited scientific data on ACL injury risk factors among elite skiers. Based on expert opinion, research on injury risk factors should focus on equipment design, course settings/speed, and athlete factors (eg, fitness). While skiers seem to make a successful...

Type II collagen C2C epitope in human synovial fluid and serum after knee injury

DEFF Research Database (Denmark)

Kumahashi, N; Swärd, P; Larsson, S

2015-01-01

PURPOSE: Investigate in a cross-sectional study time-dependent changes of synovial fluid type II collagen epitope C2C concentrations after knee injury and correlate to other joint injury biomarkers. METHODS: Synovial fluid samples were aspirated between 0 days and 7 years after injury (n = 235...... = 0.403, P type II collagen (r = 0.444, P = 0.003), ARGS-aggrecan (r = 0.337, P ... with an immediate and sustained local degradation of type II collagen....

Automated Assessment of Dynamic Knee Valgus and Risk of Knee Injury During the Single Leg Squat

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Lee, Alexander; Raina, Sachin; Kulić, Dana

2017-01-01

Many clinical assessment protocols of the lower limb rely on the evaluation of functional movement tests such as the single leg squat (SLS), which are often assessed visually. Visual assessment is subjective and depends on the experience of the clinician. In this paper, an inertial measurement unit (IMU)-based method for automated assessment of squat quality is proposed to provide clinicians with a quantitative measure of SLS performance. A set of three IMUs was used to estimate the joint angles, velocities, and accelerations of the squatting leg. Statistical time domain features were generated from these measurements. The most informative features were used for classifier training. A data set of SLS performed by healthy participants was collected and labeled by three expert clinical raters using two different labeling criteria: “observed amount of knee valgus” and “overall risk of injury”. The results showed that both flexion at the hip and knee, as well as hip and ankle internal rotation are discriminative features, and that participants with “poor” squats bend the hip and knee less than those with better squat performance. Furthermore, improved classification performance is achieved for females by training separate classifiers stratified by gender. Classification results showed excellent accuracy, 95.7 % for classifying squat quality as “poor” or “good” and 94.6% for differentiating between high and no risk of injury. PMID:29204327

[Cruciate ligament injuries under gender aspects].

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Grabau, D E; Vitzthum, K; Mache, S; Groneberg, D A; Quarcoo, D

2011-12-01

An injury of cruciate ligament is one the most common knee injuries. This accident happens mostly without external impact and towards the end of training and competition sessions. Women, especially athletes playing team sports ball games such as soccer or disciplines such as tennis, are affected 2 to 8 times more often than men. Anatomic, biomechanical and endocrinological differences are currently discussed as potential risk factors. In terms of prevention, biomechanical impact is of greatest importance given its influenceability through various training opportunities. Training programs including endurance aspects, strengthening knee musculature, balance as well as plyometric trainings were most effective. Further studies should focus more on concomitants of course of injuries. © Georg Thieme Verlag KG Stuttgart · New York.

DIAGNOSTIC ACCURACY OF CLINICAL AND MAGNETIC RESONANCE IN KNEE MENISCI AND LIGAMENTOUS INJURIES

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Nilesh

2016-03-01

Full Text Available OBJECTIVE The purpose of this study was to evaluate the reliability of clinical diagnosis compared to MRI findings in ligamentous and meniscal injuries with respect to arthroscopic confirmation as a gold standard. METHODS 485 patients with knee injuries were prospectively assessed by clinical evaluation and magnetic resonance imaging and correlated after therapeutic arthroscopy. The overall accuracy, clinically productive values of sensitivity and specificity was derived. The actual value of the test with respect to positive predictive and negative predictive value was also derived, taking arthroscopic findings as confirmatory. The overall partial and total agreement among the clinical, MRI and arthroscopy was documented. RESULTS The overall accuracy for clinical examination was 85, 92, 100 and 100 and accuracy for MRI was 90, 97, 97 and 97 for detecting medial meniscus, lateral meniscus, ACL and PCL tears respectively. Clinically lateral meniscus tears are difficult to diagnose clinically with negative predictive value (90 whereas ACL injuries do not need MRI for diagnosis as evident by a high negative predictive value (100 of clinical examination. Total agreement with the clinical findings confirmed by arthroscopy was 64.40% which was relatively high as compared to total agreement of MRI findings which was only 31.50%. We found similar total agreement versus total disagreement of both clinical and MRI to be only 2.74% indicating very high accuracy in clinical diagnosis of meniscal and ligamentous injuries combined. CONCLUSION The clinical evaluation alone is sufficient to diagnose meniscal and ACL/PCL pathologies and MRI should be considered only as a powerful negative diagnostic tool. The arthroscopy decision should not be heavily dependent on MRI for ligamentous injuries but reverse is true for meniscal lesions. MR evaluation functions as a powerful negative diagnostic tool to rule out doubtful and complex knee injuries.

Sport injuries in adolescents

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Susanne Habelt

2011-11-01

Full Text Available In spite of the wide range of injuries in adolescents during sports activities, there are only a few studies investigating the type and frequency of sport injuries in puberty. However, this information may help to prevent, diagnose and treat sports injuries among teens. 4468 injuries in adolescent patients were treated over a ten year period of time: 66,97% were boys and 32.88% girls. The most frequent sports injuries were football (31.13% followed by handball (8.89% and sports during school (8.77%. The lower extremity was involved in 68.71% of the cases. Knee problems were seen in 29.79% of the patients; 2.57% spine and 1.99% head injuries. Injuries consisted primarily of distortions (35.34% and ligament tears (18.76%; 9,00% of all injuries were fractures. We found more skin wounds (6:1 and fractures (7:2 in male patients compared to females. The risk of ligament tears was highest during skiing. Three of four ski injuries led to knee problems. Spine injuries were observed most often during horse riding (1:6. Head injuries were seen in bicycle accidents (1:3. Head injuries were seen in male patients much more often then in female patients (21:1. Fractures were noted during football (1:9, skiing (1:9, inline (2:3, and during school sports (1:11. Many adolescents participate in various sports. Notwithstanding the methodological problems with epidemiological data, there is no doubt about the large number of athletes sustain musculoskeletal injuries, sometimes serious. In most instances, the accident does not happened during professional sports and training. Therefore, school teachers and low league trainer play an important role preventing further accidence based on knowledge of individual risk patterns of different sports. It is imperative to provide preventive medical check-ups, to monitor the sport-specific needs for each individual sports, to observe the training skills as well as physical fitness needed and to evaluation coaches education.

Principles of brain plasticity in improving sensorimotor function of the knee and leg in patients with anterior cruciate ligament injury: a double-blind randomized exploratory trial

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Ageberg Eva

2012-05-01

Full Text Available Abstract Background Severe traumatic knee injury, including injury to the anterior cruciate ligament (ACL, leads to impaired sensorimotor function. Although improvements are achieved by training, impairment often persists. Because good sensorimotor function is associated with better patient-reported function and a potential lower risk of future joint problems, more effective treatment is warranted. Temporary cutaneous anesthesia of adjacent body parts was successfully used on the hand and foot to improve sensorimotor function. The aim of this study was to test whether this principle of brain plasticity could be used on the knee. The hypothesis was that temporary anesthesia of the skin area above and below the knee would improve sensorimotor function of the ipsilateral knee and leg in subjects with ACL injury. Methods In this double-blind exploratory study, 39 subjects with ACL injury (mean age 24 years, SD 5.2, 49% women, mean 52 weeks after injury or reconstruction and self-reported functional limitations and lack of trust in the knee were randomized to temporary local cutaneous application of anesthetic (EMLA® (n = 20 or placebo cream (n = 19. Fifty grams of EMLA®, or placebo, was applied on the leg 10 cm above and 10 cm below the center of patella, leaving the area around the knee without cream. Measures of sensory function (perception of touch, vibration sense, knee kinesthesia and motor function (knee muscle strength, hop test were assessed before and after 90 minutes of treatment with EMLA® or placebo. The paired t-test was used for comparisons within groups and analysis of variance between groups, except for ordinal data where the Wilcoxon signed rank test, or Mann–Whitney test, was used. The number of subjects needed was determined by an a priori sample size calculation. Results No statistically significant or clinically relevant differences were seen over time (before vs. after in the measures of sensory or motor

Effects of evidence-based prevention training on neuromuscular and biomechanical risk factors for ACL injury in adolescent female athletes: a randomised controlled trial.

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Zebis, Mette K; Andersen, Lars L; Brandt, Mikkel; Myklebust, Grethe; Bencke, Jesper; Lauridsen, Hanne Bloch; Bandholm, Thomas; Thorborg, Kristian; Hölmich, Per; Aagaard, Per

2016-05-01

Adolescent female football and handball players are among the athletes with the highest risk of sustaining anterior cruciate ligament (ACL) injuries. This study evaluated the effects of evidence-based lower extremity injury prevention training on neuromuscular and biomechanical risk factors for non-contact ACL injury. 40 adolescent female football and handball players (15-16 years) were randomly allocated to a control group (CON, n=20) or neuromuscular training group (NMT, n=20). The NMT group performed an injury prevention programme as a warm-up before their usual training 3 times weekly for 12 weeks. The CON group completed their regular warm-up exercise programme before training. Players were tested while performing a side cutting movement at baseline and 12-week follow-up, using surface electromyography (EMG) and three-dimensional movement analysis. We calculated: (1) EMG amplitude from vastus lateralis (VL), semitendinosus (ST) and biceps femoris 10 ms prior to initial contact (IC) normalised to peak EMG amplitude recorded during maximal voluntary isometric contraction and (2) VL-ST EMG preactivity difference during the 10 ms prior to foot contact (primary outcome). We measured maximal knee joint valgus moment and knee valgus angle at IC. There was a difference between groups at follow-up in VL-ST preactivity (43% between-group difference; 95% CI 32% to 55%). No between-group differences were observed for kinematic and kinetic variables. A 12-week injury prevention programme in addition to training and match play in adolescent females altered the pattern of agonist-antagonist muscle preactivity during side cutting. This may represent a more ACL-protective motor strategy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Analysis on violence injury incidence and prevention in China].

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Er, Yuliang; Gao, Xin; Duan, Leilei; Wang, Yuan; Deng, Xiao; Ji, Cuirong; Ye, Pengpeng; Jin, Ye; Wang, Linhong

2016-01-01

To understand the incidence of violence injury and its prevention in China, and provide reference for the prevention and control of violence injury. The violence injury data in China were collected from national death surveillance data set (2006-2013) and national injury surveillance system (2013) for the descriptive epidemiological analysis on the incidence of violence injury and related death. The laws and policies about violence injury prevention, related data collection capacity and violence injury prevention programs in China were described. The violence injury mortality declined by 46.3% during 2006-2013 from 1.21/100000 to 0.65/100000. The incidence of violence injury death in males peaked in age group 30-34 years (1.42/100000), and it was low in age groupviolence injury death were found in females, i.e. 0.84/100000 in infants, 0.72/100000 in age group 30-34 years and 1.18/100000 in age group≥85 years. The laws and policies about violence injury prevention were imperfect, and the data about violence injury were limited. Most prevention programs were limited in scale and duration. The crude and standardized violence injury mortality declined in China during 2006-2013. It is necessary to conduct gender specific prevention strategies and improve the related law and policy development, data collection and prevention service.

Relationship between balance ability, training and sports injury risk.

Science.gov (United States)

Hrysomallis, Con

2007-01-01

Traditionally, balance training has been used as part of the rehabilitation programme for ankle injuries. More recently, balance training has been adopted to try and prevent injuries to the ankle and knee joints during sport. The purpose of this review is to synthesise current knowledge in the area of balance ability, training and injury risk, highlight the findings and identify any future research needs. A number of studies have found that poor balance ability is significantly related to an increased risk of ankle injuries in different activities. This relationship appears to be more common in males than females. Multifaceted intervention studies that have included balance training along with jumping, landing and agility exercises have resulted in a significant decrease in ankle or knee injuries in team handball, volleyball and recreational athletes. It is unknown which component of the multifaceted intervention was most effective and whether the effects are additive. As a single intervention, balance training has been shown to significantly reduce the recurrence of ankle ligament injuries in soccer, volleyball and recreational athletes; however, it has not been clearly shown to reduce ankle injuries in athletes without a prior ankle injury. Balance training on its own has also been shown to significantly reduce anterior cruciate ligament injuries in male soccer players. Surprisingly, it was also found to be significantly associated with an increased risk of major knee injuries in female soccer players and overuse knee injuries in male and female volleyball players. The studies with the contrasting findings differed in aspects of their balance training programmes. It would appear that balance training, as a single intervention, is not as effective as when it is part of a multifaceted intervention. Research is required to determine the relative contribution of balance training to a multifaceted intervention so as to generate an effective and efficient preventative

Partial rupture of the Achilles tendon during a simulated fire ground task: insights obtained from a case report for the prevention and reporting of musculoskeletal injury.

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Gooyers, Chad E; Frost, David M; McGill, Stuart M; Callaghan, Jack P

2013-04-01

In this case report an incumbent firefighter partially ruptured his right Achilles tendon during a study of the physical demands of firefighting. Kinematics and kinetics of the lower limbs and trunk were collected while the firefighter performed two simulated fire ground tasks. From this unexpected event, two insights were obtained that should be considered in all future injury prevention and reporting efforts. (i) Consider the full anatomical linkage--the right ankle and knee kinematics leading up to the onset of injury trial were comparable to all preceding repetitions. However, there was a notable difference in the left knee starting position before the initiation of movement of the 37th hose-advance trial. (ii) Consider the cumulative load--the task in question comprised forward and backward phases. A marked difference was observed in the frontal-plane ankle moment during the return phase of the trial preceding the injury. Additionally, the magnitude of the left side vertical ground reaction force was comparable across all trials, suggesting that loads experienced by the right limb were also similar. This would indicate that the tolerance of the Achilles tendon and not the magnitude of the loading was altered. The unfortunate injury captured in this work provides insight into the complexity of characterizing the pathways of injury. It is recommended that future injury prevention and reporting efforts consider individuals' physical demands (at work and in life) and document the nature of loading (i.e., frequency, duration, magnitude, type) when considering the mechanism for injury. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Impact of Simulated Knee Injuries on the Patellofemoral and Tibiofemoral Kinematics Investigated with an Electromagnetic Tracking Approach: A Cadaver Study

Directory of Open Access Journals (Sweden)

Björn Rath

2018-01-01

Full Text Available Purpose. The purpose of this study was to evaluate the approach of using an electromagnetic tracking (EMT system for measuring the effects of stepwise, simulated knee injuries on patellofemoral (PF and tibiofemoral (TF kinematics. Methods. Three cadaver knees were placed in a motion rig. EMT sensors were mounted on the patella, the medial/lateral femoral epicondyles, the tibial condyle, and the tibial tuberosity (TT. After determining the motion of an intact knee, three injuries were simulated and the resulting bony motion was tracked. Results. Starting with the intact knee fully extended (0° flexion and bending it to approximately 20°, the patella shifted slightly in the medial direction. Then, while bending the knee to the flexed position (90° flexion, the patella shifted progressively more laterally. After transecting the anterior cruciate ligament (ACL, the base of the medial menisci (MM at the pars intermedia, and the medial collateral ligament (MCL, individual changes were observed. For example, the medial femoral epicondyle displayed a medial lift-off in all knees. Conclusion. We demonstrated that our EMT approach is an acceptable method to accurately measure PF joint motion. This method could also enable visualization and in-depth analysis of in vivo patellar function in total knee arthroplasty, if it is established for routine clinical use.

