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Noncontact Anterior Cruciate Ligament Injuries: Risk Factors and Prevention Strategies

Griffin, Letha Y. MD, PhD; Agel, Julie MA, ATC; Albohm, Marjorie J. MS, ATC; Arendt, Elizabeth A. MD; Dick, Randall W. MS; Garrett, William E. MD, PhD; Garrick, James G. MD; Hewett, Timothy E. PhD; Huston, Laura MS; Ireland, Mary Lloyd MD; Johnson, Robert J. MD; Kibler, W. Benjamin MD; Lephart, Scott PhD, ATC; Lewis, Jack L. PhD; Lindenfeld, Thomas N. MD; Mandelbaum, Bert R. MD; Marchak, Patricia ATC; Teitz, Carol C. MD; Wojtys, Edward M. MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: May-June 2000 - Volume 8 - Issue 3 - p 141-150
Perspectives on Modern Orthopaedics

An estimated 80,000 anterior cruciate ligament (ACL) tears occur annually in the United States. The highest incidence is in individuals 15 to 25 years old who participate in pivoting sports. With an estimated cost for these injuries of almost a billion dollars per year, the ability to identify risk factors and develop prevention strategies has widespread health and fiscal importance. Seventy percent of ACL injuries occur in noncontact situations. The risk factors for noncontact ACL injuries fall into four distinct categories: environmental, anatomic, hormonal, and biomechanical. Early data on existing neuromuscular training programs suggest that enhancing body control may decrease ACL injuries in women. Further investigation is needed prior to instituting prevention programs related to the other risk factors.

The information in this article was derived in part from discussions at the Hunt Valley Consensus Conference on Prevention of Noncontact ACL Injuries (conducted under the joint sponsorship of the American Orthopaedic Society for Sports Medicine, the Orthopaedic Research and Education Foundation, the National Athletic Trainers Association Research and Education Foundation, and the National Collegiate Athletic Association), Hunt Valley, Md, on June 10, 1999.

One or more of the authors or the departments with which they are affiliated have received something of value from a commercial or other party related directly or indirectly to the subject of this article.

Reprint requests: Dr. Griffin, Peachtree Orthopaedic Clinic, Suite 705, 2001 Peachtree Road, Atlanta, GA 30309.

Dr. Griffin is Team Physician, Georgia State University, Atlanta, and Staff Physician, Peachtree Orthopaedic Clinic, Atlanta. Ms. Agel is Research Coordinator, Orthopaedics Department, University of Minnesota, Minneapolis. Ms. Albohm is Director, Orthopaedic Research Foundation, Orthopaedics Indianapolis, Center for Hip and Knee Surgery, Mooresville, Ind. Dr. Arendt is Associate Professor of Orthopaedics, University of Minnesota, Minneapolis. Mr. Dick is Senior Assistant Director of Health and Safety, National Collegiate Athletic Association, Indianapolis. Dr. Garrett is Frank C. Wilson Professor and Chairman, Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill. Dr. Garrick is Clinical Professor of Pediatrics, University of California Center for Sports Medicine, San Francisco. Dr. Hewett is Assistant Professor and Director of Applied Research, Cincinnati Sportsmedicine Research and Education Foundation, University of Cincinnati, Cincinnati. Ms. Huston is Senior Research Associate, Section of Orthopaedic Surgery, University of Michigan—MedSport, Ann Arbor. Dr. Ireland is Professor and Team Physician, Department of Orthopaedics, Eastern Kentucky University, Lexington. Dr. Johnson is Vice Chairman, Academic Affairs, and Head, Division of Sports Medicine, Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington. Dr. Kibler is Medical Director, Lexington Sports Medicine Center, Lexington, Ky. Dr. Lephart is Associate Professor of Orthopaedic Surgery and Director, Neuromuscular Research Laboratory, University of Pittsburgh, Pittsburgh. Dr. Lewis is Professor, Orthopaedic Surgery Department, University of Minnesota, Minneapolis. Dr. Lindenfeld is Associate Director, Cincinnati Sports Medicine and Orthopaedic Center, Cincinnati. Dr. Mandelbaum is Fellowship Director, Santa Monica Orthopaedic and Sports Medicine Group, Santa Monica, Calif. Ms. Marchak is Research Analyst, Department of Orthopaedics, Duke University Medical Center, Durham, NC. Dr. Teitz is Associate Professor of Orthopaedics, University of Washington, Seattle. Dr. Wojtys is Professor of Orthopaedic Surgery, University of Michigan, Ann Arbor.

© 2000 by American Academy of Orthopaedic Surgeons
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