Objetivo: Investigar se há associação entre a diminuição da amplitude de movimento da articulação coxofemoral e a lesão por não-contato do ligamento cruzado anterior em jogadores de futebol. Método: Neste estudo de casos e controles, 50 jogadores de futebol, com lesão por nãocontato do ligamento cruzado anterior do joelho, confirmada por cirurgia, tiveram suas articulações coxofemorais examinadas e comparadas com o grupo controle. Os achados foram estatisticamente analisados, de acordo com dois pontos de corte (70° e 80°, na soma total de rotação interna e rotação externa), em ambos os grupos. Resultados: Uma significativa diminuição na amplitude de movimento da articulação coxofemoral foi encontrada em 38% de todos os indivíduos estudados no menor ponto de corte (70°) e 64% no maior ponto de corte (80°). A diminuição da amplitude de movimento do quadril foi maior no grupo com ruptura de LCA do que no grupo controle, com pequena diferença entre os dois pontos de corte (70° e 80°). A diferença entre pacientes e controles foi estatisticamente significativa (p = 0, 001). Conclusão: Houve uma forte associação entre a diminuição da amplitude de movimento da articulação do quadril e a ruptura de LCA em jogadores de futebol, não somente, mas, principalmente, devido à diminuição da rotação interna. Apesar da falta de comparação com outros esportes, o resultado mostrou um maior aumento da diminuição de amplitude de movimento do quadril no grupo de jogadores de futebol, quando comparado com a população em geral. / Purpose: To investigate whether there is an association between decreased hip range of motion and noncontact anterior cruciate ligament (ACL) injuries in soccer players. Methods: In this case-control study, 50 soccer players with noncontact ACL injuries confirmed by surgery had their hips examined and compared with those of a control group. Findings were statistically analyzed according to cutoff points (70 and 80 degrees of total internal-external rotation sum) for both groups. Results: A significant decrease in hip range of motion was found in 38% of all individuals studied at the lower cutoff point (70 degrees) and 64% at the upper cutoff point (80 degrees). The decrease in hip range of motion was greater in the group with ruptured ACL than in controls, with little difference between the two cutoff points (70 and 80 degrees). The difference between patients and controls was statistically significant (p < 0,001). Conclusions: There was strong association between decreased hip range of motion and ACL ruptures in soccer players, not only but mainly due to internal rotation lessening. Despite lacking comparison with other sports, our findings showed a higher decrease of hip range of motion in the group of soccer players when compared with the general population.

Objetivo: Investigar se há associação entre a diminuição da amplitude de movimento da articulação coxofemoral e a lesão por não-contato do ligamento cruzado anterior em jogadores de futebol. Método: Neste estudo de casos e controles, 50 jogadores de futebol, com lesão por nãocontato do ligamento cruzado anterior do joelho, confirmada por cirurgia, tiveram suas articulações coxofemorais examinadas e comparadas com o grupo controle. Os achados foram estatisticamente analisados, de acordo com dois pontos de corte (70° e 80°, na soma total de rotação interna e rotação externa), em ambos os grupos. Resultados: Uma significativa diminuição na amplitude de movimento da articulação coxofemoral foi encontrada em 38% de todos os indivíduos estudados no menor ponto de corte (70°) e 64% no maior ponto de corte (80°). A diminuição da amplitude de movimento do quadril foi maior no grupo com ruptura de LCA do que no grupo controle, com pequena diferença entre os dois pontos de corte (70° e 80°). A diferença entre pacientes e controles foi estatisticamente significativa (p = 0, 001). Conclusão: Houve uma forte associação entre a diminuição da amplitude de movimento da articulação do quadril e a ruptura de LCA em jogadores de futebol, não somente, mas, principalmente, devido à diminuição da rotação interna. Apesar da falta de comparação com outros esportes, o resultado mostrou um maior aumento da diminuição de amplitude de movimento do quadril no grupo de jogadores de futebol, quando comparado com a população em geral. / Purpose: To investigate whether there is an association between decreased hip range of motion and noncontact anterior cruciate ligament (ACL) injuries in soccer players. Methods: In this case-control study, 50 soccer players with noncontact ACL injuries confirmed by surgery had their hips examined and compared with those of a control group. Findings were statistically analyzed according to cutoff points (70 and 80 degrees of total internal-external rotation sum) for both groups. Results: A significant decrease in hip range of motion was found in 38% of all individuals studied at the lower cutoff point (70 degrees) and 64% at the upper cutoff point (80 degrees). The decrease in hip range of motion was greater in the group with ruptured ACL than in controls, with little difference between the two cutoff points (70 and 80 degrees). The difference between patients and controls was statistically significant (p < 0,001). Conclusions: There was strong association between decreased hip range of motion and ACL ruptures in soccer players, not only but mainly due to internal rotation lessening. Despite lacking comparison with other sports, our findings showed a higher decrease of hip range of motion in the group of soccer players when compared with the general population.