Effects of jump and balance training on knee kinematics and electromyography of female basketball athletes during a single limb drop landing: pre-post intervention study

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Nagano Yasuharu

2011-07-01

Full Text Available Abstract Background Some research studies have investigated the effects of anterior cruciate ligament (ACL injury prevention programs on knee kinematics during landing tasks; however the results were different among the studies. Even though tibial rotation is usually observed at the time of ACL injury, the effects of training programs for knee kinematics in the horizontal plane have not yet been analyzed. The purpose of this study was to determine the effects of a jump and balance training program on knee kinematics including tibial rotation as well as on electromyography of the quadriceps and hamstrings in female athletes. Methods Eight female basketball athletes participated in the experiment. All subjects performed a single limb landing at three different times: the initial test, five weeks later, and one week after completing training. The jump and balance training program lasted for five weeks. Knee kinematics and simultaneous electromyography of the rectus femoris and Hamstrings before training were compared with those measured after completing the training program. Results After training, regarding the position of the knee at foot contact, the knee flexion angle for the Post-training trial (mean (SE: 24.4 (2.1 deg was significantly larger than that for the Pre-training trial (19.3 (2.5 deg (p Conclusions The jump and balance training program successfully increased knee flexion and hamstring activity of female athletes during landing, and has the possibility of producing partial effects to avoid the characteristic knee position observed in ACL injury, thereby preventing injury. However, the expected changes in frontal and transverse kinematics of the knee were not observed.

Australian snowboard injury data base study. A four-year prospective study.

Science.gov (United States)

Bladin, C; Giddings, P; Robinson, M

1993-01-01

Information on the rate and spectrum of snowboarding injuries is limited. This 4-year prospective study at 3 major Australian ski resorts assesses incidence and patterns of snowboarding injuries, particularly in relation to skill level and footwear. Ski injury data were collected for the same period. In a predominantly male study population (men:women, 3:1), 276 snowboarding injuries were reported; 58% occurred in novices. Fifty-seven percent of injuries were in the lower limbs, 30% in the upper limbs. The most common injuries were sprains (53%), fractures (24%), and contusions (12%). Comparing skiers' versus snowboarders' injuries, snowboarders had 2.4 times as many fractures, particularly to the upper limbs (21% versus 35% of upper limb injuries), fewer knee injuries (23% versus 44% of lower limb injuries), but more ankle injuries (23% versus 6% of lower limb injuries). Ankle injuries were more common with soft-shell boots, worn most by intermediate and advanced riders. Knee injuries and distal tibial fractures were more common with hard-shell boots, worn most by novices. Overall, novices had more upper limb fractures and knee injuries; intermediate and advanced riders had more ankle injuries. Falls were the principal mode of injury. To prevent injury, beginners should use "hybrid" or soft-shell boots and take lessons.

Effects of changes in skiing posture on the kinetics of the knee joint.

Science.gov (United States)

Koyanagi, Maki; Shino, Konsei; Yoshimoto, Yoji; Inoue, Satoru; Sato, Mutsumi; Nakata, Ken

2006-01-01

This study was performed to investigate the effects of changes in the skiing posture on mechanical stress across the knee joint. The aim of the present study was to establish a safer form of skiing for the prevention of injury to the anterior cruciate ligament of the knee (ACL). Ten healthy volunteers were placed on a force plate on an artificial slope, and assumed forward and backward bending postures with a single leg by changing their centre of gravity. The knee flexion angles were limited to approximately 30 degrees by orthotics in each posture. Joint moments of the lower extremity were analyzed using a motion analysis system, and the muscle activities of the lower extremity were recorded by EMG and digitised to integrated EMG in each posture. In addition, extrusion of the lower leg by the boot was measured using a force sensor sheet inserted behind the calf. We found that the extension moment of the hip and ankle joints, and muscular activity of the hamstrings were increased in forward bending, whereas the extension moment of the knee and muscular activity of the quadriceps were decreased. Conversely, the muscular activity of the quadriceps, the flexion moment of the hip, extension moment of the knee joint, and pressure of the boot were increased in backward bending, whereas muscular activity of the hamstrings was decreased. The dependency on the hamstrings increased in forward bending in a skiing posture on a slope with slight knee flexion. Therefore, forward bending seemed to be an advantageous posture for the prevention of ACL injury. Conversely, in a backward bending skiing posture, the extension moment of the knee joint produced by muscle contraction of the quadriceps also increased imbalance in the hamstrings. The results of this study suggest that the internal force exerted by the quadriceps, in addition to the passive factor of extrusion of the lower leg by the boot, may contribute to non-contact ACL injury in a backward bending posture while skiing.

The relationship between previous hamstring injury and the concentric isokinetic knee muscle strength of irish gaelic footballers

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O'Ceallaigh Brian

2008-03-01

Full Text Available Abstract Background Hamstring injury is one of the most common injuries affecting gaelic footballers, similar to other field sports. Research in other sports on whether residual hamstring weakness is present after hamstring injury is inconsistent, and no study has examined this factor in irish gaelic footballers. The aim of this study was to examine whether significant knee muscle weakness is present in male Irish gaelic footballers who have returned to full activity after hamstring injury. Methods The concentric isokinetic knee flexion and extension strength of 44 members of a university gaelic football team was assessed at 60, 180 and 300 degrees per second using a Contrex dynamometer. Results Fifteen players (34% reported a history of hamstring strain, with 68% of injuries affecting the dominant (kicking limb. The hamstrings were significantly stronger (p 0.05 using this comparison. The previously unilaterally injured hamstrings were significantly weaker (p Conclusion Hamstring muscle weakness was observed in male Irish gaelic footballers with a history of hamstring injury. This weakness is most evident when comparisons are made to multiple control populations, both within and between subjects. The increased strength of the dominant limb should be considered as a potential confounding variable in future trials. The study design does not allow interpretation of whether these changes in strength were present before or after injury.

Meniscal Allograft Transplantation Does Not Prevent or Delay Progression of Knee Osteoarthritis.

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Catherine Van Der Straeten

Full Text Available Meniscal tears are common knee injuries. Meniscal allograft transplantation (MAT has been advocated to alleviate symptoms and delay osteoarthritis (OA after meniscectomy. We investigated (1 the long-term outcome of MAT as a treatment of symptomatic meniscectomy, (2 most important factors affecting survivorship and (3 OA progression.From 1989 till 2013, 329 MAT were performed in 313 patients. Clinical and radiographic results and MAT survival were evaluated retrospectively. Failure was defined as conversion to knee arthroplasty (KA or total removal of the MAT.Mean age at surgery was 33 years (15-57; 60% were males. No-to-mild cartilage damage was found in 156 cases, moderate-to-severe damage in 130. Simultaneous procedures in 118 patients included cartilage procedures, osteotomy or ACL-reconstruction. At a mean follow-up of 6.8 years (0.2-24.3years, 5 patients were deceased and 48 lost (14.6%, 186 MAT were in situ (56.5% whilst 90 (27.4% had been removed, including 63 converted to a KA (19.2%. Cumulative allograft survivorship was 15.1% (95% CI:13.9-16.3 at 24.0 years. In patients <35 years at surgery, survival was significantly better (24.1% compared to ≥35 years (8.0% (p = 0.017. In knees with no-to-mild cartilage damage more allografts survived (43.0% compared to moderate-to-severe damage (6.6% (p = 0.003. Simultaneous osteotomy significantly deteriorated survival (0% at 24.0 years (p = 0.010. 61% of patients underwent at least one additional surgery (1-11 for clinical symptoms after MAT. Consecutive radiographs showed significant OA progression at a mean of 3.8 years (p<0.0001. Incremental Kellgren-Lawrence grade was +1,1 grade per 1000 days (2,7yrs.MAT did not delay or prevent tibiofemoral OA progression. 19.2% were converted to a knee prosthesis at a mean of 10.3 years. Patients younger than 35 with no-to-mild cartilage damage may benefit from MAT for relief of symptoms (survivorship 51.9% at 20.2 years, but patients and healthcare payers

Increased knee valgus alignment and moment during single-leg landing after overhead stroke as a potential risk factor of anterior cruciate ligament injury in badminton.

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Kimura, Yuka; Ishibashi, Yasuyuki; Tsuda, Eiichi; Yamamoto, Yuji; Hayashi, Yoshimitsu; Sato, Shuichi

2012-03-01

In badminton, knees opposite to the racket-hand side received anterior cruciate ligament (ACL) injuries during single-leg landing after overhead stroke. Most of them occurred in the backhand-side of the rear court. Comparing lower limb biomechanics during single-leg landing after overhead stroke between the forehand-side and backhand-side court may help explain the different injury rates depending on court position. The knee kinematics and kinetics during single-leg landing after overhead stroke following back-stepping were different between the forehand-side and backhand-side court. Controlled laboratory study. Hip, knee and ankle joint kinematic and knee kinetic data were collected for 17 right-handed female college badminton players using a 3-dimensional motion analysis system. Subjects performed single-left-legged landing after an overhead stroke following left and right back-stepping. The kinematic and kinetic data of the left lower extremities during landing were measured and compared between left and right back-steps. Hip flexion and abduction and knee valgus at the initial contact, hip and knee flexion and knee valgus at the maximum knee flexion and the maximum knee valgus moment were significantly larger for the left back-step than the right back-step (p<0.05). Significant differences in joint kinematics and kinetics of the lower extremity during single-leg landing after overhead stroke were observed between different back-step directions. Increased knee valgus angle and moment following back-stepping to the backhand-side might be related to the higher incidence of ACL injury during single-leg landing after overhead stroke.

Biomechanics Associated with Patellofemoral Pain and ACL Injuries in Sports.

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Weiss, Kaitlyn; Whatman, Chris

2015-09-01

Epidemiology' (STROBE) guidelines was used to rate observational research. Fifteen journal articles focusing on ACL injuries and PFPS in sports met the inclusion criteria. These included three associated with both ACL injuries and PFPS across multiple time points. There was limited evidence for an association between ankle biomechanics and knee injury, with only one ACL injury study identifying decreased plantar flexion in association with injury. Only prospective studies can determine biomechanical risk factors associated with ACL injuries and PFPS. Case studies and case-control studies do not allow for the determination of risk factors associated with both ACL injuries and PFPS as there is no certainty regarding the presence of the observed biomechanics prior to the onset of injury. Further, each study design has its own set of limitations. Lastly, the majority of the studies included in this review had adult female participants. By evaluating several different study designs looking at knee injuries during high-risk manoeuvres, we were able to obtain a holistic perspective of biomechanics associated with PFPS and ACL injuries. Looking at different biomechanical research approaches allowed us to assess not only the mechanism of injury, but also to look for commonalities in biomechanics (in particular, altered frontal plane mechanics at the knee and altered sagittal plane mechanics at the knee and hip) between injured and uninjured participants pre-injury, at the time of injury, and following injury, to better understand potential causes of PFPS and ACL injury. Development of injury prevention programmes should focus on correcting these mechanics observed across the three time points during high-risk manoeuvres as this may help decrease the prevalence of ACL injury and PFPS. Programmes focusing not only on neuromuscular training, but also skill-specific training focused on correcting mechanics during these high-risk manoeuvres may be of greatest benefit regarding prevention

Rasch analysis of the Knee injury and Osteoarthritis Outcome Score (KOOS): a statistical re-evaluation

DEFF Research Database (Denmark)

Comins, J; Brodersen, J; Krogsgaard, M

2008-01-01

The knee injury and Osteoarthritis Outcome Score (KOOS), based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), is widely used to evaluate subjective outcome in anterior cruciate ligament (ACL) reconstructed patients. However, the validity of KOOS has not been assessed...

Core Competencies for Injury and Violence Prevention

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Stephens-Stidham, Shelli; Peek-Asa, Corinne; Bou-Saada, Ingrid; Hunter, Wanda; Lindemer, Kristen; Runyan, Carol

2009-01-01

Efforts to reduce the burden of injury and violence require a workforce that is knowledgeable and skilled in prevention. However, there has been no systematic process to ensure that professionals possess the necessary competencies. To address this deficiency, we developed a set of core competencies for public health practitioners in injury and violence prevention programs. The core competencies address domains including public health significance, data, the design and implementation of prevention activities, evaluation, program management, communication, stimulating change, and continuing education. Specific learning objectives establish goals for training in each domain. The competencies assist in efforts to reduce the burden of injury and violence and can provide benchmarks against which to assess progress in professional capacity for injury and violence prevention. PMID:19197083

Knee and ankle injuries from playing football

International Nuclear Information System (INIS)

Kramer, J.; Scheurecker, G.

2010-01-01

Soccer is the most common sport activity worldwide. Over the last two decades the increase in soccer players has mainly been due to increased interest by females. In general, soccer is a relatively safe sport activity, especially if minor injuries resulting in short periods of absence from playing or training are neglected. However, due to the high number of soccer players severe injuries are also frequent. These are a problem not only for the injured player and the team but may also become problematic for the socio-economic system. In up to 80-90% structures of the lower extremities are injured. For sufficient radiological diagnosis knowledge of the biomechanics of the soccer game and some details about the history of the injury may be of help. To prevent soccer injuries or keep the degree of injury low, special programs had been developed. (orig.) [de

MRI EVALUATION OF INTERNAL DERANGEMENT OF KNEE

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Ashok Srikar Chowdhary

2018-01-01

Full Text Available BACKGROUND Internal derangement of knee means loss of normal knee function due to ligament or meniscal injuries. MRI is a routinely utilised noninvasive modality for evaluation of various knee disorders including internal derangement. MRI provides excellent soft tissue contrast and multiplanar images when compared to other musculoskeletal imaging modalities. The aim of the study is to study the demographic profile of patients presenting with internal derangement of knee, identify the various ligament and meniscal injuries causing internal derangement of knee and describe the MRI features of the ligament and meniscal injuries. MATERIALS AND METHODS This study was undertaken from January 2016 to mid-December 2017 in the Department of Radiodiagnosis, MVJ Medical College and Research Hospital, Hoskote. The study population consisted of 108 patients with internal derangement of knee who underwent MRI of knee. All the MRI scans of the knee in this study were performed using Siemens Magnetom Essenza (A Tim+Dot system MR machine with a 1.5 tesla field strength magnet using a flex coil. RESULTS The study population consisted of 108 patients comprising of 90 males and 18 females. The age of the patients ranged from 16 to 67 years. Majority of the patients belonged to the age group of 21-30 years constituting about 41% of the total study population. Anterior cruciate ligament injury was the commonest followed by medial and lateral meniscus tears. Flap tear was the commonest type of meniscal tear. Posterior horn of the meniscus was the commonest tear site. CONCLUSION MRI is the investigation of choice in evaluating internal derangement of knee. MRI can accurately diagnose ligament and meniscal injuries and guide arthroscopy.

