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Warathanagasame P, Sakulsriprasert P, Sinsurin K, Richards J, McPhee JS. Comparison of Hip and Knee Biomechanics during Sidestep Cutting in Male Basketball Athletes with and without Anterior Cruciate Ligament Reconstruction. J Hum Kinet 2023; 87:17-27. [PMID: 37559777 PMCID: PMC10407324 DOI: 10.5114/jhk/162965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/06/2023] [Indexed: 08/11/2023] Open
Abstract
This study aimed to compare hip and knee biomechanics during sidestep cutting on the operated and non-operated sides in individuals with anterior cruciate ligament reconstruction (ACLR), and in an uninjured control group. Twenty male basketball athletes, 10 individuals with ACLR and 10 controls, were recruited. Hip and knee joint angles and angular velocities were investigated with a three-dimensional motion analysis system, and ground reaction forces (GRF) along with moments were collected during the deceleration phase of the stance limb during sidestep cutting maneuvers. We found significantly higher peak hip flexion, hip internal rotation angular velocities, and peak thigh angular velocity in the sagittal plane in the ACLR group. In addition, the peak vertical GRF and peak posterior GRF of the ACLR group were significantly higher than those of the control group. Univariate analyses indicated that the posterior GRF of the non-operated side was significantly higher than in the matched operated side in the control group. The operated and non-operated sides in male basketball athletes with ACLR showed alterations in hip and knee biomechanics compared with a control group, especially in the sagittal plane. Therefore, the emphasis of neuromuscular control training for the hip and the knee in basketball players with ACLR is required.
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Affiliation(s)
- Pinyada Warathanagasame
- Biomechanics and Sports, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Prasert Sakulsriprasert
- Biomechanics and Sports, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Komsak Sinsurin
- Biomechanics and Sports, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Jim Richards
- Allied Health Research Unit, University of Central Lancashire, Lancashire, United Kingdom
| | - Jamie S. McPhee
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
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Naili JE, Markström JL, Häger CK. A Longitudinal Case-Control Study of a Female Athlete Preinjury and After ACL Reconstruction: Hop Performance, Knee Muscle Strength, and Knee Landing Mechanics. Sports Health 2023; 15:357-360. [PMID: 36744632 PMCID: PMC10170219 DOI: 10.1177/19417381221147305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Athletes with an anterior cruciate ligament (ACL) injury followed by ACL reconstruction (ACLR) often perform various testing to guide return to sport, but preinjury data are rarely available for comparison. This longitudinal case-control study reports absolute value and between-leg symmetry data on maximal performances for single-leg hop height and distance, muscle strength, and side hop landing mechanics of an 18-year-old female soccer athlete collected 5 months before sustaining an ACL injury and again at 10, 13, and 29 months post-ACLR. Her data were compared across test sessions and to cross-sectional data of 15 asymptomatic female athletes.
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Affiliation(s)
- Josefine E Naili
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Jonas L Markström
- Department of Community Medicine and Rehabilitation, Unit of Physiotherapy, Umeå University, Umeå, Sweden.,Umeå School of Business, Economics and Statistics, Unit of Statistics, Umeå University, Umeå, Sweden
| | - Charlotte K Häger
- Department of Community Medicine and Rehabilitation, Unit of Physiotherapy, Umeå University, Umeå, Sweden
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Knurr KA, Kliethermes SA, Stiffler-Joachim MR, Cobian DG, Baer GS, Heiderscheit BC. Running Biomechanics Before Injury and 1 Year After Anterior Cruciate Ligament Reconstruction in Division I Collegiate Athletes. Am J Sports Med 2021; 49:2607-2614. [PMID: 34260290 PMCID: PMC8338897 DOI: 10.1177/03635465211026665] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Preinjury running biomechanics are an ideal comparator for quantifying recovery after anterior cruciate ligament (ACL) reconstruction (ACLR), allowing for assessments within the surgical and nonsurgical limbs. However, availability of preinjury running biomechanics is rare and has been reported in case studies only. PURPOSE/HYPOTHESIS The purpose of this study was to determine if running biomechanics return to preinjury levels within the first year after ACLR among collegiate athletes. We hypothesized that (1) surgical knee biomechanics would be significantly reduced shortly after ACLR and would not return to preinjury levels by 12 months and (2) nonsurgical limb mechanics would change significantly from preinjury. