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Megan P. Brady and Windee Weiss

Clinical Scenario A common injury among elite, recreational, and youth athletes is the anterior cruciate ligament (ACL) tear. 1 Approximately 200,000 ACL injuries occur every year. 2 The gold standard in ACL injury evaluation is diagnostic arthroscopy 3 , 4 ; however, the diagnostic accuracy of

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Steven H. Ryder, Robert J. Johnson, Bruce D. Beynnon and Carl F. Ettlinger

Athletes are particularly at risk for anterior cruciate ligament injury, and there is some evidence that female athletes are more at risk than males. The conflicting principles of stability and mobility are at odds within the knee, setting the stage for potentially serious injuries. Some investigators suggest that the size of the intercondylar notch should be used to identify athletes at risk for ACL damage, but more research is required before clinical decisions can be based on notch width measurements. Athletic shoe modifications and artificial playing surfaces may influence the incidence of ACL injures. Functional knee braces appear to have beneficial strain shielding effect on the ACL for anterior directed loads and internal–external torques applied to the tibia, but this effect appears to decrease as the magnitude of these anterior directed loads and torques increases. Ski equipment is often pointed to as a contributing factor in ACL injuries, but there is no evidence that modifications in ski equipment will decrease ACL disruptions. An education program based on recognizing the events that lead to ACL injury in skiing may reduce knee injuries in the future.

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Grant E. Norte, Katherine R. Knaus, Chris Kuenze, Geoffrey G. Handsfield, Craig H. Meyer, Silvia S. Blemker and Joseph M. Hart

Anterior cruciate ligament (ACL) injuries continue to constitute a common major joint injury among active individuals, often resulting in high economic costs, 1 reduced physical activity, 2 and decreased quality of life. 2 An estimated range of 80,000 to more than 250,000 ACL injuries are

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Grant E. Norte, Jay N. Hertel, Susan A. Saliba, David R. Diduch and Joseph M. Hart

Clinical outcomes following anterior cruciate ligament reconstruction (ACL-R) are often evaluated based on impairment and patient-reported function. The use of clinically meaningful tests is an important aspect of return to activity decision making following ACL-R. Information from a variety of

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Dawn T. Gulick

The prevalence of knee disorders is estimated at more than 50% in a lifetime. 1 , 2 There are approximately 250,000 to 300,000 anterior cruciate ligament (ACL) injuries per year in the United States. 2 , 3 There are over 175,000 reconstructions annually. 2 , 3 Athletes involved in high

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Jessica E. Digiacomo, Riann M. Palmieri-Smith, John A. Redman III and Lindsey K. Lepley

Anterior cruciate ligament (ACL) injuries are among the most functionally disabling conditions in orthopedics, most commonly occurring in young athletes between the ages of 15 and 25. 1 , 2 The rate of injury is estimated at more than 200,000 times per year, with about 75% of individuals electing

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Pier Paolo Mariani, Luca Laudani, Jacopo E. Rocchi, Arrigo Giombini and Andrea Macaluso

Anterior cruciate ligament (ACL) rupture is one of the most common traumatic injuries among physically active individuals. Surgical reconstruction remains the standard approach for athletes who aim to return to high-level sporting activities and aims to re-establish the ligamentous stability of the

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Erica M. Willadsen, Andrea B. Zahn and Chris J. Durall

Clinical Scenario The high prevalence of noncontact anterior cruciate ligament (ACL) injuries in adolescent female athletes is thought to originate from hormonal, neuromuscular, and structural differences between sexes. 1 Although hormonal and structural factors are nonmodifiable, neuromuscular

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Mary Lloyd Ireland, Michael Gaudette and Scott Crook

The high rate of noncontact ACL injuries in female athletes has become a prominent and controversial subject. This article attempts to provide insight into this trend in athletic injuries. Anatomic, physiological, and biomechanical differences are discussed as possible causative factors. Epidemiological data regarding ACL injuries are reviewed, comparing the genders. The discussion also includes anecdotal findings that support current research. This review is intended to raise awareness of the problem and promote screening for risk factors and implementation of more thorough and aggressive preventive programs.

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Melissa DiFabio, Lindsay V. Slater, Grant Norte, John Goetschius, Joseph M. Hart and Jay Hertel

decision-making in athletes, especially when using objective data to assist with decisions. 15 , 16 Limb symmetry index (LSI) is commonly used to quantify deficits between the involved (ACLR limb) and contralateral, healthy limb. 17 – 19 Quadriceps strength asymmetry is present after initial ACL injury