Real-time biofeedback to target risk of anterior cruciate ligament injury: a technical report for injury prevention and rehabilitation.

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Ford, Kevin R; DiCesare, Christopher A; Myer, Gregory D; Hewett, Timothy E

2015-05-20

Biofeedback training enables an athlete to alter biomechanical and physiological function by receiving biomechanical and physiological data concurrent with or immediately after a task. To compare the effects of 2 different modes of real-time biofeedback focused on reducing risk factors related to anterior cruciate ligament injury. Randomized crossover study design. Biomechanics laboratory and sports medicine center. Female high school soccer players (age 14.8 ± 1.0 y, height 162.6 ± 6.8 cm, mass 55.9 ± 7.0 kg; n = 4). A battery of kinetic- or kinematic-based real-time biofeedback during repetitive double-leg squats. Baseline and posttraining drop vertical jumps were collected to determine if either feedback method improved high injury risk landing mechanics. Maximum knee abduction moment and angle during the landing was significantly decreased after kinetic-focused biofeedback (P = .04). The reduced knee abduction moment during the drop vertical jumps after kinematic-focused biofeedback was not different (P = .2). Maximum knee abduction angle was significantly decreased after kinetic biofeedback (P < .01) but only showed a trend toward reduction after kinematic biofeedback (P = .08). The innovative biofeedback employed in the current study reduced knee abduction load and posture from baseline to posttraining during a drop vertical jump.

Translation and cross-cultural adaptation of the lower extremity functional scale into a Brazilian Portuguese version and validation on patients with knee injuries.

Science.gov (United States)

Metsavaht, Leonardo; Leporace, Gustavo; Riberto, Marcelo; Sposito, Maria Matilde M; Del Castillo, Letícia N C; Oliveira, Liszt P; Batista, Luiz Alberto

2012-11-01

Clinical measurement. To translate and culturally adapt the Lower Extremity Functional Scale (LEFS) into a Brazilian Portuguese version, and to test the construct and content validity and reliability of this version in patients with knee injuries. There is no Brazilian Portuguese version of an instrument to assess the function of the lower extremity after orthopaedic injury. The translation of the original English version of the LEFS into a Brazilian Portuguese version was accomplished using standard guidelines and tested in 31 patients with knee injuries. Subsequently, 87 patients with a variety of knee disorders completed the Brazilian Portuguese LEFS, the Medical Outcomes Study 36-Item Short-Form Health Survey, the Western Ontario and McMaster Universities Osteoarthritis Index, and the International Knee Documentation Committee Subjective Knee Evaluation Form and a visual analog scale for pain. All patients were retested within 2 days to determine reliability of these measures. Validation was assessed by determining the level of association between the Brazilian Portuguese LEFS and the other outcome measures. Reliability was documented by calculating internal consistency, test-retest reliability, and standard error of measurement. The Brazilian Portuguese LEFS had a high level of association with the physical component of the Medical Outcomes Study 36-Item Short-Form Health Survey (r = 0.82), the Western Ontario and McMaster Universities Osteoarthritis Index (r = 0.87), the International Knee Documentation Committee Subjective Knee Evaluation Form (r = 0.82), and the pain visual analog scale (r = -0.60) (all, Pcoefficient = 0.957) of the Brazilian Portuguese version of the LEFS were high. The standard error of measurement was low (3.6) and the agreement was considered high, demonstrated by the small differences between test and retest and the narrow limit of agreement, as observed in Bland-Altman and survival-agreement plots. The translation of the LEFS into a

Below Knee Impact Responses using Cadaveric Specimens.

Science.gov (United States)

Balasubramanian, Sriram; Beillas, Philippe; Belwadi, Aditya; Hardy, Warren N; Yang, King H; King, Albert I; Masuda, Mitsutoshi

2004-11-01

Knee injuries represent about 10% of all injuries suffered during car crashes. Efforts to assess the injury risk to the posterior cruciate ligament (PCL) have been based on a study available in the literature (Viano et al., 1978), in which only two of the five knees tested had PCL ruptures. The aims of the current study were to repeat the study with a higher number of samples, study the effects of other soft tissues on knee response, and assess the adequacy of the experimental setup for the identification of a PCL tolerance. A total of 14 knees were tested using a high-speed materials testing machine. Eight were intact knees (with the patella and all the muscular and ligamentous structures), three were PCL-only knees (patella and all the muscular and ligamentous structures other than the PCL removed), and the last three were PCL-only knees with the tibia protected from bending fracture. Of the eight intact knees tested, only one had PCL mid substance rupture, one had a partial articular fracture of the tibia below the plateau, and six had simple transverse fracture of the tibial metaphysis. Of the three PCL-only knees without tibial protection, one had PCL mid substance rupture, one had avulsion at the posterior intercondylar attachment point, and the last one had a simple oblique fracture of the tibial metaphysis. Of the three PCL only knees with tibia protection, two had PCL mid-substance ruptures and the third one had an avulsion at the tibial insertion site with partial articular fracture of the lateral plateau. Overall, the results of the current study were similar to those observed by Viano et al. (1978). The average displacement at failure for all PCL related injuries was 17.2+/-2.8 mm for the current study (n=6) and 16.2+/-3.9 mm for Viano et al. (1978) (n=4). This value is higher than the Injury Assessment Reference Value of 15 mm proposed by Mertz (1984) and used in various regulations. Both studies suggest that the existence of the soft tissues other

Contribution of mechanical unloading to trabecular bone loss following non-invasive knee injury in mice

OpenAIRE

Anderson, Matthew J.; Diko, Sindi; Baehr, Leslie M.; Baar, Keith; Bodine, Sue C.; Christiansen, Blaine A.

2016-01-01

Development of osteoarthritis commonly involves degeneration of epiphyseal trabecular bone. In previous studies, we observed 30–44% loss of epiphyseal trabecular bone (BV/TV) from the distal femur within one week following non-invasive knee injury in mice. Mechanical unloading (disuse) may contribute to this bone loss, however it is unclear to what extent the injured limb is unloaded following injury, and whether disuse can fully account for the observed magnitude of bone loss. In this study,...

Feasibility study of simultaneous physical examination and dynamic MR imaging of medial collateral ligament knee injuries in a 1.5-T large-bore magnet

International Nuclear Information System (INIS)

Studler, Ueli; White, Lawrence M.; Deslandes, Melanie; Sussman, Marshall S.; Geddes, Christopher; Theodoropoulos, John

2011-01-01

To determine the feasibility of evaluating medial knee joint laxity with dynamic magnetic resonance (MR) imaging and simultaneous physical joint examination in a large-bore 1.5-T system. The study included 10 patients (5 women, 5 men; mean age 35 years) with clinically diagnosed and categorized acute injuries of the medial collateral ligament (MCL). Intermittent valgus stress was applied separately to both the affected and the contralateral knee joint during dynamic MR imaging with a two-dimensional fast low-angle shot sequence. The width of the medial joint space and the opening angle between the femoral condyles and the tibial plateau were measured. Results obtained from dynamic MR imaging of the affected knee were compared with morphological MCL changes on static MRI, to kinematics of the contralateral side and to the clinical grading of MCL injuries. On clinical examination, all patients had grade 2 MCL injuries except one, who had a grade 1 lesion. Using morphological MRI criteria, 9 grade II and 1 grade III injuries were seen. Mean medial joint space width and opening angles of all affected knees were 2.8 mm and 2.7 respectively, compared with 1.7 mm and 2.1 on the contralateral side. The Wilcoxon signed rank test indicated that the differences in width (P = 0.005) and opening angle (P = 0.037) between the affected and contralateral knees were significant. Dynamic MR imaging and simultaneous physical joint examination is feasible. Our results suggest that this technique might enable the imaging documentation of medial ligamentous knee instability. (orig.)

Lifting Safety: Tips To Help Prevent Back Injuries

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... Prevent Back Injuries Lifting Safety: Tips to Help Prevent Back Injuries Share Print Back injuries are common problems at work, home, and play. They can be caused by accidents or improper lifting technique. Below are tips to ...

Knee joint kinematics and kinetics during the hop and cut after soft tissue artifact suppression: Time to reconsider ACL injury mechanisms?

Science.gov (United States)

Smale, Kenneth B; Potvin, Brigitte M; Shourijeh, Mohammad S; Benoit, Daniel L

2017-09-06

The recent development of a soft tissue artifact (STA) suppression method allows us to re-evaluate the tibiofemoral kinematics currently linked to non-contact knee injuries. The purpose of this study was therefore to evaluate knee joint kinematics and kinetics in six degrees of freedom (DoF) during the loading phases of a jump lunge and side cut using this in silico method. Thirty-five healthy adults completed these movements and their surface marker trajectories were then scaled and processed with OpenSim's inverse kinematics (IK) and inverse dynamics tools. Knee flexion angle-dependent kinematic constraints defined based on previous bone pin (BP) marker trajectories were then applied to the OpenSim model during IK and these constrained results were then processed with the standard inverse dynamics tool. Significant differences for all hip, knee, and ankle DoF were observed after STA suppression for both the jump lunge and side cut. Using clinically relevant effect size estimates, we conclude that STA contamination had led to misclassifications in hip transverse plane angles, knee frontal and transverse plane angles, medial/lateral and distractive/compressive knee translations, and knee frontal plane moments between the NoBP and the BP IK solutions. Our results have substantial clinical implications since past research has used joint kinematics and kinetics contaminated by STA to identify risk factors for musculoskeletal injuries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Barefoot running: does it prevent injuries?

Science.gov (United States)

Murphy, Kelly; Curry, Emily J; Matzkin, Elizabeth G

2013-11-01

Endurance running has evolved over the course of millions of years and it is now one of the most popular sports today. However, the risk of stress injury in distance runners is high because of the repetitive ground impact forces exerted. These injuries are not only detrimental to the runner, but also place a burden on the medical community. Preventative measures are essential to decrease the risk of injury within the sport. Common running injuries include patellofemoral pain syndrome, tibial stress fractures, plantar fasciitis, and Achilles tendonitis. Barefoot running, as opposed to shod running (with shoes), has recently received significant attention in both the media and the market place for the potential to promote the healing process, increase performance, and decrease injury rates. However, there is controversy over the use of barefoot running to decrease the overall risk of injury secondary to individual differences in lower extremity alignment, gait patterns, and running biomechanics. While barefoot running may benefit certain types of individuals, differences in running stance and individual biomechanics may actually increase injury risk when transitioning to barefoot running. The purpose of this article is to review the currently available clinical evidence on barefoot running and its effectiveness for preventing injury in the runner. Based on a review of current literature, barefoot running is not a substantiated preventative running measure to reduce injury rates in runners. However, barefoot running utility should be assessed on an athlete-specific basis to determine whether barefoot running will be beneficial.

Effects of jump and balance training on knee kinematics and electromyography of female basketball athletes during a single limb drop landing: pre-post intervention study.

Science.gov (United States)

Nagano, Yasuharu; Ida, Hirofumi; Akai, Masami; Fukubayashi, Toru

2011-07-14

Some research studies have investigated the effects of anterior cruciate ligament (ACL) injury prevention programs on knee kinematics during landing tasks; however the results were different among the studies. Even though tibial rotation is usually observed at the time of ACL injury, the effects of training programs for knee kinematics in the horizontal plane have not yet been analyzed. The purpose of this study was to determine the effects of a jump and balance training program on knee kinematics including tibial rotation as well as on electromyography of the quadriceps and hamstrings in female athletes. Eight female basketball athletes participated in the experiment. All subjects performed a single limb landing at three different times: the initial test, five weeks later, and one week after completing training. The jump and balance training program lasted for five weeks. Knee kinematics and simultaneous electromyography of the rectus femoris and Hamstrings before training were compared with those measured after completing the training program. After training, regarding the position of the knee at foot contact, the knee flexion angle for the Post-training trial (mean (SE): 24.4 (2.1) deg) was significantly larger than that for the Pre-training trial (19.3 (2.5) deg) (p training trial (40.2 (1.9) deg) was significantly larger than that for the Pre-training trial (34.3 (2.5) deg) (p training. A significant increase was also found in the activity of the hamstrings 50 ms before foot contact (p jump and balance training program successfully increased knee flexion and hamstring activity of female athletes during landing, and has the possibility of producing partial effects to avoid the characteristic knee position observed in ACL injury, thereby preventing injury. However, the expected changes in frontal and transverse kinematics of the knee were not observed.

Prevention of farm injuries in Denmark

DEFF Research Database (Denmark)

Rasmussen, Kurt; Carstensen, Ole; Lauritsen, Jens

2003-01-01

This study examined the effects of a 4-year randomized intervention program that combined a safety audit with safety behavior training in the prevention of farm injuries.......This study examined the effects of a 4-year randomized intervention program that combined a safety audit with safety behavior training in the prevention of farm injuries....

Quasi-stiffness of the knee joint in flexion and extension during the golf swing.

Science.gov (United States)

Choi, Ahnryul; Sim, Taeyong; Mun, Joung Hwan

2015-01-01

Biomechanical understanding of the knee joint during a golf swing is essential to improve performance and prevent injury. In this study, we quantified the flexion/extension angle and moment as the primary knee movement, and evaluated quasi-stiffness represented by moment-angle coupling in the knee joint. Eighteen skilled and 23 unskilled golfers participated in this study. Six infrared cameras and two force platforms were used to record a swing motion. The anatomical angle and moment were calculated from kinematic and kinetic models, and quasi-stiffness of the knee joint was determined as an instantaneous slope of moment-angle curves. The lead knee of the skilled group had decreased resistance duration compared with the unskilled group (P golf swing and developing rehabilitation strategies following surgery.

