Hip biomechanics differ in responders and non-responders to an ACL injury prevention program

Knee Surg Sports Traumatol Arthrosc. 2020 Apr;28(4):1236-1245. doi: 10.1007/s00167-018-5158-1. Epub 2018 Sep 27.

Abstract

Purpose: To investigate the differences in demographic, anthropometric, biomechanical, and/or performance variables between those that do (responders) and do not (non-responders) exhibit reductions in knee abduction moments after an anterior cruciate ligament injury prevention program (ACL-IPP).

Methods: Forty-three adolescent female athletes completed biomechanical (3D motion analysis of a drop vertical jump) and performance testing before and after randomization into a 6-week ACL-IPP. Participants were classified into responders and non-responders based on their level of reduction of knee abduction moment from pre- to post-test.

Results: Compared to non-responders, responders exhibited increased hip adduction excursion at baseline (p = 0.02) and trended towards attending more training sessions (p = 0.07) and participating in soccer and not basketball (p = 0.07). Responders also showed greater improvements in hip flexion angles (p = 0.02) and moments (p < 0.001), and knee abduction angles (p < 0.001) and excursions (p = 0.001). There were no significant differences in age or experience with prior injury prevention programs (n.s.).

Conclusions: After an ACL-IPP, athletes that exhibit the greatest reduction in knee abduction moments exhibit greater hip adduction excursion at baseline and show corresponding improvements in hip flexion and knee abduction kinematics and hip flexion moments. These results can help clinicians prospectively identify individuals that may not respond to an ACL-IPP and target individualized training for those at risk of injury.

Level of evidence: I.

Clinical trial registration number: Clinicaltrials.gov NCT02530333.

Keywords: Anterior cruciate ligament; Injury prevention; Knee abduction moments; Knee valgus.

MeSH terms

  • Adolescent
  • Anterior Cruciate Ligament Injuries / physiopathology
  • Anterior Cruciate Ligament Injuries / prevention & control*
  • Athletes*
  • Basketball / injuries*
  • Biomechanical Phenomena
  • Female
  • Hip Joint / physiopathology*
  • Humans
  • Knee Joint / physiopathology*
  • Movement / physiology*
  • Risk Factors
  • Soccer / injuries*
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT02530333