ACL Injuries; Young athletes who do not achieve a 90% score on a battery of tests that measure fitness to return to athletic competition; so including quadricep strength, are at increased risk for a second knee injury, according to research presented at the Annual Meeting of the American Orthopedic Society of Sports Medicine.
An ACL injury is a tear or sprain of the anterior cruciate (KROO-she-ate) ligament (ACL) one of the major ligaments in your knee. ACL injuries most commonly occur during sports that involve sudden stops or changes in direction, jumping and landing such as soccer, basketball, football and downhill skiing. Many people hear or feel a “pop” in the knee when an ACL injury occurs. Your knee may swell, feel unstable and become too painful to bear weight.
Anterior cruciate ligament
Orthopedic surgeons and sports medicine professionals have established return-to-sports criteria; hence to help guide patients as they consider participating in athletic competition after injury. Researchers pointed to the strength of the quadricep as one of the most important; hence measures to predict risk for further injury to the anterior cruciate ligament. Each patient was given a return to sport assessment that include six tests: isometric quadriceps strength, four functional hop tests and the International Knee Documentation Committee (IKDC) patient report outcome survey.
Limb symmetry index was calculate for strength and hop test assessments. Subjects were classify as patients who successfully pass all six return-to-sport; tests at a level of 90 compare to those that fail to meet all six criteria. The researchers sought to determine if successfully passing all six measures result; so in a reduce risk of second ACL injury in the first 24 months after returning to their sport, as well as to assess if ability to successfully pass individual return-to-sport; criteria result in reduce risk of a second ACL injury.
Contralateral ACL Injuries
Of the 181 patients enrolled, 39 suffer a second ACL injury with 18 ipsilateral graft failures; also 21 contralateral ACL tears in the first 24 months after RTS following surgery. At the time of return-to-sport assessment; 57 patients achieve 90% or greater on all testing. When individual return-to-sport criterion were evaluate; so patients who fail to achieve 90% quadricep strength were 84% less likely to suffer an ipsilateral graft failure but three times more likely to suffer a contralateral ACL injury.
The doctors report that current criteria to evaluate readiness to return young athletes; hence to pivoting and cutting sports may not identify young, active patients independently; hence at high risk for a future ipsilateral graft tear or contralateral ACL injury. “Further investigation is need on the relationship between quad strength and side of future ACL injury; also whether other factors may help contribute to a predictive model of future ACL injury specific to limb,” said Paterno.