The pediatric knee.

Science.gov (United States)

Orth, Robert C

2013-03-01

Knee pain is a common problem in children and adolescents, and MRI of the knee is the most commonly performed pediatric cross-sectional musculoskeletal imaging exam. The purpose of this pictorial review is to highlight differences between adult and pediatric knee imaging with an emphasis on normal developmental variants, injury and disease patterns unique to children and adolescents, and differences in response and presentation to conditions affecting both adults and children.

Incidence of Patients With Knee Strain and Sprain Occurring at Sports or Recreation Venues and Presenting to United States Emergency Departments.

Science.gov (United States)

Gray, Aaron M; Buford, William L

2015-11-01

Knee injuries account for a substantial percentage of all athletic injuries. The relative rates of knee injury for a variety of sports by sex and age need to be understood so we can better allocate resources, such as athletic trainers, to properly assess and treat injuries and reduce injury risk. To describe the epidemiology of patients with sport-related knee strain and sprain presenting to US emergency departments from 2002 to 2011. Cross-sectional study. Using the Consumer Products Safety Commission's National Electronic Injury Surveillance System and the US Census Bureau, we extracted raw data to estimate national rates of patients with knee strain and sprain presenting to emergency departments. Participants were individuals sustaining a knee strain or sprain at sports or recreation venues and presenting to local emergency departments for treatment. We included 12 popular sports for males and 11 for females. Ages were categorized in six 5-year increments for ages 5 to 34 years and one 10-year increment for ages 35 to 44 years. Incidence rates were calculated using weights provided by the National Electronic Injury Surveillance System and reported with their 95% confidence intervals for sport, sex, and age. Strain and sprain injury rates varied greatly by sport, sex, and age group. The highest injury rates occurred in football and basketball for males and in soccer and basketball for females. The most at-risk population was 15 to 19 years for both sexes. Athletes experience different rates of knee strain and sprain according to sport, sex, and age. Increased employment of athletic trainers to care for the highest-risk populations, aged 10 to 19 years, is recommended to reduce emergency department use and implement injury-prevention practices.

Evaluation and management of knee pain in young athletes: overuse injuries of the knee

OpenAIRE

Patel, Dilip R.; Villalobos, Ana

2017-01-01

Recurrent or chronic activity related knee pain is common in young athletes. Numerous intrinsic conditions affecting the knee can cause such pain. In addition, knee pain can be referred pain from low back, hip or pelvic pathology. The most common cause of knee pain in young athletes is patellofemoral pain syndrome, or more appropriately termed idiopathic anterior knee pain. Although, numerous anatomical and biomechanical factors have been postulated to contribute the knee pain in young athlet...

MRI of the posterolateral corner of the knee, please have a look ...

African Journals Online (AJOL)

The knee PLC injuries are frequently seen, with other major knee injuries, such as ACL and PCL. Objective: This article aimed to clarify PLC injuries that could be diagnosed by MRI, and may have an impact on the management of the associated major knee injuries. Patient and methods: It was conducted through ...

The relationship between leg preference and knee mechanics during sidestepping in collegiate female footballers.

Science.gov (United States)

Brown, Scott R; Wang, Henry; Dickin, D Clark; Weiss, Kaitlyn J

2014-11-01

This study examined the relationship between leg preference and knee mechanics in females during sidestepping. Three-dimensional data were recorded on 16 female collegiate footballers during a planned 45° sidestep manoeuvre with their preferred and non-preferred kicking leg. Knee kinematics and kinetics during initial contact, weight acceptance, peak push-off, and final push-off phases of sidestepping were analysed in both legs. The preferred leg showed trivial to small increases (ES = 0.19-0.36) in knee flexion angle at initial contact, weight acceptance, and peak push-off, and small increases (ES = 0.21-0.34) in peak power production and peak knee extension velocity. The non-preferred leg showed a trivial increase (ES = 0.10) in knee abduction angle during weight acceptance; small to moderate increases (ES = 0.22-0.64) in knee internal rotation angle at weight acceptance, peak push-off, and final push-off; a small increase (ES = 0.22) in knee abductor moment; and trivial increases (ES = 0.09-0.14) in peak power absorption and peak knee flexion velocity. The results of this study show that differences do exist between the preferred and non-preferred leg in females. The findings of this study will increase the knowledge base of anterior cruciate ligament injury in females and can aid in the design of more appropriate neuromuscular, plyometric, and strength training protocols for injury prevention.

Impact of Foot Type on Cost of Lower Extremity Injury

Science.gov (United States)

2013-01-25

were at higher risk for injury. Additionally, researchers have found relationships between chronic heel pain and osteoarthritis of the knee and hip...Cost of Injury, in Physical Training and Sports Injury Prevention Guidelines . 2010, U.S. Army Public Health Command (Provisional). 11. Injury...study. BMC Musculoskelet Disord, 2007. 8: p. 41. 48. Reilly, K., et al., The role of foot and ankle assessment of patients with lower limb osteoarthritis

The floating knee: epidemiology, prognostic indicators & outcome following surgical management.

Science.gov (United States)

Rethnam, Ulfin; Yesupalan, Rajam S; Nair, Rajagopalan

2007-11-26

Floating Knee injuries are complex injuries. The type of fractures, soft tissue and associated injuries make this a challenging problem to manage. We present the outcome of these injuries after surgical management. 29 patients with floating knee injuries were managed over a 3 year period. This was a prospective study were both fractures of the floating knee injury were surgically fixed using different modalities. The associated injuries were managed appropriately. Assessment of the end result was done by the Karlstrom criteria after bony union. The mechanism of injury was road traffic accident in 27/29 patients. There were 38 associated injuries. 20/29 patients had intramedullary nailing for both fractures. The complications were knee stiffness, foot drop, delayed union of tibia and superficial infection. The bony union time ranged from 15 - 22.5 weeks for femur fractures and 17 - 28 weeks for the tibia. According to the Karlstrom criteria the end results were Excellent - 15, Good - 11, Acceptable - 1 and Poor - 3. The associated injuries and the type of fracture (open, intra-articular, comminution) are prognostic indicators in the Floating knee. Appropriate management of the associated injuries, intramedullary nailing of both the fractures and post operative rehabilitation are necessary for good final outcome.

Common Running Overuse Injuries and Prevention

Directory of Open Access Journals (Sweden)

Žiga Kozinc

2017-09-01

Full Text Available Runners are particularly prone to developing overuse injuries. The most common running-related injuries include medial tibial stress syndrome, Achilles tendinopathy, plantar fasciitis, patellar tendinopathy, iliotibial band syndrome, tibial stress fractures, and patellofemoral pain syndrome. Two of the most significant risk factors appear to be injury history and weekly distance. Several trials have successfully identified biomechanical risk factors for specific injuries, with increased ground reaction forces, excessive foot pronation, hip internal rotation and hip adduction during stance phase being mentioned most often. However, evidence on interventions for lowering injury risk is limited, especially regarding exercise-based interventions. Biofeedback training for lowering ground reaction forces is one of the few methods proven to be effective. It seems that the best way to approach running injury prevention is through individualized treatment. Each athlete should be assessed separately and scanned for risk factors, which should be then addressed with specific exercises. This review provides an overview of most common running-related injuries, with a particular focus on risk factors, and emphasizes the problems encountered in preventing running-related injuries.

Knee extensor strength and body weight in adolescent men and the risk of knee osteoarthritis by middle age.

Science.gov (United States)

Turkiewicz, Aleksandra; Timpka, Simon; Thorlund, Jonas Bloch; Ageberg, Eva; Englund, Martin

2017-10-01

To assess the extent to which knee extensor strength and weight in adolescence are associated with knee osteoarthritis (OA) by middle age. We studied a cohort of 40 121 men who at age 18 years in 1969/1970 underwent mandatory conscription in Sweden. We retrieved data on isometric knee extensor strength, weight, height, smoking, alcohol consumption, parental education and adult occupation from Swedish registries. We identified participants diagnosed with knee OA or knee injury from 1987 to 2010 through the National Patient Register. We estimated the HR of knee OA using multivariable-adjusted Cox proportional regression model. To assess the influence of adult knee injury and occupation, we performed a formal mediation analysis. The mean (SD) knee extensor strength was 234 (47) Nm, the mean (SD) weight was 66 (9.3) kg. During 24 years (median) of follow-up starting at the age of 35 years, 2049 persons were diagnosed with knee OA. The adjusted HR (95% CI) of incident knee OA was 1.12 (1.06 to 1.18) for each SD of knee extensor strength and 1.18 (1.15 to 1.21) per 5 kg of body weight. Fifteen per cent of the increase in OA risk due to higher knee extensor strength could be attributed to knee injury and adult occupation. Higher knee extensor strength in adolescent men was associated with increased risk of knee OA by middle age, challenging the current tenet of low muscle strength being a risk factor for OA. We confirmed higher weight to be a strong risk factor for knee OA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effects of changing speed on knee and ankle joint load during walking and running.

Science.gov (United States)

de David, Ana Cristina; Carpes, Felipe Pivetta; Stefanyshyn, Darren

2015-01-01

Joint moments can be used as an indicator of joint loading and have potential application for sports performance and injury prevention. The effects of changing walking and running speeds on joint moments for the different planes of motion still are debatable. Here, we compared knee and ankle moments during walking and running at different speeds. Data were collected from 11 recreational male runners to determine knee and ankle joint moments during different conditions. Conditions include walking at a comfortable speed (self-selected pacing), fast walking (fastest speed possible), slow running (speed corresponding to 30% slower than running) and running (at 4 m · s(-1) ± 10%). A different joint moment pattern was observed between walking and running. We observed a general increase in joint load for sagittal and frontal planes as speed increased, while the effects of speed were not clear in the transverse plane moments. Although differences tend to be more pronounced when gait changed from walking to running, the peak moments, in general, increased when speed increased from comfortable walking to fast walking and from slow running to running mainly in the sagittal and frontal planes. Knee flexion moment was higher in walking than in running due to larger knee extension. Results suggest caution when recommending walking over running in an attempt to reduce knee joint loading. The different effects of speed increments during walking and running should be considered with regard to the prevention of injuries and for rehabilitation purposes.

New Generation Lockable Knee Brace

Science.gov (United States)

2000-01-01

A knee brace that uses Space Shuttle propulsion technology has moved a step closer to being available to help knee injury and stroke patients and may possibly benefit patients with birth defects, spinal cord injuries, and post-polio conditions. After years of hard work, inventors at NASA's Marshall Space Flight Center (MSFC) in Huntsville, Alabama, have turned over the final design and prototype to industry partners at Horton's Orthotic Lab in Little Rock, Arkansas for further clinical testing. The device, called the Selectively Lockable Knee Brace, may mean faster, less painful rehabilitation for patients by allowing the knee to move when weight is not on the heel. Devices currently on the market lock the knee in a rigid, straight-leg position, or allow continuous free motion. The knee brace is just one example of how space technology is being used to improve the lives of people on Earth. NASA's MSFC inventors Michael Shadoan and Neill Myers are space propulsion engineers who use the same mechanisms and materials to build systems for rockets that they used to design and develop the knee brace.

Preoperative prediction of potentially preventable morbidity after fast-track hip and knee arthroplasty

DEFF Research Database (Denmark)

Jørgensen, Christoffer C; Petersen, Morten Aa; Kehlet, Henrik

2016-01-01

. DESIGN: Prospective observational study. SETTING: Elective primary unilateral total hip and knee arthroplasty with prospectively collected preoperative patient characteristics; similar standardised fast-track protocols; evaluation of complications through discharge and medical records; and complete 90...... days follow-up through nationwide databases. PARTICIPANTS: 8373 consecutive unselected total hip arthroplasty (THA) and knee arthroplasty from January 2010 to November 2012. RESULTS: There were 557 procedures (6.4%) followed by potentially preventable complications resulting in hospitalisation >4 days...

Preventing occupational injury among police officers: does motivation matter?

Science.gov (United States)

Chan, D K C; Webb, D; Ryan, R M; Tang, T C W; Yang, S X; Ntoumanis, N; Hagger, M S

2017-08-01

Injury prevention is an important issue for police officers, but the effectiveness of prevention initiatives is dependent on officers' motivation toward, and adherence to, recommended health and safety guidelines. To understand effects of police officers' motivation to prevent occupational injury on beliefs about safety and adherence to injury prevention behaviours. Full-time police officers completed a survey comprising validated psychometric scales to assess autonomous, controlled and amotivated forms of motivation (Treatment Self-Regulation Questionnaire), behavioural adherence (Self-reported Treatment Adherence Scale) and beliefs (Safety Attitude Questionnaire) with respect to injury prevention behaviours. There were 207 participants; response rate was 87%. Hierarchical multiple regression analyses demonstrated that autonomous motivation was positively related to behavioural adherence, commitment to safety and prioritizing injury prevention. Controlled motivation was a positive predictor of safety communication barriers. Amotivation was positively associated with fatalism regarding injury prevention, safety violation and worry. These findings are consistent with the tenets of self-determination theory in that autonomous motivation was a positive predictor of adaptive safety beliefs and adherence to injury prevention behaviours. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Active muscle response contributes to increased injury risk of lower extremity in occupant-knee airbag interaction.

Science.gov (United States)

Nie, Bingbing; Sathyanarayan, Deepak; Ye, Xin; Crandall, Jeff R; Panzer, Matthew B

2018-02-28

Recent field data analysis has demonstrated that knee airbags (KABs) can reduce occupant femur and pelvis injuries but may be insufficient to decrease leg injuries in motor vehicle crashes. An enhanced understanding of the associated injury mechanisms requires accurate assessment of physiological-based occupant parameters, some of which are difficult or impossible to obtain from experiments. This study sought to explore how active muscle response can influence the injury risk of lower extremities during KAB deployment using computational biomechanical analysis. A full-factorial matrix, consisting of 48 finite element simulations of a 50th percentile occupant human model in a simplified vehicle interior, was designed. The matrix included 32 new cases in combination with 16 previously reported cases. The following influencing factors were taken into account: muscle activation, KAB use, KAB design, pre-impact seating position, and crash mode. Responses of 32 lower extremity muscles during emergency braking were replicated using one-dimensional elements of a Hill-type constitutive model, with the activation level determined from inverse dynamics and validated by existing volunteer tests. Dynamics of unfolding and inflating of the KABs were represented using the state-of-the-art corpuscular particle method. Abbreviated Injury Scale (AIS) 2+ injury risks of the knee-thigh-hip (KTH) complex and the tibia were assessed using axial force and resultant bending moments. With all simulation cases being taken together, a general linear model was used to assess factor significance (P systems. Future efforts are recommended on realistic vehicle and restraint environment and advanced modeling strategies toward a full understanding of KAB efficacy.