Objetivo: Investigar se há associação entre a diminuição da amplitude de movimento da articulação coxofemoral e a lesão por não-contato do ligamento cruzado anterior em jogadores de futebol. Método: Neste estudo de casos e controles, 50 jogadores de futebol, com lesão por nãocontato do ligamento cruzado anterior do joelho, confirmada por cirurgia, tiveram suas articulações coxofemorais examinadas e comparadas com o grupo controle. Os achados foram estatisticamente analisados, de acordo com dois pontos de corte (70° e 80°, na soma total de rotação interna e rotação externa), em ambos os grupos. Resultados: Uma significativa diminuição na amplitude de movimento da articulação coxofemoral foi encontrada em 38% de todos os indivíduos estudados no menor ponto de corte (70°) e 64% no maior ponto de corte (80°). A diminuição da amplitude de movimento do quadril foi maior no grupo com ruptura de LCA do que no grupo controle, com pequena diferença entre os dois pontos de corte (70° e 80°). A diferença entre pacientes e controles foi estatisticamente significativa (p = 0, 001). Conclusão: Houve uma forte associação entre a diminuição da amplitude de movimento da articulação do quadril e a ruptura de LCA em jogadores de futebol, não somente, mas, principalmente, devido à diminuição da rotação interna. Apesar da falta de comparação com outros esportes, o resultado mostrou um maior aumento da diminuição de amplitude de movimento do quadril no grupo de jogadores de futebol, quando comparado com a população em geral. / Purpose: To investigate whether there is an association between decreased hip range of motion and noncontact anterior cruciate ligament (ACL) injuries in soccer players. Methods: In this case-control study, 50 soccer players with noncontact ACL injuries confirmed by surgery had their hips examined and compared with those of a control group. Findings were statistically analyzed according to cutoff points (70 and 80 degrees of total internal-external rotation sum) for both groups. Results: A significant decrease in hip range of motion was found in 38% of all individuals studied at the lower cutoff point (70 degrees) and 64% at the upper cutoff point (80 degrees). The decrease in hip range of motion was greater in the group with ruptured ACL than in controls, with little difference between the two cutoff points (70 and 80 degrees). The difference between patients and controls was statistically significant (p < 0,001). Conclusions: There was strong association between decreased hip range of motion and ACL ruptures in soccer players, not only but mainly due to internal rotation lessening. Despite lacking comparison with other sports, our findings showed a higher decrease of hip range of motion in the group of soccer players when compared with the general population.

Die Therapie der vorderen Kreuzbandruptur im Wachstumsalter wird nach wie vor kontrovers diskutiert. Es sollte mit der vorliegenden Studie untersucht werden, ob die operative oder konservative Therapie der vorderen Kreuzbandruptur im Wachstumsalter favorisiert werden sollte. Hierzu erfolgte eine Literaturrecherche in den Datenbanken Medline, dem Cochrane controlled trial register, Embase und Medpilot. Zehn Studien mit insgesamt 154 Patienten konnten zur Auswertung der konservativen Therapie, 55 Studien mit 935 Patienten zur operativen Therapie verwendet werden. Das Durchschnittsalter der konservativ behandelten Gruppe lag bei 12,3 (10-14,4) Jahren, das der operativen Gruppe bei 13,3 (10,0-15,8) Jahren. Zusammenfassend ergaben sich signifikant bessere Ergebnisse bezüglich Lysholm Score (95,5 vs. 73,2; p<0,05), der Instabilität gemessen am Giving Way Phänomen (2,8% vs. 89,5%; p<0,05) und der Wiedererlangung des Sportniveaus (91,2% vs. 30,9%; p<0,05) in der operativ versorgten Gruppe. Das relative Risiko für Beinlängendifferenzen von mehr als 1 cm bzw. Achsabweichungen von mehr als 3° nach operativer Behandlung ist mit 2,1% gering. Rerupturen treten in 3,8% der Fälle auf. Kein wesentlicher Einfluss auf das klinische Ergebnis konnte hinsichtlich Nachuntersuchungszeitraum und Publikationsjahr gefunden werden. Aufgrund der vorliegenden Ergebnisse ist die operative Therapie bei der vorderen Kreuzbandruptur im Wachstumsalter der konservativen Therapie überlegen und somit in den meisten Fällen vorzuziehen.

