Mechanisms, prediction, and prevention of ACL injuries: Cut risk with three sharpened and validated tools.
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. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1843-1855, 2016.
Departments of Orthopedics, Mayo Clinic Biomechanics Laboratories and Sports Medicine Research Center, Physical Medicine and Rehabilitation and Physiology & Biomedical Engineering, Mayo Clinic, 200 First Street SW, RO_Gu_01_28BIOM, Rochester and Minneapolis, Minnesota 55905.|The Ohio State University, Sports Medicine, Biomedical Engineering, Columbus, Ohio 45229.
Timothy E
TE
Hewett
Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229.|Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio 45229.|The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts.|Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania.|Cincinnati Children's Hospital Medical Center, Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, Ohio 45229.|Departments of Pediatrics, University of Cincinnati College of Medicine, Orthopaedic Surgery, Cincinnati, Ohio 45229.
Gregory D
GD
Myer
Department of Physical Therapy, Highpoint University, Highpoint, North Carolina.
Kevin R
KR
Ford
Cincinnati Children's Hospital Medical Center, Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, Ohio 45229.|Department of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229.
Mark V
MV
Paterno
Departments of Orthopedics, Mayo Clinic Biomechanics Laboratories and Sports Medicine Research Center, Physical Medicine and Rehabilitation and Physiology & Biomedical Engineering, Mayo Clinic, 200 First Street SW, RO_Gu_01_28BIOM, Rochester and Minneapolis, Minnesota 55905.|Cincinnati Children's Hospital Medical Center, Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, Ohio 45229.
Carmen E
CE
Quatman
D000070598:Anterior Cruciate Ligament Injuries / Q000209:etiology* / Q000517:prevention & control; D006801:Humans
biomaterials; tendon and ligament