Prevention of Injury and Violence in the USA

Science.gov (United States)

Haegerich, Tamara M; Dahlberg, Linda L; Simon, Thomas R; Baldwin, Grant T; Sleet, David A; Greenspan, Arlene I

2015-01-01

In the first three decades of life, more individuals in the USA die from injuries and violence than from any other cause. Millions more people survive and are left with physical, emotional, and financial problems. Injuries and violence are not accidents; they are preventable. Prevention has a strong scientific foundation, yet efforts are not fully implemented or integrated into clinical and community settings. In this Series paper, we review the burden of injuries and violence in the USA, note effective interventions, and discuss methods to bring interventions into practice. Alliances between the public health community and medical care organisations, health-care providers, states, and communities can reduce injuries and violence. We encourage partnerships between medical and public health communities to consistently frame injuries and violence as preventable, identify evidence-based interventions, provide scientific information to decision makers, and strengthen the capacity of an integrated health system to prevent injuries and violence. PMID:24996591

Prevention of injury and violence in the USA.

Science.gov (United States)

Haegerich, Tamara M; Dahlberg, Linda L; Simon, Thomas R; Baldwin, Grant T; Sleet, David A; Greenspan, Arlene I; Degutis, Linda C

2014-07-05

In the first three decades of life, more individuals in the USA die from injuries and violence than from any other cause. Millions more people survive and are left with physical, emotional, and financial problems. Injuries and violence are not accidents; they are preventable. Prevention has a strong scientific foundation, yet efforts are not fully implemented or integrated into clinical and community settings. In this Series paper, we review the burden of injuries and violence in the USA, note effective interventions, and discuss methods to bring interventions into practice. Alliances between the public health community and medical care organisations, health-care providers, states, and communities can reduce injuries and violence. We encourage partnerships between medical and public health communities to consistently frame injuries and violence as preventable, identify evidence-based interventions, provide scientific information to decision makers, and strengthen the capacity of an integrated health system to prevent injuries and violence. Copyright © 2014 Elsevier Ltd. All rights reserved.

Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes.

Science.gov (United States)

Gilbert, Frances C; Burdette, G Trey; Joyner, A Barry; Llewellyn, Tracy A; Buckley, Thomas A

Concussions have been associated with elevated musculoskeletal injury risk; however, the influence of unreported and unrecognized concussions has not been investigated. The purpose of this study was to examine the association between concussion and lower extremity musculoskeletal injury rates across a diverse array of sports among collegiate student-athletes at the conclusion of their athletic career. The hypothesis was that there will be a positive association between athletes who reported a history of concussions and higher rates of lower extremity injuries. Cross-sectional study. Level 3. Student-athletes (N = 335; 62.1% women; mean age, 21.2 ± 1.4 years) from 13 sports completed a reliable injury history questionnaire. Respondents indicated the total number of reported, unreported, and potentially unrecognized concussions as well as lower extremity injuries including ankle sprains, knee injuries, and muscle strains. Chi-square analyses were performed to identify the association between concussion and lower extremity injuries. There were significant associations between concussion and lateral ankle sprain ( P = 0.012), knee injury ( P = 0.002), and lower extremity muscle strain ( P = 0.031). There were also significant associations between reported concussions and knee injury ( P = 0.003), unreported concussions and knee injury ( P = 0.002), and unrecognized concussions and lateral ankle sprain ( P = 0.001) and lower extremity muscle strains ( P = 0.006), with odds ratios ranging from 1.6 to 2.9. There was a positive association between concussion history and lower extremity injuries (odds ratios, 1.6-2.9 elevated risk) among student-athletes at the conclusion of their intercollegiate athletic careers. Clinicians should be aware of these elevated risks when making return-to-participation decisions and should incorporate injury prevention protocols.

Frequency and cost of claims by injury type from a state workers' compensation fund from 1998 through 2008.

Science.gov (United States)

Mroz, Tracy M; Carlini, Anthony R; Archer, Kristin R; Wegener, Stephen T; Hoolachan, Jordan I; Stiers, William; Shore, Rebecca A; Castillo, Renan C

2014-06-01

To determine which work-related injuries are the most frequent and costly. Secondary analysis of workers' compensation claims data. Data were provided by a large, Maryland workers' compensation insurer from 1998 through 2008. Not applicable. None. For 45 injury types, the number of claims and compensation amount was calculated for total compensation and for medical and indemnity compensation separately. Back and knee injuries were the most frequently occurring single injury types, whereas heart attack and occupational disease were the most expensive in terms of mean compensation. When taking into account both the frequency and cost of injury (mean cost × number occurrences), back, knee, and shoulder injuries were the most expensive single injury types. Successful prevention and management of back, knee, and shoulder injuries could lead to a substantial reduction in the burden associated with work-related injuries. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A one year prospective study on ankle stability and landing technique : The occurrence of ankle and knee injuries in elite ball team athletes

NARCIS (Netherlands)

Msc Henrike van der Does; M.S. Brink; Koen A.P.M. Lemmink

2014-01-01

Background: In team sports lower extremity injuries account for more than 50% of all injuries, indicating the importance of early detection of athletes at risk. Objective: To investigate the predictive value of ankle stability and landing technique at baseline for ankle and knee injury occurrence

Development of the Knee Injury and Osteoarthritis Outcome Score for Children (KOOS-Child) Comprehensibility and content validity

DEFF Research Database (Denmark)

Ortqvist, M.; Roos, E. M.; Brostrom, E. W.

2012-01-01

researcher conducted cognitive interviews with 34 Swedish children who had symptomatic knee injuries (either primary or repeated). They were 10-16 years of age, and were selected to allow for equal group representation of age and sex. All the interviews were recorded. 4 researchers analyzed the data...... of separate subscale scores as a profile. However, its applicability in children has not been established. In this study, we examined how well the KOOS could be understood in a cohort of children with knee injury, with a view to preparing a pediatric version (KOOS-Child). Material and methods A trained...... and modified the original KOOS questionnaire. Results Many children (n = 14) had difficulty in tracking items based on the time frame and an equivalent number of children had trouble in understanding several terms. Mapping errors resulted from misinterpretation of items and from design issues related...

Preventing dance injuries: current perspectives

Directory of Open Access Journals (Sweden)

Russell JA

2013-09-01

Full Text Available Jeffrey A Russell Division of Athletic Training, School of Applied Health Sciences and Wellness, Ohio University, Athens, OH, USA Abstract: Dancers are clearly athletes in the degree to which sophisticated physical capacities are required to perform at a high level. The standard complement of athletic attributes – muscular strength and endurance, anaerobic and aerobic energy utilization, speed, agility, coordination, motor control, and psychological readiness – all are essential to dance performance. In dance, as in any athletic activity, injuries are prevalent. This paper presents the research background of dance injuries, characteristics that distinguish dance and dancers from traditional sports and athletes, and research-based perspectives into how dance injuries can be reduced or prevented, including the factors of physical training, nutrition and rest, flooring, dancing en pointe, and specialized health care access for dancers. The review concludes by offering five essential components for those involved with caring for dancers that, when properly applied, will assist them in decreasing the likelihood of dance-related injury and ensuring that dancers receive optimum attention from the health care profession: (1 screening; (2 physical training; (3 nutrition and rest; (4 specialized dance health care; and (5 becoming acquainted with the nature of dance and dancers. Keywords: dance, injuries, injury prevention, fitness, wellness, health

ECSS Position Statement 2009: Prevention of acute sports injuries

NARCIS (Netherlands)

Steffen, K.; Andersen, T.E.; Krosshaug, T.; van Mechelen, W.; Myklebust, G.; Verhagen, E.A.L.M.; Bahr, R.

2010-01-01

To maximize the health benefits of sports and exercise and to minimize the direct and indirect costs associated with injuries, developing and adopting injury prevention strategies is an important goal. The aim of this ECSS consensus paper on injury prevention is to review current evidence on injury

Preventing running injuries. Practical approach for family doctors.

OpenAIRE

Johnston, C. A. M.; Taunton, J. E.; Lloyd-Smith, D. R.; McKenzie, D. C.

2003-01-01

OBJECTIVE: To present a practical approach for preventing running injuries. QUALITY OF EVIDENCE: Much of the research on running injuries is in the form of expert opinion and comparison trials. Recent systematic reviews have summarized research in orthotics, stretching before running, and interventions to prevent soft tissue injuries. MAIN MESSAGE: The most common factors implicated in running injuries are errors in training methods, inappropriate training surfaces and running shoes, malalign...

Injury Prevention Research

Centers for Disease Control (CDC) Podcasts

2009-09-01

Research provides the knowledge that we need to understand what is possible, what is not, and the best way to proceed in our intervention efforts.  Created: 9/1/2009 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 9/1/2009.

The Effectiveness of Injury Prevention Programs to Modify Risk Factors for Non-Contact Anterior Cruciate Ligament and Hamstring Injuries in Uninjured Team Sports Athletes: A Systematic Review.

Directory of Open Access Journals (Sweden)

Alireza Monajati

Full Text Available Hamstring strain and anterior cruciate ligament injuries are, respectively, the most prevalent and serious non-contact occurring injuries in team sports. Specific biomechanical and neuromuscular variables have been used to estimate the risk of incurring a non-contact injury in athletes.The aim of this study was to systematically review the evidences for the effectiveness of injury prevention protocols to modify biomechanical and neuromuscular anterior cruciate and/or hamstring injuries associated risk factors in uninjured team sport athletes.PubMed, Science Direct, Web of Science, Cochrane Libraries, U.S. National Institutes of Health clinicaltrials.gov, Sport Discuss and Google Scholar databases were searched for relevant journal articles published until March 2015. A manual review of relevant articles, authors, and journals, including bibliographies was performed from identified articles.Nineteen studies were included in this review. Four assessment categories: i landing, ii side cutting, iii stop-jump, and iv muscle strength outcomes, were used to analyze the effectiveness of the preventive protocols. Eight studies using multifaceted interventions supported by video and/or technical feedback showed improvement in landing and/or stop-jump biomechanics, while no effects were observed on side-cutting maneuver. Additionally, multifaceted programs including hamstring eccentric exercises increased hamstring strength, hamstring to quadriceps functional ratio and/or promoted a shift of optimal knee flexion peak torque toward a more open angle position.Multifaceted programs, supported by proper video and/or technical feedback, including eccentric hamstring exercises would positively modify the biomechanical and or neuromuscular anterior cruciate and/or hamstring injury risk factors.

The Effectiveness of Injury Prevention Programs to Modify Risk Factors for Non-Contact Anterior Cruciate Ligament and Hamstring Injuries in Uninjured Team Sports Athletes: A Systematic Review.

Science.gov (United States)

Monajati, Alireza; Larumbe-Zabala, Eneko; Goss-Sampson, Mark; Naclerio, Fernando

2016-01-01

Hamstring strain and anterior cruciate ligament injuries are, respectively, the most prevalent and serious non-contact occurring injuries in team sports. Specific biomechanical and neuromuscular variables have been used to estimate the risk of incurring a non-contact injury in athletes. The aim of this study was to systematically review the evidences for the effectiveness of injury prevention protocols to modify biomechanical and neuromuscular anterior cruciate and/or hamstring injuries associated risk factors in uninjured team sport athletes. PubMed, Science Direct, Web of Science, Cochrane Libraries, U.S. National Institutes of Health clinicaltrials.gov, Sport Discuss and Google Scholar databases were searched for relevant journal articles published until March 2015. A manual review of relevant articles, authors, and journals, including bibliographies was performed from identified articles. Nineteen studies were included in this review. Four assessment categories: i) landing, ii) side cutting, iii) stop-jump, and iv) muscle strength outcomes, were used to analyze the effectiveness of the preventive protocols. Eight studies using multifaceted interventions supported by video and/or technical feedback showed improvement in landing and/or stop-jump biomechanics, while no effects were observed on side-cutting maneuver. Additionally, multifaceted programs including hamstring eccentric exercises increased hamstring strength, hamstring to quadriceps functional ratio and/or promoted a shift of optimal knee flexion peak torque toward a more open angle position. Multifaceted programs, supported by proper video and/or technical feedback, including eccentric hamstring exercises would positively modify the biomechanical and or neuromuscular anterior cruciate and/or hamstring injury risk factors.

Ipsilateral Floating Hip and Floating Knee – A Rare Entity

Directory of Open Access Journals (Sweden)

Yashavantha Kumar

2013-04-01

Full Text Available Introduction: Ipsilateral floating hip and floating knee are very rare injuries. These injuries so uncommon that only three cases of similar kind have been reported. These injuries are due to high velocity injuries following motor vehicle accidents. Management of such complex injuries is a challenging task even in experienced hands as there are no standard treatment guidelines for such fractures. Case Report: We hereby report a 20 yr old male who sustained ipsilateral floating hip and ipsilateral floating knee injuries following motor vehicle accident. Patient was stabilized initially and later taken up for surgery. Patient was treated with interlocking nail for femur and tibia in the same sitting whereas acetabulam fracture was managed conservatively. At five months all the fractures united well with restoration of good range of motion in both hip and knee. Conclusion: Ipsilateral floating knee and floating hip are very rare injuries seen following high velocity motor vehicle accidents. There are no standard guidelines for treatment of those fractures as only a few cases of similar kind have been reported in literature. Early fixation and aggressive mobilization ensures fracture union and fewer complications. Keywords: Floating hip, Floating Knee, Ipsilateral.

Domain 2: Sport Safety and Injury Prevention

Science.gov (United States)

Gurchiek, Larry; Mokha, Monique Butcher

2004-01-01

Most coaches recognize the importance of creating a safe environment and preventing injuries of their athletes. Domain 2 is dedicated to this important aspect of coaching, and outlines specific areas within safety and injury prevention that coaches should address. Domain 2 sets the standards for facility, equipment, and environmental safety…

Injuries in recreational curling include head injuries and may be prevented by using proper footwear.

Science.gov (United States)

Ting, D K; Brison, R J

2015-04-01

Our study examines a recreational curling population to describe patterns of injury occurrence, estimate risk of injury and to gauge attitudes towards equipment-based prevention strategies. In a retrospective case series, we queried the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), a national injury surveillance database, for curling injuries entered between 1993 and 2011. Kingston General Hospital and Hotel Dieu Hospital provide the two Kingston, Ontario, sites for emergency department (ED) care and participate in CHIRPP. Each retrieved entry underwent a chart review. A secondary survey was mailed to select individuals who had experienced curling injuries to solicit details on their injury and attitudes towards equipment to prevent injury. We used descriptive statistics for rates and proportions. Over 90% of acute curling injuries resulted from a fall, and 31.7% were head impacts. We found that acute injuries requiring ED presentation occur at a rate of approximately 0.17 per 1000 athlete-exposures (95% CI: 0.12-0.22). The secondary survey was completed by 54% of potential respondents. Of survey respondents, 41.3% attributed their fall to a lack of proper footwear and 73.5% of respondents agreed with mandatory sport-specific footwear as a prevention strategy, but only 8% agreed with mandatory helmet wear. Although curling injuries requiring medical care are not common, head injuries make up a large proportion. Mandated use of appropriate footwear appears to be the most effective prevention strategy, as well as the measure deemed most acceptable by players.