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Thirteen Division I collegiate athletes were identified between 2015 and 2020 (6 female; mean ± SD age, 20.7 ± 1.3 years old) who had whole body kinematics and ground-reaction forces recorded during treadmill running (3.7 ± 0.6 m/s) before sustaining an ACL injury. Running analyses were repeated at 4, 6, 8, and 12 months (4M, 6M, 8M, 12M) after ACLR. Linear mixed effects models were used to assess differences in running biomechanics between post-ACLR time points and preinjury within each limb, reported as Tukey-adjusted P values. RESULTS When compared with preinjury, the surgical limb displayed significant deficits at all postoperative assessments (P values <.01; values reported as least squares mean difference [SE]): peak knee flexion angle (4M, 13.2° [1.4°]; 6M, 9.9° [1.4°]; 8M, 9.8° [1.4°]; 12M, 9.0° [1.5°]), peak knee extensor moment (N·m/kg; 4M, 1.32 [0.13]; 6M, 1.04 [0.13]; 8M, 1.04 [0.13]; 12M, 0.87 [0.15]; 38%-57% deficit), and rate of knee extensor moment (N·m/kg/s; 4M, 22.7 [2.4]; 6M, 17.9 [2.3]; 8M, 17.5 [2.4]; 12M, 16.1 [2.6]; 33%-46% deficit). No changes for these variables from preinjury (P values >.88) were identified in the nonsurgical limb. CONCLUSION After ACLR, surgical limb knee running biomechanics were not restored to the preinjury state by 12M, while nonsurgical limb mechanics remained unchanged as compared with preinjury. Collegiate athletes after ACLR demonstrate substantial deficits in running mechanics as compared with preinjury that persist beyond the typical return-to-sport time frame. The nonsurgical knee appears to be a valid reference for recovery of the surgical knee mechanics during running, owing to the lack of change within the nonsurgical limb.
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Affiliation(s)
- Keith A. Knurr
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Stephanie A. Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Mikel R. Stiffler-Joachim
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Daniel G. Cobian
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Geoffrey S. Baer
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Bryan C. Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA,Department of Biomedical Engineering, University of Wisconsin–Madison, Madison, Wisconsin, USA,Corresponding Author: Bryan C. Heiderscheit, PT, PhD, Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin, 1685 Highland Avenue, Madison, WI 53705-2281, USA ()
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Lee J, Pathak P, Panday SB, Moon J. Effect of Foot-Planting Strategy on Anterior Cruciate Ligament Loading in Women During a Direction Diversion Maneuver: A Musculoskeletal Modeling Approach. Orthop J Sports Med 2020; 8:2325967120963180. [PMID: 33283003 PMCID: PMC7686614 DOI: 10.1177/2325967120963180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/03/2020] [Indexed: 11/15/2022] Open
Abstract
Background Although there is a higher prevalence of noncontact anterior cruciate ligament (ACL) injuries during a direction diversion maneuver (DDM), no previous studies have reported how foot-planting strategies affect ACL loading. Purpose To investigate the effect of foot-planting strategies on ACL loading in women during a DDM task using a musculoskeletal modeling approach. Study Design Descriptive laboratory study. Methods A total of 13 female participants performed a DDM task, which involved running at 4.5 ± 0.2 m/s and turning left at 35° to 55° under a foot-planting strategy in 3 directions: neutral, toe-in, and toe-out. Kinematic and kinetic data were measured with the use of a 3-dimensional motion capture system and force platform to calculate variables such as joint angle, shear force, and moment. Anterior ACL and posterior ACL forces were extracted using musculoskeletal modeling. Results The peak anterior ACL force was significantly larger for the toe-out condition (31.29 ± 4.02 N/body weight [BW]) compared with the toe-in condition (25.43 ± 5.68 N/BW) (P = .047), with no significant difference in the neutral condition. The toe-out condition had a higher knee valgus angle (2.98° ± 4.20°; P = .041), knee shear force (10.20 ± 1.69 N/BW; P = .009), and knee internal rotation moment (-0.18 ± 0.16 N·m/BW×height; P = .012) than the toe-in and neutral conditions. Conclusion Through musculoskeletal modeling, we were able to conclude that the toe-out condition during the DDM might result in a higher risk of ACL injuries. Athletes and sports practitioners should avoid the toe-out foot-planting strategy when participating in a sporting activity. Clinical Relevance Based on these findings, medical professionals and athletic coaches can gain knowledge on how foot-planting strategy affects ACL loading. Understanding the actual cause of an ACL injury can be useful for designing preventive training programs or strategies to decrease the risk of such injuries.
