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Do Biomechanics Analyses of the Knee indicate a greater ACL Injury Risk during a particular Phase of Stance during Football Cutting?
Author(s):
Kaila R. (United Kingdom)
,
Kaila R. (United Kingdom)
Affiliations:
Irwin G.
Irwin G.
Affiliations:
ESSKA Academy. Kaila R. May 9, 2018; 209269; P02-1990 Topic: Biomechanics
Dr. Rajiv Kaila
Dr. Rajiv Kaila
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Abstract
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Objectives: The majority of all ACL tears in sports are non-contact in origin. A better understanding when the ACL is at greatest risk can direct injury prevention.

Methods: An eight camera gait analysis system (120Hz) synchronised with a force platform (960Hz) using 3D inverse dynamics enabled prospective measures of absolute knee internal/external rotational moments (Mz), valgus/varus moments (My) and anterior/posterior joint forces (IJFx), throughout stance phase of randomly cued straight ahead running (SA) and sidestep cutting at 30 and 60 degrees using the dominant lower limb. 14 injury-free professional footballers undertook the maneuvers using standardised studded boots on a FIFA approved surface at standardised velocity. A non-parametric ANOVA followed by Friedman's tests were employed to quantified differences between the variables. A significant difference was determined by p < 0.001. Values and timings were compared with critical limits for ACL injury from robotic, in-vivo and cadaveric research .

Results: Peak My sufficient for ACL rupture occurred between 18%-55% of stance when knee flexion was greater than 38°. The range varied between 177.8N-231.6Nm.
Peaks of Mz sufficient for ACL rupture occurred between 33%-58% of the stance phase for 30º and 60º cutting manoeuvres. The range varied between 308.9Nm-352.7Nm.
The peak IJFx was 1344N. Although insufficient for ACL rupture this increased significantly for greater cutting angles from the straight line run (p < 0.001), greatest during 28%-44% of stance.
Knee flexion 20-30degrees puts the ACL at risk and occurred between 10-22% stance and 70-82% stance.

Conclusions: ACL injury risk was greatest with the coincidence of My and Mz between 33-55% of stance. Between 33%-44% of stance when IJFx also peaked may be the most crucial timing for ACL injury. The increasing knee flexion above 30degrees at this time may protect against ACL injury. Coincidence of IJFx, My and Mz peak values at 33-44% of stance may implicate ACL injury and explain concomitant MCL injuries. Training knee flexion during cutting may reduce the risk.

Keywords:
knee, ACL, injury risk, football, cutting
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