Objective: Anterior cruciate ligament (ACL) injuries are increasing in adolescents and increase the risk for early-onset knee osteoarthritis (OA). Biomarkers can be a non-invasive measure to assess physiological properties following knee injury or trauma. The objective of this thesis was to i) perform a systematic review to determine the most studied biomarkers of knee healing following ACL reconstruction (ACLR), and age of these patients, and ii) explore the feasibility of measuring these biomarkers in adolescents with ACL injuries. Design: Studies were included if i) participants underwent ACLR, and ii) at least one biomarker of healing was measured. Participant age, sample(s) collected, and biomarker(s) studied were recorded. Interleukin-6 (IL-6), c-terminal crosslinking telopeptide of type II collagen (CTX-II) and procollagen type II collagen propeptide (PIICP) were then measured using ELISA in adolescents prior to ACLR in urine (u) and synovial fluid (sf). Spearman’s Rho (rs) coefficients were calculated to determine the association between uCTX-II/sfCTX-II, and uIL-6/sfIL-6. A ratio of PIICP: CTX-II was calculated to represent the ratio of cartilage synthesis to degradation. Results: The review produced six studies evaluating healing following ACLR. IL-6 and CTX-II were the most studied (3/6 studies), and only one study included adolescents (age 19.6±4.5). Due to multiple undetectable biomarker levels, we could only report rs for uCTX-II/sfCTX-II (rs = -.200, p-value = .800, n=4). We also reported a ratio for sfPIICP: sfCTX-II (23.06 ±19.23). Conclusion: Exploring biomarkers in adolescents was motivated by their unique physiology due to puberty, and this was the first study to do so. The findings from this pilot study indicate that further analysis is required to determine optimal sample preparation. This will allow for reliable results while studying the feasibility of these biomarkers during ACLR recovery. This insight can ensure more informed decision making by clinicians clearing patients for return-to-activity.

Year 2019, football, rugby, netball and skiing had most occurring ACL injuries, listed by United Kingdom National Ligament Report (NLR). The standard procedure treatment of complete laceration of the ACL, is performed by tissue autograft implantation designed from a patellar tendon, for replacement of damaged tissue using orthopaedic surgery. The aim of this thesis is to design and fabricate an ACL graft, attempting to mimic the natural ACL, for the purpose of tissue reconstruction. The desired graft analogues exhibited properties imitating native connective tissue, reducing pain through drug delivery with great biocompatibility and enhance suture mechanical strength. Various biomaterials were implemented into this study, utilising strategies; polymer solution fabrication, electrospinning, hydrogel synthesis, mechanical braiding and graft assembly to fabricate an ACL graft. The polymeric material poly (E- caprolactone) (PCL) was researched, utilising its ability to fabricate scaffolds. Results showed, three analogue ACL grafts (Braided PCL-BP, Braided PCL + Hydrogel-BPH & Braided PCL + Sutures-BPS) created utilising the properties of braiding, hydrogels and sutures, ultimately improving the versatility of electrospinning for tissue engineering and reconstruction. Graft analogues were tested and compared against patellar tendons producing similar tensile properties. Poly vinyl alcohol (PVA) hydrogels successfully held ibuprofen, revealing drug delivery characteristics, polyester threads improved mechanical properties of electrospun grafts and dry degradation showed that PCL did not lose significant mass over two months. Conclusion, tensile strength of patella tendon was 395x, 790x & 56x of analogue grafts (BP, BPH & BPS) respectively, having potential for improvement of tensile parameters for ligament reconstruction.

No / Objective To evaluate landing strategies of female football and basketball athletes with relation to possible injury mechanisms and disparity in injury. Design Descriptive laboratory study. Participants 52 female football players and 41 female basketball players. Main outcome measures Frontal plane projection angle (FPPA) was measured during the single leg land (SLL) and drop jump (DJ) screening tasks. Results 2 × 2 × 2 mixed factorial ANOVA showed significant main effects were observed for sport, whilst significant interaction effects were seen between sport and task. Females in both sports exhibited significantly greater FPPA values during the SLL task than the DJ task (p < 0.001). Basketball players demonstrated significantly greater FPPA values during SLL than football players (p < 0.001), whilst no differences were found between sports in the DJ task (p = 0.328). Conclusion Female basketball players display greater FPPA values during unilateral landing tasks than female football players which may reflect the greater ACL injury occurrence in this population. Injury prevention programs in these athletes should incorporate unilateral deceleration and landing tasks and should consider the specific injury mechanisms in each sport.

No / Objective To assess the learning effect, test–retest reliability and measurement error associated with the SEBT. Design Repeated-measures study. Setting Controlled university laboratory environment. Participants Twenty-two healthy recreational athletes (11 male age 22.3 ± 3.7 years, 11 female age 22.8 ± 3.1 years). Main Outcome Measures Repeated-measures ANOVA assessed learning affects. Intraclass correlations coefficients, standard error of measurement and smallest detectable difference values were calculated to assess reliability and measurement error. Results Results showed that excursion distances stabilised after four trials, therefore trials five to seven were analysed for reliability. Test–retest reliability for all reach directions was high, with intraclass correlation coefficients ranging from 0.84 to 0.92. 95% confidence intervals, standard error of measurement and smallest detectable difference ranged from 77.84 to 94.00, 2.21–2.94% and 6.13–8.15%, respectively. Conclusion These statistics will allow clinicians to evaluate whether changes in SEBT scores are due to change in an individual’s performance or random error. The findings of this study show that the SEBT is a reliable measure of lower limb function in healthy recreational athletes. Changes in normalised scores of at least 6–8% are needed to feel confident that a real change in SEBT performance has occurred.