Retrospective Evaluation Of MRI Findings Of Knee Joint In 255 Patients

Directory of Open Access Journals (Sweden)

Ahmet Mete

2003-03-01

Full Text Available Retrospective evaluation of knee MRI obtained from 255 cases and to demonstrate most common knee joint pathologies in our region.In our study knee joints of 255 cases who admitted to different clinics of our hospital with various complains of knee between October 1996 and December 1998 were examined in wide spectrum with MRI. Via 1.0 Tesla MRI device and special knee coil in sagittal, coronal and axial plains MRI images were obtained. The number of male and female patients were 173 and 82 and their ages were ranged between 14 and 70, and the mean age was 3413.The most common knee pathologies were intra-articular fluid (%58.04, medial (%46,66 and lateral (%12.55 meniscal injuries, anterior cruciate ligament injury (%17.25 and osteoarthritis (%14.9. The other important lesions were degeneration of medial and lateral meniscus, Baker’s cyst, bursitis, posterior cruciate ligament injury , medial and lateral collateral ligament injuries, synovial hypertrophy, chondromalasia of patella, and contusion.In our images of knee the most common lesions were injuries of meniscus and ligament. Because of being noninvasive technique for knee joint pathologies, capacity of multiplanar imaging, high contrast resolution and chance of detailed anatomic evaluation MR imaging was found to be most appropriate imaging technique for knee joint pathologies.

Preventive Biomechanics: A Paradigm Shift With a Translational Approach to Injury Prevention.

Science.gov (United States)

Hewett, Timothy E; Bates, Nathaniel A

2017-09-01

Preventive medicine techniques have alleviated billions of dollars' worth of the economic burden in the medical care system through the implementation of vaccinations and screenings before the onset of disease symptoms. Knowledge of biomechanical tendencies has progressed rapidly over the past 20 years such that clinicians can identify, in healthy athletes, the underlying mechanisms that lead to catastrophic injuries such as anterior cruciate ligament (ACL) ruptures. As such, preventive medicine concepts can be applied to noncontact musculoskeletal injuries to reduce the economic burden of sports medicine treatments and enhance the long-term health of athletes. To illustrate the practical medical benefits that could be gained from preventive biomechanics applied to the ACL as well as the need and feasibility for the broad implementation of these principles. Literature review. The recent literature pertinent to the screening and prevention of musculoskeletal injuries was reviewed and compiled into a clinical commentary on the current state and applicability of preventive biomechanics. Investigators have identified neuromuscular training protocols that screen for and correct the underlying biomechanical deficits that lead to ACL injuries. The literature shows that when athletes comply with these prescribed training protocols, the incidence of injuries is significantly reduced within that population. Such preventive biomechanics practices employ basic training methods that would be familiar to athletic coaches and have the potential to save billions of dollars in cost in sports medicine. The widespread implementation of preventive biomechanics concepts could profoundly affect the field of sports medicine with a minimum of initial investment.

Force Sense of the Knee Not Affected by Fatiguing the Knee Extensors and Flexors

NARCIS (Netherlands)

Allison, Katelyn F.; Sell, Timothy C.; Benjaminse, Anne; Lephart, Scott M.

Context: Knee injuries commonly occur in later stages of competition, indicating that fatigue may influence dynamic knee stability. Force sense (FS) is a submodality of proprioception influenced by muscle mechanoreceptors, which, if negatively affected by fatigue, may result in less-effective

MRI of the posterolateral corner of the knee, please have a look

Directory of Open Access Journals (Sweden)

Mahmoud Agha

2017-08-01

Full Text Available The knee PLC injuries are frequently seen, with other major knee injuries, such as ACL and PCL. Objective: This article aimed to clarify PLC injuries that could be diagnosed by MRI, and may have an impact on the management of the associated major knee injuries. Patient and methods: It was conducted through retrospective MRI revision of 1000 patients who were presented with post-traumatic knee complaints, from January 2011 to March 2016. Results: ITB band injuries were seen in 113 patients (11.3%, biceps tendon injury in 59 patients (5.9%, FCL injuries in 223 patients (22.3%, popliteus muscle injury in 53 patients (5.3%, PFL in 17 (1.7%, arcuate ligament injury in 38 patients (3.8% and arcuate bone fracture (fibular styloid fracture in 22 patients (2.2%. Overall PLC injuries recorded 283 patients, either as separate or combined PLC items. Of these 283 patients, 96 patients had associated ACL tear (33.9%, 19 had PCL tear (6.7%, 73 had medial corner injury (25.7%, 55 combined injuries (19.4% and 40 isolated PLC injuries (14.1%. Conclusion: Different types of PLC injuries may occur in association with other major knee sectorial injuries that may require repair before the associated injured major sector correction, in an attempt to avoid early ACL or PCL graft failure.

The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized controlled trial

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Pollard Henry

2010-04-01

Full Text Available Abstract Background Hamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football. Methods Sixty male subjects were assessed for eligibility with 59 meeting entry requirements and randomly allocated to an intervention (n = 29 or control group (n = 30, being matched for age and hamstring injury history. Twenty-eight intervention and 29 control group participants completed the trial. Both groups received the current best practice medical and sports science management, which acted as the control. Additionally, the intervention group received a sports chiropractic intervention. Treatment for the intervention group was individually determined and could involve manipulation/mobilization and/or soft tissue therapies to the spine and extremity. Minimum scheduling was: 1 treatment per week for 6 weeks, 1 treatment per fortnight for 3 months, 1 treatment per month for the remainder of the season (3 months. The main outcome measure was an injury surveillance with a missed match injury definition. Results After 24 matches there was no statistical significant difference between the groups for the incidence of hamstring injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051 and primary non-contact knee injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051. The difference for primary lower-limb muscle strains was significant (OR:0.097, 95%CI:0.011-0.839, p = 0.025. There was no significant difference for weeks missed due to hamstring injury (4 v14, χ2:1.12, p = 0.29 and lower-limb muscle strains (4 v 21, χ2:2.66, p = 0.10. A significant difference in weeks missed due to non-contact knee injury was noted (1 v 24, χ2:6.70, p = 0.01. Conclusions This study

Injuries in recreational curling include head injuries and may be prevented by using proper footwear

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D. K. Ting

2015-04-01

Full Text Available Introduction: Our study examines a recreational curling population to describe patterns of injury occurrence, estimate risk of injury and to gauge attitudes towards equipment-based prevention strategies. Methods: In a retrospective case series, we queried the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP, a national injury surveillance database, for curling injuries entered between 1993 and 2011. Kingston General Hospital and Hotel Dieu Hospital provide the two Kingston, Ontario, sites for emergency department (ED care and participate in CHIRPP. Each retrieved entry underwent a chart review. A secondary survey was mailed to select individuals who had experienced curling injuries to solicit details on their injury and attitudes towards equipment to prevent injury. We used descriptive statistics for rates and proportions. Results: Over 90% of acute curling injuries resulted from a fall, and 31.7% were head impacts. We found that acute injuries requiring ED presentation occur at a rate of approximately 0.17 per 1000 athlete-exposures (95% CI: 0.12–0.22. The secondary survey was completed by 54% of potential respondents. Of survey respondents, 41.3% attributed their fall to a lack of proper footwear and 73.5% of respondents agreed with mandatory sport-specific footwear as a prevention strategy, but only 8% agreed with mandatory helmet wear. Conclusions: Although curling injuries requiring medical care are not common, head injuries make up a large proportion. Mandated use of appropriate footwear appears to be the most effective prevention strategy, as well as the measure deemed most acceptable by players.

Popliteal artery injury following traumatic knee joint dislocation in a 14-year-old boy: A case report and review of the literature

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Cvetković Slobodan

2014-01-01

Full Text Available Introduction. Posterior knee joint dislocation associated with injury of the popliteal artery in children is an extremely rare condition. Rapid diagnosis and treatment are essential for limb salvage and function. Case report. We reported a 14-year-old boy who suffered traumatic displacement of the right knee and contusion of the popliteal artery during motorcycle accident. The diagnosis was confirmed using Doppler and duplex ultrasonography and digital substraction transfemoral arteriography. The urgent surgical procedure was performed using posterior approach to the popliteal artery. During the surgical exploration, rupture of the posterior cruciate ligament associated with thrombosed popliteal artery have been found. The damaged popliteal artery was resected and replaced with autologous saphenous vein graft. The last stage of the procedure was a transosseous femoral fixation of posterior circuate ligament. A 3-year-follow-up after the surgery demonstrated intact arterial perfusion and very good function of the knee with a minimal difference as compared with the contralateral knee. Conclusion. Combined orthopedic and vascular injuries are very rare in children. They require combined treatment. [Projekat Ministarstva nauke Republike Srbije, br. 175008

Potential factors associated with knee pain in cyclists: a systematic review

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Bini RR

2018-05-01

Full Text Available Rodrigo Rico Bini, Alice Flores Bini La Trobe Rural Health School, La Trobe University, Flora Hill Campus, Bendigo, VIC, Australia Abstract: The potential factors associated with overuse injuries and pain in cyclists that are supported by evidence remain unclear. Our study aimed at assessing, using a systematic search of the most updated evidence, the main factors related to overuse knee-related pain and/or injuries in cyclists. The search assessed any potential mechanism related to knee pain or injury that could be used in the clinical practice. Databases were searched (i.e., PubMed, Scopus, Web of Science, and EBSCO. Studies were included if they presented results from original studies. They had to include, preferably but not limited to, recreational and/or competitive cyclists with or without knee pain. Quality of articles was assessed. Eleven articles were deemed eligible for full text appraisal. Studies involved generally the assessment of biomechanical outcomes associated with knee pain in cyclists. Overall, studies showed that cyclists with knee pain present larger knee adduction and larger ankle dorsiflexion and differences in activation for hamstrings and quadriceps muscles. Unclear results were observed for knee moments and no differences were observed for knee flexion angle, tibiofemoral and patellofemoral forces. It is important to state that varied types of knee pain were mixed in most studies, with 2 focused on anterior-related pain. Cyclists with overuse-related pain or injuries on their knees presented an increased medial projection of their knees and an altered activation of the Vastus Medialis and Vastus Lateralis muscles. However, this limited evidence is based on retrospective studies comparing cyclists with and without pain, which limits the conclusion on how cyclists develop knee pain and what are the main options for treatment of knee pain. Keywords: injury, cycling, overuse, biomechanics

Motives for sports participation as predictions of self-reported outcomes after anterior cruciate ligament injury of the knee.

Science.gov (United States)

Roessler, K K; Andersen, T E; Lohmander, S; Roos, E M

2015-06-01

Aim of the study was to access how individual's motives for participation in sports impact on self-reported outcomes 2 years after an anterior cruciate ligament injury. Based on a longitudinal cohort study, this secondary analysis present data from the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) study, a randomized controlled trial. At baseline, 121 patients recorded in an initial questionnaire that their motives for sports participation fell into four categories: achievement, health, social integration, or fun and well-being. These four categories were used as variables in the analyses. All 121 subjects completed the 2-year follow-up. The largest improvement was seen in the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale sports and recreation function, with an effect size of 2.43. KOOS sports and recreation function was also the subscale score best predicted by the motives for sports participation. Baseline motives achievement and fun and well-being predicted worse levels of pain and function 2 years after the injury, even after adjusting for age, gender, treatment and baseline scores. Psychological aspects, such as motives for participation in sport, can be factors in predicting of patient-reported outcomes 2 years after injury. Evaluating motives for sports participation may help predict the outcome 2 years after ACL injury. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A finite element lower extremity and pelvis model for predicting bone injuries due to knee bolster loading

NARCIS (Netherlands)

Rooij, L. van; Hoof, J. van; Barbir, A.; Made, R. van der; Slaats, P.M.A.; McCann, M.J.; Ridella, S.A.; Rupp, J.D.

2004-01-01

Injuries to the knee-thigh-hip (KTH) complex in frontal motor vehicle crashes are of substantial concern because of their frequency and potential to result in long-term disability. Current frontal impact Anthropometric Test Dummies (ATDs) have been shown to respond differently than human cadavers

A 2-Year Prospective Cohort Study of Overuse Running Injuries: The Runners and Injury Longitudinal Study (TRAILS).

Science.gov (United States)

Messier, Stephen P; Martin, David F; Mihalko, Shannon L; Ip, Edward; DeVita, Paul; Cannon, D Wayne; Love, Monica; Beringer, Danielle; Saldana, Santiago; Fellin, Rebecca E; Seay, Joseph F

2018-05-01

The National Center for Injury Prevention and Control, noting flaws in previous running injury research, called for more rigorous prospective designs and comprehensive analyses to define the origin of running injuries. To determine the risk factors that differentiate recreational runners who remain uninjured from those diagnosed with an overuse running injury during a 2-year observational period. Cohort study; Level of evidence, 2. Inclusion criteria were running a minimum of 5 miles per week and being injury free for at least the past 6 months. Data were collected at baseline on training, medical and injury histories, demographics, anthropometrics, strength, gait biomechanics, and psychosocial variables. Injuries occurring over the 2-year observation period were diagnosed by an orthopaedic surgeon on the basis of predetermined definitions. Of the 300 runners who entered the study, 199 (66%) sustained at least 1 injury, including 73% of women and 62% of men. Of the injured runners, 111 (56%) sustained injuries more than once. In bivariate analyses, significant ( P ≤ .05) factors at baseline that predicted injury were as follows: Short Form Health Survey-12 mental component score (lower mental health-related quality of life), Positive and Negative Affect Scale negative affect score (more negative emotions), sex (higher percentage of women were injured), and knee stiffness (greater stiffness was associated with injury); subsequently, knee stiffness was the lone significant predictor of injury (odds ratio = 1.18) in a multivariable analysis. Flexibility, quadriceps angle, arch height, rearfoot motion, strength, footwear, and previous injury were not significant risk factors for injury. The results of this study indicate the following: (1) among recreational runners, women sustain injuries at a higher rate than men; (2) greater knee stiffness, more common in runners with higher body weights (≥80 kg), significantly increases the odds of sustaining an overuse running

Injuries in recreational curling include head injuries and may be prevented by using proper footwear

OpenAIRE

D. K. Ting; R. J. Brison

2015-01-01

Introduction: Our study examines a recreational curling population to describe patterns of injury occurrence, estimate risk of injury and to gauge attitudes towards equipment-based prevention strategies. Methods: In a retrospective case series, we queried the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), a national injury surveillance database, for curling injuries entered between 1993 and 2011. Kingston General Hospital and Hotel Dieu Hospital provide the two Kingston,...