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Affiliation(s)
- Jusung Lee
- Department of Sport Science, Kangwon National University, Chuncheon, Republic of Korea
| | - Prabhat Pathak
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Siddhartha Bikram Panday
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea.,Department of Sport and Leisure Studies, Keimyung University, Daegu, Republic of Korea
| | - Jeheon Moon
- Department of Physical Education, Korea National University of Education, Cheongju, Republic of Korea.,Department of Sport Science, Korea Institute of Sport Science, Seoul, Republic of Korea
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Samaan MA, Ringleb SI, Bawab SY, Greska EK, Weinhandl JT. Altered lower extremity joint mechanics occur during the star excursion balance test and single leg hop after ACL-reconstruction in a collegiate athlete. Comput Methods Biomech Biomed Engin 2018; 21:344-358. [PMID: 29544359 DOI: 10.1080/10255842.2018.1452203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The effects of ACL-reconstruction on lower extremity joint mechanics during performance of the Star Excursion Balance Test (SEBT) and Single Leg Hop (SLH) are limited. The purpose of this study was to determine if altered lower extremity mechanics occur during the SEBT and SLH after ACL-reconstruction. One female Division I collegiate athlete performed the SEBT and SLH tasks, bilaterally, both before ACL injury and 27 months after ACL-reconstruction. Maximal reach, hop distances, lower extremity joint kinematics and moments were compared between both time points. Musculoskeletal simulations were used to assess muscle force production during the SEBT and SLH at both time points. Compared to the pre-injury time point, SEBT reach distances were similar in both limbs after ACL-reconstruction except for the max anterior reach distance in the ipsilateral limb. The athlete demonstrated similar hop distances, bilaterally, after ACL-reconstruction compared to the pre-injury time point. Despite normal functional performance during the SEBT and SLH, the athlete exhibited altered lower extremity joint mechanics during both of these tasks. These results suggest that measuring the maximal reach and hop distances for these tasks, in combination with an analysis of the lower extremity joint mechanics that occur after ACL-reconstruction, may help clinicians and researchers to better understand the effects of ACL-reconstruction on the neuromuscular system during the SEBT and SLH.
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Affiliation(s)
- Michael A Samaan
- a Department of Radiology and Biomedical Imaging , University of California - San Francisco , San Francisco , CA , USA
| | - Stacie I Ringleb
- b Department of Mechanical and Aerospace Engineering , Old Dominion University , Norfolk , VA , USA
| | - Sebastian Y Bawab
- b Department of Mechanical and Aerospace Engineering , Old Dominion University , Norfolk , VA , USA
| | - Eric K Greska
- c Department of Exercise Science and Community Health , University of West Florida , Pensacola , FL , USA
| | - Joshua T Weinhandl
- d Department of Kinesiology, Recreation and Sports Studies , The University of Tennessee , Knoxville , TN , USA
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Mokhtarzadeh H, Yeow CH, Goh JCH, Oetomo D, Ewing K, Lee PVS. Antagonist muscle co-contraction during a double-leg landing maneuver at two heights. Comput Methods Biomech Biomed Engin 2017; 20:1382-1393. [DOI: 10.1080/10255842.2017.1366992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hossein Mokhtarzadeh
- Department of Mechanical Engineering, University of Melbourne, Victoria, Australia
- Department of Orthopedic Surgery, Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Chen Hua Yeow
- Division of Bioengineering, National University of Singapore, Singapore, Singapore
| | - James Cho Hong Goh
- Division of Bioengineering, National University of Singapore, Singapore, Singapore
| | - Denny Oetomo
- Department of Mechanical Engineering, University of Melbourne, Victoria, Australia
| | - Katie Ewing
- Department of Mechanical Engineering, University of Melbourne, Victoria, Australia
| | - Peter Vee Sin Lee
- Department of Mechanical Engineering, University of Melbourne, Victoria, Australia
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Abstract
PURPOSE OF REVIEW As anterior cruciate ligament (ACL) injury is becoming increasingly prevalent in the population of active children and young adolescents, it is crucial to be aware of both the modifiable and nonmodifiable factors that place this population at increased ACL injury risk. Historically, there has not been a definitive consensus on all of these risk factors-particularly the nonmodifiable ones. RECENT FINDINGS The present review has accumulated the most recent evidence for the nonmodifiable risk factors in ACL injury focusing particularly on female gender, generalized joint laxity, knee recurvatum, increased lateral tibial slope, decreased intercondylar notch width, structural lower extremity valgus, limb length discrepancy, family history, and history of contralateral knee ACL injury. SUMMARY Physicians should be aware of the nonmodifiable risk factors for ACL tears in active children and adolescents and should also encourage avoidance of modifiable risk factors in this population. Young athletes with nonmodifiable risk factors are at a particularly increased risk of recurrent injury following ACL reconstruction (ACLR). We believe that a primary extra-articular augmentation via iliotibial band tenodesis at the same time of ACLR may decrease the rate of reinjury for the high risk athlete with multiple nonmodifiable risk factors.
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