May 2014

Late-breaking ACL data raise questions about use of landing-based screening

shutterstock_911573-lrBy Jordana Bieze Foster

A presenter from Norway gave IOC conference attendees a sneak peek at his group’s latest findings and generated considerable discussion by suggesting that many aspects of drop-landing mechanics are not predictive of anterior cruciate ligament (ACL) injury in elite female athletes.

Eirik Kristianslund, MD, a researcher at the Oslo Sports Trauma Research Center, presented the results not as part of a Free Communications session, but as part of a symposium on screening for ACL injury using drop-jump tasks.

Kristianslund and colleagues analyzed landing mechanics in 708 elite female handball and soccer athletes (mean age, 21 years) as they performed a drop jump from a 30-cm height, followed by a maximum-height jump after landing. During seven years of follow-up, 38 players sustained ACL injuries.

Knee valgus angle at initial contact, maximum knee adduction moment, peak vertical ground reaction force, and maximum knee flexion angle were not significantly associated with ACL injury risk. Of the variables measured, the only one that was significantly associated with ACL injury risk was medial knee motion, with an odds ratio of 1.35. However, Kristianslund noted that the average between-group difference in medial knee motion was only 5 mm, and questioned whether that measure would be clinically useful for screening.

Although the findings do not support drop-jump screening to identify high-risk individuals in this population of elite athletes, many of whom may have previously undergone neuromuscular training, Kristianslund cautioned that the results may not apply to other populations.

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