NCIPC's contribution to global injury and violence prevention: past, present, and future.

Science.gov (United States)

Mahendra, Reshma R; Roehler, Douglas R; Degutis, Linda C

2012-09-01

Injuries and violence impact millions across the globe each year. For the past 20 years, the National Center for Injury Prevention and Control (NCIPC) at the Centers for Disease Control and Prevention (CDC) has assembled the largest cadre of injury and violence prevention experts in the world to reduce the burden of injuries and violence domestically and to inform global injury and violence prevention efforts. This article focuses on NCIPC's global injury and violence prevention work that involves: increasing awareness of the preventability of injury and violence, partnerships to promote injury research and best practices; establishing standards and guidance for data collection; building capacity through training and mentoring; and supporting evidence-based strategies. To decrease the global burden, the authors propose priority setting to maximize the development and sustainability of financial and human resources for injury and violence prevention. The authors call for increased capacity and resources for global injury and violence prevention. Published by Elsevier Ltd.

ROLE OF HAMSTRING MUSCLES IN KNEE JOINT STABILITY PROVIDING AND INJURY PREVENTION

OpenAIRE

Pontaga, Inese

2016-01-01

The aim of our investigation was to determine the ratio of maximal torque values and the torques in the certain positions of range of movements (ROM) between hamstring (H) and quadriceps femoris (Q) muscles at medium and high velocity of movement in concentric (CC) and eccentric (ECC) action of hamstring muscles. The knee muscles of 15 amateur female short and middle distance runners were tested by the dynamometer system in the isokinetic movements with the angular velocity of 90º/s and 240º...

Popliteal artery injury during posterior cruciate ligament reconstruction

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Marcos Henrique Frauendorf Cenni

2015-06-01

Full Text Available This study reports a case of popliteal artery injury during arthroscopic reconstruction of the posterior cruciate ligament. The evolution of the injury is described and comments are made regarding the anatomy of this artery and potential risks of this surgical technique. This study had the aims of alerting the medical community, especially knee surgeons, regarding a severe surgical complication and discussing the ways of preventing it.

Influence of a Viscoelastic Insole on Foot, Knee and Back Pain among Members of the United States Army Band

Science.gov (United States)

2010-07-13

Attenuation of spinal transients at heel strike using viscoelastic heel insoles: an in vivo study. Preventive Medicine. 2004;39:351-354. 30...2009 – March 2010 A-4 35. Bender JA, Pierson JK, Kaplan HM, Johnson AJ. Factors affecting the occurrence of knee injuries . Journal of the...EPIDEMIOLOGICAL REPORT NO. 12-HF-97G010-09 INFLUENCE OF A VISCOELASTIC INSOLE ON FOOT, KNEE AND BACK PAIN AMONG MEMBERS

Incidence of and Risk Factors for Knee Collateral Ligament Injuries With Proximal Tibia Fractures: A Study of 32,441 Patients.

Science.gov (United States)

Samuel, Andre M; Diaz-Collado, Pablo J; Szolomayer, Lauren K; Wiznia, Daniel H; Chan, Wayne W; Lukasiewicz, Adam M; Basques, Bryce A; Bohl, Daniel D; Grauer, Jonathan N

2018-03-01

Proximal tibia fractures are associated with concurrent collateral ligament injuries. Failure to recognize these injuries may lead to chronic knee instability. The purpose of this study was to identify risk factors for concurrent collateral ligament injuries with proximal tibia fractures and their association with inpatient outcomes. A total of 32,441 patients with proximal tibia fractures were identified in the 2011-2012 National Trauma Data Bank. A total of 1445 (4.5%) had collateral ligament injuries, 794 (2.4%) had injuries to both collateral ligaments, 456 (1.4%) had a medial collateral ligament injury only, and 195 (0.6%) had a lateral collateral ligament injury only. On multivariate analysis, risk factors found to be associated with collateral ligament injuries included distal femur fracture (odds ratio, 2.1), pedestrian struck by motor vehicle (odds ratio, 2.0), obesity (odds ratio, 1.6), young age (odds ratio, 1.9 for 18 to 29 years vs 40 to 49 years), motorcycle accident (odds ratio, 1.5), and Injury Severity Score of 20 or higher (odds ratio, 1.4). In addition, patients with simultaneous injuries to both collateral ligaments had higher odds of inpatient adverse events (odds ratio, 1.51) and longer hospital stay (mean, 2.27 days longer). The risk factors reported by this study can be used to identify patients with proximal tibia fractures who may warrant more careful and thorough evaluation and imaging of their knee collateral ligaments. [Orthopedics. 2018; 41(2):e268-e276.]. Copyright 2018, SLACK Incorporated.

Running injuries and associated factors in participants of ING Taipei Marathon.

Science.gov (United States)

Chang, Wei-Ling; Shih, Yi-Fen; Chen, Wen-Yin

2012-08-01

To investigate the distribution of lower extremity running injuries and their associated factors. Descriptive and exploratory study. 1004 participants of the 2005 ING Taipei International Marathon. We used a self-developed questionnaire to collect data of previous running injuries and applied multivariate logistic regression modeling to examine relationships between these injuries and associated factors. Of the 893 valid questionnaires, 396 (44.4%) reported having previous lower extremity pain related to running. Knee joint pain was the most common problem (32.5%). Hip pain was associated with the racing group, training duration, and medial arch support. Use of knee orthotics (P = 0.002) and ankle braces (P = 0.007) was related to a higher rate of knee and ankle pain. Participants of the full marathon group who practiced on a synthetic track had a higher incidence of ankle pain. A training duration of >60 min was linked to an increased rate of foot pain (P = 0.003). Our data indicated that running injuries were associated with training duration and use of orthotics. Clinicians can use this information in treating or preventing running associated injuries and pain. Copyright © 2011 Elsevier Ltd. All rights reserved.

Risk analysis of occupational factors influencing the development of arthrosis of the knee

International Nuclear Information System (INIS)

Sahlstroem, Arne; Montgomery, Fredrik

1997-01-01

The aim of this study was to identify occupational activities important for the development of arthrosis of the knee, taking into account the confounding factors that were suspected or could be recognized. In the archives of the Department of Diagnostic Radiology at the Malmoe University Hospital all radiographs of weight-bearing knees of patients with painful knee joints from the period 1982-1986 were reassessed. We found 340 probands, i.e., subjects with arthrosis of the knee of at least grade 1 in the Ahlbaeck classification. These probands and their age- and sex-matched controls (680) were analyzed by a validated questionnaire for details of activities at work inducing knee moment over three 15-year-periods as well as their history of knee injuries at work or in their leisure time. The questionnaire was answered by 266 (79%) arthrosis probands and 463 controls (70%). The results of the questionnaire answers and of the recorded history of knee injuries were statistically analyzed by logistic regression. The relative risk of knee arthrosis was slightly increased (RR: 1.9; CI: 1.4-2.7) in probands with weight-bearing knee bending, i.e., dynamic load of the knee joint when bending, whereas knee injuries (meniscectomies and haemarthrosis) were associated with a higher risk. Weight-bearing knee bending corrected for confounders was not a significant factor for knee arthrosis. Overweight was observed to increase the relative risk. A sedentary profession had, on the other hand, a low risk. The knee injuries (66) were, but for 9 probands, sustained in leisure activities, mainly soccer. We thus conclude that work which induces weight-bearing knee bending by itself does not significantly increase the risk of developing arthrosis of the knee - knee injuries and overweight are more important

S-13: Interventions for Prevention and Rehabilitation of Hamstring Injuries

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Reza Rahimi Moghaddam

2017-03-01

Full Text Available INTRODUCTION: The hamstring muscles have very important role in the stabilization of body posture, movement of the lower extremities and trunk movements in relation to the thigh. Hamstring injuries are common among athletes, especially in sports like soccer with sprinting demands, kicking, and sudden accelerations. Hamstring strains are frustrating for the injured athletes because the symptoms are persistent, healing is slow, and the rate of re-injury is high. This indicates a need to develop prevention strategies for hamstring injuries. The aims of this review are introducing hamstring strains, associated risk factors, and providing rehabilitative ecommendations for injured athletes to prevent re-injury. METHOD: Information was gathered from an online literatures search using the key words hamstring injuries, soccer injuries, injury prevention, hamstring rehabilitation, and stretching exercises. Screening of references and hand searches of relevant journals were also employed. All relevant studies in English were reviewed and abstracted.RESULTS: It has been shown that hamstring strains account for 12-16% of all injuries in athletes with a re-injury rate reported as high as 22-34%. The hamstrings have a tendency to shorten. Tight hamstrings with limited range of motion and flexibility may lead to postural deficiency and deformities. It also makes the hamstring susceptible to re-injury. Risk factors such as age, strength imbalance, previous injury and flexibility should be considered. CONCLUSION: Prevention intervention may minimize the risk factors of hamstring injuries. Training modalities should emphasize on eccentric strength training, and prevention of fatigue. There is wide disagreement about the impact of stretching exercise on prevention/rehabilitation of hamstring injuries.

High-volume image-guided injection for recalcitrant medial collateral ligament injuries of the knee

International Nuclear Information System (INIS)

Drumm, O.; Chan, O.; Malliaras, P.; Morrissey, D.; Maffulli, N.

2014-01-01

Aim: To evaluate the effectiveness of a novel injection technique in the management of recalcitrant medial collateral ligament (MCL) injuries of the knee. Materials and methods: The injection, comprising 10 ml local anaesthetic with 25–50 mg hydrocortisone, is directed beneath the periosteal attachment of the MCL. Twenty-eight patients who received the intervention were asked to complete a questionnaire, a visual analogue scale (VAS) and the International Knee Documentation Committee (IKDC) subjective knee form to quantify symptoms pre-injection and at follow-up. Data were assessed using descriptive statistics. Further analysis was conducted using the Wilcoxon signed-rank test and Fisher's exact test. Results: Sixty-eight percent (n = 19) of patients responded. Three patients were excluded according to the exclusion criteria. Of those studied, 37.5% (n = 6) were professional athletes. At follow-up, patients reported a mean improvement on the VAS of 75.5% (SD = 23.6). There was a significant improvement in IKDC scores (mean difference 42%, SD = 14.2) pre- and post-injection (Wilcoxon signed-rank test, p < 0.001). No residual symptoms were reported by 50% (n = 8) of patients, and a further 37.5% (n = 6) of patients had improved. Of those patients who played sport, two-thirds (n = 10) had returned to their previous level of sport at follow-up, including all of the professional athletes. Conclusion: Periosteal high-volume image-guided injection is a useful treatment for recalcitrant MCL injury. Results are encouraging, particularly amongst the professional athletes studied

Musculoskeletal MR: knee

International Nuclear Information System (INIS)

Staebler, A.; Glaser, C.; Reiser, M.

2000-01-01

Magnetic resonance imaging is the most sensitive, specific, and accurate noninvasive method for diagnosing internal derangement of the knee. During the past 15 years knowledge of pathologic conditions of the knee had evolved significantly. Beyond the basic principles of imaging knee injuries great impact was made on the understanding of indirect or collateral findings, even in rare diseases. In this article the spectrum of disorders of the knee are reviewed and an overview of the current literature is given. This includes considerations about how to achieve a high-standard MR imaging study of the knee, and principles of imaging anterior cruciate ligament and meniscal tears. A focus is put on distinct diseases including intra-articular and intraosseous ganglion cysts, iliotibial band friction syndrome, transient osteoporosis, osteonecrosis, osteochondritis dissecans, and imaging of the articular cartilage. (orig.)

Occupational injury insurance - A strategy for prevention?

DEFF Research Database (Denmark)

Jacobsen, Thomas

1993-01-01

Can compulsory occupational injury insurance be used as a strategy for prevention in the work place? This is discussed on the basis of two different insurance systems - the Danish and the French.......Can compulsory occupational injury insurance be used as a strategy for prevention in the work place? This is discussed on the basis of two different insurance systems - the Danish and the French....

A Retrospective Review from 2006 to 2011 of Lower Extremity Injuries in Badminton in New Zealand

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Joanna Reeves

2015-06-01

Full Text Available Aim: To describe lower extremity injuries for badminton in New Zealand. Methods: Lower limb badminton injuries that resulted in claims accepted by the national insurance company Accident Compensation Corporation (ACC in New Zealand between 2006 and 2011 were reviewed. Results: The estimated national injury incidence for badminton injuries in New Zealand from 2006 to 2011 was 0.66%. There were 1909 lower limb badminton injury claims which cost NZ$2,014,337 (NZ$ value over 2006 to 2011. The age-bands frequently injured were 10–19 (22%, 40–49 (22%, 30–39 (14% and 50–59 (13% years. Sixty five percent of lower limb injuries were knee ligament sprains/tears. Males sustained more cruciate ligament sprains than females (75 vs. 39. Movements involving turning, changing direction, shifting weight, pivoting or twisting were responsible for 34% of lower extremity injuries. Conclusion: The knee was most frequently injured which could be due to multi-planar loading. Turning or cutting movements typically involve motion in the frontal and transverse planes that may place the knee at greater risk of injury than movement in the sagittal plane alone. Further research on badminton specific movements is warranted to better understand the mechanisms of lower extremity injuries in the sport. Sports medicine and support personnel should take into account the susceptibility of the knee to injury when designing training and injury prevention programmes given the large number of change of direction movements during badminton.

Injury prevention and public health

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David A. Sleet

2010-06-01

Full Text Available Injuries are one of the most under-recognized public health problems facing the world today. With more than 5 million deaths every year, violence and injuries account for 9% of global mortality, as many deaths as from HIV, Malaria and Tuberculosis combined. Eight of the 15 leading causes of death for people ages 15 to 29 years are injury-related: road traffic injuries, suicides, homicides, drowning, burns, war injuries, poisonings and falls. For every death due to war, there are three deaths due to homicide and five deaths due to suicide. However, most violence happens to people behind closed doors and results not in death, but often in years of physical and emotional suffering [1]. Injuries can be classified by intent: unintentional or intentional. Traffic injuries, fire-related injuries, falls, drowning, and poisonings are most often classified as unintentional injuries; injuries due to assault, selfinflicted violence such as suicide, and war are classified as intentional injuries, or violence. Worldwide, governments and public and private partners are increasingly aware of the strains that unintentional injuries and violence place on societies. In response they are strengthening data collection systems, improving services for victims and survivors, and increasing prevention efforts [1].

Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football

DEFF Research Database (Denmark)

Thorborg, Kristian; Krommes, Kasper Kühn; Esteve, Ernest

2017-01-01

Objective To investigate the effect of FIFA injury prevention programmes in football (FIFA 11 and FIFA 11+). Design Systematic review and meta-analysis. Eligibility criteria for selecting studies Randomised controlled trials comparing the FIFA injury prevention programmes with a control (no or sham...... intervention) among football players. Data sources MEDLINE via PubMed, EMBASE via OVID, CINAHL via Ebsco, Web of Science, SportDiscus and Cochrane Central Register of Controlled Trials, from 2004 to 14 March 2016. Results 6 cluster-randomised controlled trials had assessed the effect of FIFA injury prevention...... programmes compared with controls on the overall football injury incidence in recreational/subelite football. These studies included 2 specific exercise-based injury prevention programmes: FIFA 11 (2 studies) and FIFA 11+ (4 studies). The primary analysis showed a reduction in the overall injury risk ratio...

Neuromuscular Activity and Knee Kinematics in Adolescents with Patellofemoral Pain

DEFF Research Database (Denmark)

Rathleff, Michael Skovdal; Samani, Afshin; Olesen, Jens L

2013-01-01

This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS).......This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS)....

Flowtron foot-pumps for prevention of venous thromboembolism in total hip and knee replacement.

Science.gov (United States)

Pitto, Rocco P; Koh, Chuan K

2015-03-01

Mechanical prophylaxis with foot-pumps provides an interesting alternative to chemical agents in the prevention of venous thomboembolism following major orthopaedic surgery procedures. The aim of this prospective study was to assess efficacy and safety of the Flowtron(®) foot-pumps system following total hip and knee replacement. The foot pumps were used as main tool for prevention of thromboembolic events, in most cases in association with a variety of chemicals. The primary endpoint of the study was to assess the incidence of deep vein thrombosis and pulmonary embolism after total hip and knee replacement. The secondary endpoints included postoperative bleeding, swelling, bruising and wound ooze. 424 consecutive patients were included in the study. Symptomatic deep vein thrombosis was detected in 7 patients (1.6%). All symptomatic deep vein thromboses were detected after discharge before the six week follow-up clinic. Five non-fatal pulmonary embolisms occurred (1.2%). Only one patient presented a major wound bleeding (0.2%). The mean difference of swelling of thigh pre-versus postoperatively was only 22.8 mm. In conclusion, thromboembolism prophylaxis after total hip and knee replacement using Flowtron(®) foot-pumps as main prevention tool of an individualised protocol appears effective and safe. This is the first clinical report related to this popular brand of foot pumps.

Injury prevention for adult male soccer players

NARCIS (Netherlands)

van Beijsterveldt, A.M.C.

2013-01-01

Soccer causes the largest number of injuries each year (18% of all sports injuries) in the Netherlands. The aim of this dissertation is to contribute to the body of evidence on injury prevention for adult male soccer players. Chapter 1 is a general introduction and presents the “sequence of

Activity preferences, lifestyle modifications and re-injury fears influence longer-term quality of life in people with knee symptoms following anterior cruciate ligament reconstruction: a qualitative study

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Stephanie R Filbay

2016-04-01

Full Text Available Questions: How do people with knee symptoms describe their quality of life and experiences 5 to 20 years after anterior cruciate ligament reconstruction (ACLR? What factors impact upon the quality of life of these people? Design: Qualitative study. Participants: Seventeen people with knee symptoms 5 to 20 years after ACLR and high (n = 8 or low (n = 9 quality of life scores were recruited from a cross-sectional study. Methods: Semi-structured telephone interviews were conducted and transcribed. The data obtained from the interventions underwent inductive coding and thematic analysis. Results: Four consistent themes emerged from the interviews as common determinants of quality of life following ACLR: physical activity preferences; lifestyle modifications; adaptation and acceptance; and fear of re-injury. All participants described the importance of maintaining a physically active lifestyle and the relationship between physical activity and quality of life. Participants who avoided sport or activity reported experiencing reduced quality of life. Participants who suppressed or overcame re-injury fears to continue sport participation described experiencing a satisfactory quality of life while taking part in sport despite knee symptoms. For some participants, resuming competitive sport resulted in subsequent knee trauma, anterior cruciate ligament re-rupture or progressive deterioration of knee function, with negative impacts on quality of life following sport cessation. Participants who enjoyed recreational exercise often adapted their lifestyle early after ACLR, while others described adapting their lifestyle at a later stage to accommodate knee impairments; this was associated with feelings of acceptance and satisfaction, irrespective of knee symptoms. Conclusion: Activity preferences, lifestyle modifications and fear of re-injury influenced quality of life in people with knee symptoms up to 20 years following ACLR. People with a preference

“…Keep mobile, I think that’s half the battle.” A qualitative study of prevention of knee pain in symptomless older adults

Directory of Open Access Journals (Sweden)

Ali Fizzah

2012-09-01

Full Text Available Abstract Background The emphasis on prevention in English health policy continues to centre predominantly on major diseases such as coronary heart disease and diabetes. A number of key documents detailing self-management techniques and prevention of osteoarthritis (OA are currently available, including the NICE guidelines and the Arthritis Foundation’s National Public Health Agenda for Osteoarthritis. However, few investigations have explored preventative knowledge of knee OA amongst the population. In particular, asymptomatic members of the population may use further information in considering how to prevent knee pain. This study considers perceptions around the prevention of knee pain amongst an asymptomatic population; this target population may provide alternative insights by which to stimulate preventative behaviours. Methods A sample of thirteen patients with no current knee pain was selected from responders to a population survey. Each interview was tape recorded and fully transcribed. Qualitative computer software package NVivo8 was used to manage the data. Thematic analysis was conducted using the constant comparative method. Results The definition and causes of knee pain were interpreted in a multitude of ways. The importance of prevention was recognised by a sub-set, while a small proportion of participants negated the role of prevention. A range of social factors, including early adoption of actions, influenced the implementation and continuation of preventative behaviours. Individual responsibility for prevention was a key theme, although the role of society was also considered. Exercise was cited as a principal preventative strategy, although some participants viewed exercise as a destructive activity. A number of participants deemed pharmacotherapy to be harmful and at odds with normal physiology, instead preferring to adopt preventative behaviour over medication usage. Conclusions This asymptomatic population exhibit

Posterolateral Corner of the Knee:Current Concepts

Directory of Open Access Journals (Sweden)

Jorge Chahla

2016-04-01

Full Text Available Injuries to the posterolateral corner (PLC comprise a significant portion of knee ligament injuries. A high index of suspicion is necessary when evaluating the injured knee to detect these sometimes occult injuries. Moreover, a thorough physical examination and a comprehensive review of radiographic studies are necessary to identify these injuries. In this sense, stress radiographs can help to objectively determine the extent of these lesions. Non-operative and operative treatment options have been reported depending on the extent of the injury. Complete PLC lesions rarely heal with non-operative treatment, and are therefore most often treated surgically. The purpose of this article was to review the anatomy and clinically relevant biomechanics, diagnosis algorithms, treatment and rehabilitation protocols for PLC injuries.

National programme for prevention of burn injuries

Directory of Open Access Journals (Sweden)

Gupta J

2010-10-01

Full Text Available The estimated annual burn incidence in India is approximately 6-7 million per year. The high incidence is attributed to illiteracy, poverty and low level safety consciousness in the population. The situation becomes further grim due to the absence of organized burn care at primary and secondary health care level. But the silver lining is that 90% of burn injuries are preventable. An initiative at national level is need of the hour to reduce incidence so as to galvanize the available resources for more effective and standardized treatment delivery. The National Programme for Prevention of Burn Injuries is the endeavor in this line. The goal of National programme for prevention of burn injuries (NPPBI would be to ensure prevention and capacity building of infrastructure and manpower at all levels of health care delivery system in order to reduce incidence, provide timely and adequate treatment to burn patients to reduce mortality, complications and provide effective rehabilitation to the survivors. Another objective of the programme will be to establish a central burn registry. The programme will be launched in the current Five Year Plan in Medical colleges and their adjoining district hospitals in few states. Subsequently, in the next five year plan it will be rolled out in all the medical colleges and districts hospitals of the country so that burn care is provided as close to the site of accident as possible and patients need not to travel to big cities for burn care. The programme would essentially have three components i.e. Preventive programme, Burn injury management programme and Burn injury rehabilitation programme.

Preventing unintentional injury in children and adolescents--the importance of local injury data collection.

LENUS (Irish Health Repository)

O'Carroll, C

2012-02-01

We sought to prospectively study all injuries in children and adolescents up to 16 years of age presenting to a regional Emergency Department (ED), to ascertain detailed injury patterns and to use this data to recommend injury prevention priorities. Electronic injury surveillance was prospectively collected over a 10 year period (1997-2007) in a hospital with a paediatric catchment population of 75,000 in a region with pockets of high social deprivation. All fatalities were obtained from data provided by the Central Statistics Office (CSO). Over a 10 year period, there were 31 fatalities, 5,408 admissions and 40,817 new attendances due to injury. Males outnumbered females in a 3:2 ratio. Of all injuries 24,317 (60%) occurred at home. Peak injury presentation time was in the evening between 18:00 and 20:00. Minor injuries (bruises, minor head injuries, lacerations and sprains) accounted for 32,456 (80%) of total. Fractures resulting from high falls (n=1,194) tended to result from bunk beds, staircases, horses, walls and playground equipment. Burns (n=630) involved hot liquids (tea, coffee), hot bath water, hot cooking oil and hot cooking plates. Pedestrian injuries (n=251) were predominantly \\'dart outs\\' in urban areas. Car passenger injuries (n=869) showed low rates of documented car restraint use. Poisonings (n= 1,153) were predominantly medicinal products. Cyclist injuries (n=477) indicated low documented use of appropriate helmet wear. Prevention priorities should focus on home injuries, hot liquid burn and scald injuries and high falls from walls, beds and playground equipment. To prevent road-related injuries and deaths, further legislation, urban planning and greater police enforcement is required.

Abdominal Hollowing Reduces Lateral Trunk Displacement During Single-Leg Squats in Healthy Females But Does Not Affect Peak Hip Abduction Angle or Knee Abductio Angle/Moment.

Science.gov (United States)

Linde, Lukas D; Archibald, Jessica; Lampert, Eve C; Srbely, John Z

2017-07-17

Females suffer 4-6 times more non-contact anterior cruciate ligament (ACL) injuries than males due to neuromuscular control deficits of the hip musculature leading to increases in hip adduction angle, knee abduction angle, and knee abduction moment during dynamic tasks such as single-leg squats. Lateral trunk displacement has been further related to ACL injury risk in females, leading to the incorporation of core strength/stability exercises in ACL preventative training programs. However, the direct mechanism relating lateral trunk displacement and lower limb ACL risk factors is not well established. To assess the relationship between lateral trunk displacement and lower limb measures of ACL injury risk by altering trunk control through abdominal activation techniques during single-leg squats in healthy females. Interventional Study Setting: Movement and Posture Laboratory Participants: 13 healthy females (21.3±0.88y, 1.68±0.07m, 58.27±5.46kg) Intervention: Trunk position and lower limb kinematics were recorded using an optoelectric motion capture system during single-leg squats under differing conditions of abdominal muscle activation (abdominal hollowing, abdominal bracing, control), confirmed via surface electromyography. Lateral trunk displacement, peak hip adduction angle, peak knee abduction angle/moment, and average muscle activity from bilateral internal oblique, external oblique, and erector spinae muscles. No differences were observed for peak lateral trunk displacement, peak hip adduction angle or peak knee abduction angle/moment. Abdominal hollowing and bracing elicited greater muscle activation than the control condition, and bracing was greater than hollowing in four of six muscles recorded. The lack of reduction in trunk, hip, and knee measures of ACL injury risk during abdominal hollowing and bracing suggests that these techniques alone may provide minimal benefit in ACL injury prevention training.

M. biceps femoris - A wolf in sheep's clothing: The downside of a lower limb injury prevention training.

Science.gov (United States)

Ertelt, Thomas; Gronwald, Thomas

2017-11-01

Both, hamstring and ACL injuries are among the most typical injuries, particularly in change of direction and high speed running sports. They're also difficult to treat. Therefore, in the past few years, sports medicine practitioners and exercise scientists have mainly been focusing on the development and implementation of preventive programs in order to reduce the number of lower limb injuries, mainly by improving knee alignment. A number of studies have been able to prove the success of these training interventions, which are mainly addressing sensorimotor abilities and plyometric activities. The number of non-contact hamstring injuries has nevertheless been on the rise, particularly in sports like soccer and football. Therefore, the purpose of the following article is to introduce the hypothesis that the above-mentioned training interventions have a massive influence on the activation patterns on the targeted muscle group, and on the M. biceps femoris in particular. Muscle function and the resulting internal load are directly related to muscle architecture at the insertion. Training induced adaptations in hamstring activation patterns can thus lead to an increased injury susceptibility. In this case, a simulation model that directly relates to an acute deceleration maneuver provides valuable insights into the function of the biceps femoris muscle, especially when the rate of activity and the muscle geometry at the insertion area are taken into consideration. We conclude that there needs to be a greater individualization of prevention programs, especially in regards to anatomical requirements, in order to further reduce injury rates in elite sports. Moreover, it would also seem reasonable to apply a similar approach to aspects of chronic pain such as chronic non-specific low back pain. Copyright © 2017 Elsevier Ltd. All rights reserved.

Gait changes in patients with knee osteoarthritis are replicated by experimental knee pain

DEFF Research Database (Denmark)

Henriksen, Marius; Nielsen, Thomas Graven; Aaboe, Jens

2010-01-01

Medial knee osteoarthritis (OA) is characterized by pain and associated with abnormal knee moments during walking. The relationship between knee OA pain and gait changes remains to be clarified, and a better understanding of this link could advance the treatment and prevention of disease...... progression. This study investigated changes in knee moments during walking following experimental knee pain in healthy volunteers, and whether these changes replicated the joint moments observed in medial knee OA patients....

Jumper's Knee (Patellar Tendonitis) (For Parents)

Science.gov (United States)

... Safe Videos for Educators Search English Español Jumper's Knee (Patellar Tendonitis) KidsHealth / For Parents / Jumper's Knee (Patellar ... prevent continued damage to the knee. How the Knee Works To understand how jumper's knee happens, it ...