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Kenneth C. Lam and Jessica G. Markbreiter

Knee injuries are common in interscholastic sports and account for 15.2% of all reported sport-related injuries. 1 , 2 Although ankle sprains are the most commonly reported sport-related injury, 3 knee injuries account for the largest percentage of severe injuries (ie, an injury that causes more

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Francesca Genoese, Shelby Baez and Johanna M. Hoch

Clinical Scenario More than 2.5 million athletic injuries present to emergency departments each year, and approximately 700,000 are knee injuries. 1 Common knee injuries that may occur during athletic participation include sprains, strains, contusions, fractures, dislocations, and tendinopathies

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Laura Miele, Carl W. Nissen, Kevin Fitzsimmons, Trudy Lerer and Garry Lapidus

Injury prevention programs have a positive effect on performance and the reduction of risk in most studies and reviews. However, not all teams and coaches utilize them. In order to better understand this, a 19-item survey was conducted to assess high school coaches’ perceptions, attitudes, and current practices regarding knee injury prevention among adolescent athletes during a mandatory Connecticut certification/re-certification course. The results of the survey show that high school coaches report a wide variability in their attitudes and utilization of training programs related to knee injury prevention. Coaches reported several barriers to employing the programs; the leading issue being time. Future education and outreach efforts should address the barriers in order to increase use of injury prevention training.

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Nelson Cortes and James Onate

Context:

Clinical assessment tools are needed to identify individual athletes who possess elevated risk for anterior cruciate ligament injury. Existing methods require expensive equipment and the investment of a large amount of time for data processing, which makes them unfeasible for preparticipation screening of a large number of athletes.

Objective:

To assess the extent of agreement between LESS and the iLESS classifications of jump landing performance and the level of agreement between ratings assigned by a novice evaluator and an expert evaluator.

Methods:

Ratings of drop-jump landings from 20 video recordings of NCAA Division I collegiate athletes, which were randomly selected from a large database.

Results:

The dichotomous iLESS score corresponded to the dichotomous classification of LESS score for 15 of 20 cases rated by the expert evaluator and 17 of 20 cases rated by the novice evaluator. For the iLESS, only 2 scores out of 20 differed between the evaluators.

Conclusions:

A high level of agreement was observed between the LESS and iLESS methods for classification of jump- landing performance. Because the iLESS method is inexpensive and efficient, it may prove to be valuable for preparticipation assessment of knee injury risk.

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Dusa Marn-Vukadinovic and Helena Jamnik

Context:

Valid patient-based outcome instruments are necessary for comprehensive patient care that focuses on all aspects of health, from impairments to participation restrictions.

Objective:

To validate the Slovenian translation of Medical Outcome Survey (MOS) Short Form Health Survey (SF-36) and to assess relations among various knee measurements, activity tested with Oxford Knee Score (OKS) and health-related quality of life as estimated with SF-36 domains.

Design:

Descriptive validation study.

Setting:

Isokinetic laboratory in outpatient rehabilitation unit.

Participants:

101 subjects after unilateral sport knee injury.

Interventions:

All subjects completed the SF-36 and OKS, and isokinetic knee-muscle strength output at 60°/s was determined in 78 participants. Within a 3-d period, 43 subjects completed the SF-36 and OKS questionnaires again.

Main Outcome Measures:

Reliability testing included internal consistency and test–retest reliability. Correlations between SF-36 subscales and OKS were calculated to assess construct validity, and correlation between SF-36 subscales and muscle strength was calculated to assess concurrent validity.

Results:

Chronbach α was above .78 for all SF-36 subscales. ICCs ranged from .80 to .93. The correlation between OKS and the physical-functioning subscale, showing convergent construct validity, was higher (r = .83, P < .01) than between OKS and mental health (r = .50, P < .01), showing divergent construct validity. Knee-extensor weakness negatively correlated with physical-functioning (r = −.59, P < .01) and social-functioning (r = −.43, P < .01) subscales.

Conclusions:

The Slovenian translation of the SF-36 is a reliable and valuable tool. The relationships between knee-muscle strength and activity and between knee-muscle strength and SF-36 subscales in patients after sport knee injury were established.

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Steven Malvasi, Brian Gloyeske, Matthew Johnson and Timothy Miller

Background:

Injury to the anterior cruciate ligament (ACL) is one of the most common orthopedic injuries in the United States, while injury to the patellar tendon (PT) is less common. A combined rupture to the ACL and PT is consequentially uncommon and increases the difficulty of a correct initial diagnosis. The purpose of this paper is to critically appraise the current peer-reviewed literature regarding multi-ligamentous knee injuries (MLKI) in sport.

Methods:

A systematic review was undertaken to identify all relevant peer-reviewed articles regarding MLKI from March 1980 to January 2015. All articles pertaining to simultaneous rupture of the ACL and PT were included for review.

Results:

A total of 27 cases presented in 15 articles were used. Findings suggest that the combination of a palpable gap over the PT, a positive Lachman test, inability to complete terminal knee extension, and a superior position of the patella are clinical examination markers for a possible MLKI involving the ACL and PT.

Conclusion:

Simultaneous rupture to the ACL and PT is incredibly rare within the sport population, making diagnosis and treatment of such injury challenging. A thorough examination of the extensor mechanism of the knee is important in making the proper diagnosis.

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Guilherme S. Nunes, Igor Yamashitafuji, Bruna Wageck, Guilherme Garcia Teixeira, Manuela Karloh and Marcos de Noronha

Context: The treatment of edema after a knee injury is usually 1 of the main objectives during rehabilitation. To assess the success of treatment, 2 methods are commonly used in clinical practice: volumetry and perimetry. Objective: To investigate the intra- and interassessor reliability of volumetry and perimetry to assess knee volume. Design: Cross-sectional. Setting: Laboratory. Participants: 45 health participants (26 women) with mean age of 22.4 ± 2.8 y. Main Outcome Measures: Knee volume was assessed by 3 assessors (A, B, and C) with 3 methods (lower-limb volumetry [LLV], knee volumetry [KV], and knee perimetry [KP]). Assessor A was the most-experienced assessor, and assessor C, the least experienced. LLV and KV were performed with participants in the orthostatic position, while KP was performed with participants in supine. Results: For the interassessor analysis, the ICC2,1 was high (.82) for KV and very high for LLV (.99) and KP (.99). For the intra-assessor analysis, ICC2,1 ranged from moderate to high for KV (.69-.83) and was very high for LLV (.99) and KP (.97-.99). Conclusion: KV, LLV, and KP are reliable methods, both intra- and interassessor, to measure knee volume.

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Herbert Wagner, Patrick Fuchs, Andrea Fusco, Philip Fuchs, Jeffrey W. Bell and Serge P. von Duvillard

·kg −1 ·min −1 for male vs 49.6 [4.8] mL·kg −1 ·min −1 for female players). 1 Differences between male and female players were also found in the number of injuries during training or game, whereas the risks for knee injuries (traumatic and overuse) in female players are significantly higher compared

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Johanna M. Hoch and Carl G. Mattacola

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Mikiko Nakajima and Mallori Tittle