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The anterior cruciate ligament injury controversy: is "valgus collapse" a sex-specific mechanism?

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  • معلومة اضافية
    • Abstract:
      BACKGROUND: Anterior cruciate ligament (ACL) injury is a devastating injury that puts an athlete at high risk of future osteoarthritis. Identification of risk factors and development of ACL prevention programmes likely decrease injury risk. Although studies indicate that sagittal plane biomechanical factors contribute to ACL loading mechanisms, it is unlikely that non-contact ACL injuries occur solely in a sagittal plane. Some authors attempt to ascribe the solely sagittal plane injury mechanism to both female and male ACL injuries and rebuff the concept that knee "valgus" is associated with isolated ACL injury. Prospective studies that utilise coupled biomechanical and epidemiological approaches demonstrated that frontal knee motions and torques are strong predictors of future non-contact ACL injury risk in female athletes. Video analysis studies also indicate a frontal plane "valgus collapse" mechanism of injury in women. As load sharing between knee ligaments is complex, frontal as well as sagittal and transverse plane loading mechanisms likely contribute to non-contact ACL injury. The purpose of this review is to summarise existing evidence regarding ACL injury mechanisms and to propose that sex-specific mechanisms of ACL injury may occur, with women sustaining injuries by a predominantly "valgus collapse" mechanism. CONCLUSION: Prevention programmes and interventions that only target high-risk sagittal plane landing mechanics, especially in the female athlete, are likely to be less effective in ameliorating important frontal and transverse plane contributions to ACL injury mechanisms and could seriously hamper ACL injury prevention efforts. Programmes that target the reduction of high-risk valgus and sagittal plane movements will probably prove to be superior for ACL injury prevention. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of British Journal of Sports Medicine is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1Cincinnati Children’s Hospital Research Foundation Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, Ohio, USA University of Toledo, Engineering Center for Orthopaedic Research Excellence, Toledo, Ohio, USA Cincinnati Children’s Hospital Research Foundation, Division of Molecular Cardiovascular Biology Cincinnati, Ohio, USA University of Cincinnati College of Medicine, Departments of Pediatrics, Orthopaedic, Surgery Biomedical Engineering, and Department of Rehabilitation Sciences, College of Allied Health Sciences, Cincinnati, Ohio, USA
    • ISSN:
      0306-3674
    • Accession Number:
      10.1136/bjsm.2009.059139
    • Accession Number:
      39989705
  • Citations
    • ABNT:
      C E QUATMAN. The anterior cruciate ligament injury controversy: is “valgus collapse” a sex-specific mechanism? British Journal of Sports Medicine, [s. l.], v. 43, n. 5, p. 328–335, 2009. DOI 10.1136/bjsm.2009.059139. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=39989705&custid=s8280428. Acesso em: 14 jul. 2020.
    • AMA:
      C E Quatman. The anterior cruciate ligament injury controversy: is “valgus collapse” a sex-specific mechanism? British Journal of Sports Medicine. 2009;43(5):328-335. doi:10.1136/bjsm.2009.059139.
    • AMA11:
      C E Quatman. The anterior cruciate ligament injury controversy: is “valgus collapse” a sex-specific mechanism? British Journal of Sports Medicine. 2009;43(5):328-335. doi:10.1136/bjsm.2009.059139
    • APA:
      C E Quatman. (2009). The anterior cruciate ligament injury controversy: is “valgus collapse” a sex-specific mechanism? British Journal of Sports Medicine, 43(5), 328–335. https://doi.org/10.1136/bjsm.2009.059139
    • Chicago/Turabian: Author-Date:
      C E Quatman. 2009. “The Anterior Cruciate Ligament Injury Controversy: Is ‘Valgus Collapse’ a Sex-Specific Mechanism?” British Journal of Sports Medicine 43 (5): 328–35. doi:10.1136/bjsm.2009.059139.
    • Harvard:
      C E Quatman (2009) ‘The anterior cruciate ligament injury controversy: is “valgus collapse” a sex-specific mechanism?’, British Journal of Sports Medicine, 43(5), pp. 328–335. doi: 10.1136/bjsm.2009.059139.
    • Harvard: Australian:
      C E Quatman 2009, ‘The anterior cruciate ligament injury controversy: is “valgus collapse” a sex-specific mechanism?’, British Journal of Sports Medicine, vol. 43, no. 5, pp. 328–335, viewed 14 July 2020, .
    • MLA:
      C E Quatman. “The Anterior Cruciate Ligament Injury Controversy: Is ‘Valgus Collapse’ a Sex-Specific Mechanism?” British Journal of Sports Medicine, vol. 43, no. 5, May 2009, pp. 328–335. EBSCOhost, doi:10.1136/bjsm.2009.059139.
    • Chicago/Turabian: Humanities:
      C E Quatman. “The Anterior Cruciate Ligament Injury Controversy: Is ‘Valgus Collapse’ a Sex-Specific Mechanism?” British Journal of Sports Medicine 43, no. 5 (May 2009): 328–35. doi:10.1136/bjsm.2009.059139.
    • Vancouver/ICMJE:
      C E Quatman. The anterior cruciate ligament injury controversy: is “valgus collapse” a sex-specific mechanism? British Journal of Sports Medicine [Internet]. 2009 May [cited 2020 Jul 14];43(5):328–35. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=39989705&custid=s8280428