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
Kenneth C. Lam and Jessica G. Markbreiter
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
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.
Nelson Cortes and James Onate
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.
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.
Ratings of drop-jump landings from 20 video recordings of NCAA Division I collegiate athletes, which were randomly selected from a large database.
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.
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.
Suzi Edwards and Mark Liberatore
reliability. Thank you also to the staff at The Exercise Clinic and The EY Gym for agreeing to take part in the study and assisting in the collection of data. References 1. Majewski M , Susanne H , Klaus S . Epidemiology of athletic knee injuries: a 10-year study . The Knee . 2006 ; 13 ( 3 ): 184
Dusa Marn-Vukadinovic and Helena Jamnik
Valid patient-based outcome instruments are necessary for comprehensive patient care that focuses on all aspects of health, from impairments to participation restrictions.
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.
Descriptive validation study.
Isokinetic laboratory in outpatient rehabilitation unit.
101 subjects after unilateral sport knee injury.
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.
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.
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.
Steven Malvasi, Brian Gloyeske, Matthew Johnson and Timothy Miller
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.
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.
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.
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.
Yumeng Li, He Wang and Kathy J. Simpson
tissues (eg, ligament laxity). 6 Though conflicting results have been reported, alterations in biomechanics of CAI have been observed for the ankle, 2 , 7 , 8 knee, 9 – 11 and hip joint 12 during landings. Previous studies also investigated the influence of ankle sprains on knee injury mechanisms. Two
Yvonne M. Golightly, Stephen W. Marshall, Leigh F. Callahan and Kevin Guskiewicz
Injury has been identified as a potential risk factor for osteoarthritis. However, no previous study has addressed playing-career injuries and subsequent osteoarthritis in a large sample of former athletes. The purpose of this study was to describe the prevalence and determinants of arthritis and osteoarthritis in retired professional football players.
Self-reported arthritis prevalence and retrospectively-recalled injury history were examined in a cross-sectional survey of 2,538 retired football players.
Football players reported a high incidence of injury from their professional playing days (52.8% reported knee injuries, 74.1% reported ligament/tendon injuries, and 14.2% reported anterior cruciate ligament tears). For those under 60 years, 40.6% of retired NFL players reported arthritis, compared with 11.7% of U.S. males (prevalence ratio =3.5, 95%CI: 3.3 to 3.7). Within the retired NFL player cohort, osteoarthritis was more prevalent in those with a history of knee injury (prevalence ratio = 1.7, 95%CI: 1.5 to 1.9) and ligament/tendon injury (prevalence ratio = 1.6, 95%CI: 1.4 to 1.9).
In males under the age of 60, arthritis is over 3 times more prevalent in retired NFL players than in the general U.S. population. This excess of early-onset arthritis may be due to the high incidence of injury in football.
Jenny Toonstra and Carl G. Mattacola
Context: Physicians and clinicians need portable, efficient, and cost-effective assessment tools to determine the effectiveness of rehabilitation programs after knee injury. Progress in rehabilitation should be evaluated using valid and reliable measurement methods. Objective: To examine the test-retest reliability of portable fixed dynamometry (PFD), handheld dynamometry (HHD), and isokinetic dynamometry (IKD). In addition, the authors sought to examine the validity of PFD and HHD by comparing differences in peak torque of the knee flexors and extensors to that of the "gold standard" IKD. Design: Repeated measures. Participants: 16 healthy subjects (age 29.3 ± 7.2 y, height 167.4 ± 8.04 cm, mass 73.7 ± 20.0 kg). Main Outcome Measures: The dependent variables were trial (trial 1, trial 2) and instrument (IKD, PFD, and HHD). Results: Test-retest reliability was high for both PFD and IKD. However, fair to poor reliability was found for HHD. There were no differences in peak torque (Nm) between IKD and PFD. However, significant differences in peak torque were observed between IKD and HHD and between PFD and HHD. Conclusions: PFD provides reliable measures of strength and also demonstrates similar output measures as IKD. Its portability, ease of use, and cost provide clinicians an effective means of measuring strength.