A lesão do ligamento cruzado anterior (LCA) é incapacitante para vários esportes pela instabilidade e deficiência funcional. O tratamento indicado é a reconstrução cirúrgica do ligamento, no entanto, nem sempre a recuperação funcional após a operação é suficiente para o retorno ao esporte. O objetivo deste estudo foi avaliar o controle postural dinâmico, a força muscular e o parâmetro funcional medido pelo Hop Test de atletas com e sem lesão do LCA. Métodos: Foram incluídos 74 atletas, 60 homens e 14 mulheres, com idades entre 16 e 45 anos, divididos em dois grupos: Grupo-Lesão LCA (GL) com 34 atletas (25,05 anos ± 6,82) e Grupo-Controle (GC) com 40 atletas sem lesão de LCA (27,7 anos ± 8,16). Todos os voluntários realizaram posturografia, dinamometria isocinética e o Hop Test. O GL foi avaliado antes e 12 meses após a reconstrução. O Grupocontrole (GC) foi avaliado num único momento. Resultados: Nas comparações pré e pós-operatórias do GL: a posturografia mostrou maior área de deslocamento no pré-operatório; na dinamometria isocinética, o pico de torque e trabalho total foram maiores no pós-operatório, mas a relação entre músculos flexores e extensores foi menor que a preconizada em ambas as avaliações (pré e pós-operatório); no Hop Test, a distância saltada e a simetria entre os membros foram maiores no pós-operatório. Na comparação com o GC, a posturografia mostrou maior oscilação anteroposterior e menor oscilação mediolateral no GL pré-operatório; na dinamometria isocinética, o pico de torque e trabalho total foram maiores no pré-operatório. No pós-operatório, GL mostrou maior relação entre flexores e extensores que GC. Conclusão: Os atletas submetidos à reconstrução do LCA apresentaram melhor desempenho funcional na avaliação pós-operatória quando comparados com o pré-operatório e com GC. Porém, os parâmetros isocinéticos apresentaram recuperação incompleta / The injury of the anterior cruciate ligament (ACL) is crippling for various sports by instability and functional impairment. The recommended treatment is surgical ligament reconstruction, however, sometimes that functional recovery after operation is not enough to return to the sport. The objective of this study was to evaluate the dynamic postural control, muscle strength, and functional parameter measured by Hop Test of athletes with and without ACL injury. Method: We included 74 athletes, 60 men and 14 women, who are between 16 and 45 years old, divided into two groups: Injury Group (GL) with 34 athletes (25.05 years ± 6.82) and Group Control (GC) with 40 athletes without ACL injury (27.7 years ± 8.16). All volunteers held posturography, isokinetic dynamometry and the Hop Test. The GL was assessed before and 12 months after the reconstruction. The Control Group was evaluated in a single moment. Results: Pre and postoperative comparison of GL: posturography showed greater area of displacement; in isokinetic dynamometry, peak torque and total work were higher in the postoperative period, but the relationship between flexors and extensors muscles was lower than recommended in both evaluation (pre and postoperative); in Hop Test, the distance hopped and the symmetry between the limbs was greater in the postoperative period. In comparison to the GC, posturography showed greater anteroposterior oscillation and lower mediolateral oscillation in preoperative GL; in isokinetic dynamometry, peak torque and total work were higher in GL preoperative. In postoperative period GL showed higher relationship between flexors and extensors than GC. Conclusion: The athletes submitted to ACL reconstruction showed better functional performance in postoperative assessment when surgery was compared to the preoperative period, and to GC. However, isokinetic parameters showed incomplete recovery

Bakgrund: Främre korsbandsskador är en av de vanligaste och svåraste skadorna inom damfotboll. Det finns stark evidens för att skadeförebyggande knäkontrollsträning förebygger främre korsbandsskador om följsamheten till träningen är hög. Syfte: Syftet med studien är att undersöka kvinnliga fotbollsspelares följsamhet till knäkontrollsträning och om det finns ett samband mellan följsamhet och self-efficacy, upplevda fördelar, upplevda hinder, yttre påminnelser, upplevd sårbarhet samt upplevd allvarlighetsgrad.  Metod: En kvantitativ ansats med en icke-experimentell tvärsnittsdesign har använts för att besvara studiens syfte och frågeställningar. Ett ändamålsenligt urval har tillämpats och data samlades in genom en webbenkät där 73 besvarade enkäter inkom. En deskriptiv frekvensanalys och Spearman’s rangkorrelation användes för att analysera resultatet. Resultat: 58,9% av deltagarna utförde knäkontrollsträning >2 ggr/veckan och följer rekommendationerna för knäkontrollsträning. Det fanns ett lågt samband mellan knäkontrollsträning och upplevda hinder, self-efficacy och yttre påminnelser. Mellan resterande variabler, divisioner och knäkontrollsträning förelåg inget signifikant samband.  Slutsatser: Resultatet tyder på en högre följsamhet till knäkontrollsträning än vad tidigare studier påvisat, dock anses följsamheten fortfarande vara för låg. Resultatet visar även på inget eller lågt samband mellan knäkontrollsträning och de centrala begreppen i HBM. Vidare forskning bör göras på ett större antal deltagare, män och ur andra beteendemedicinska perspektiv.

Bakgrund: Skada på främre korsbandet (ACL) är en av de vanligaste skadorna en fotbollsspelare kan drabbas av. Anatomi och fysiologi kan förklara varför kvinnor drabbas i högre grad än män. Vid tillämpning av knäkontroll har incidensen av korsbandsskador setts minska men följsamhet till programmet har setts vara låg. Motivation och följsamhet är viktigt för att vidmakthålla ett hälsorelaterat beteende och med hjälp av en fysioterapeuts kompetenser inom beteendemedicin kan förutsättningarna optimeras för att öka tillämpningen av knäkontrollsträning. Syfte: Undersöka upplevelser av vad som motiverar och hindrar kvinnliga fotbollsspelare till genomförande av knäkontrollsträning. Metod: En kvalitativ beskrivande design med semistrukturerad intervjuguide. Sju kvinnliga fotbollsspelare inom Damallsvenskan och division 1 inkluderades. Manifest innehållsanalys med en induktiv ansats användes. Resultat: 12 underkategorier uppdelade i fyra kategorier presenterades: Spelarens attityd till knäkontrollsträning, tid, kunskap för knäkontroll, förväntningar på effekter av knäkontroll. Slutsats: Uppsatsen påvisar att det finns flera psykosociala motivatorer och hinder för genomförande av knäkontrollsträning. Beteendemedicinsk tillämpning vid implementering av programmet kan optimera förutsättningarna för att fotbollsspelare ska utföra programmet.

Introduktion: En främre korsbandsskada är en vanlig idrottsskada där många efter rehabiliteringen inte återgår till sin tidigare aktivitetsnivå. Förutom nedsatt knäfunktion kan många faktorer spela in i valet att återgå eller inte exempelvis motivation, rädsla och identitetsförlust. Studiens syfte var att utforska fysioterapeuters tankar, erfarenheter och rutiner kring psykosocial hälsa hos patienter med en främre korsbandsskada med målet om att återgå till tidigare idrott. Metod: Studien har genomförts genom en kvalitativ intervjustudie med en induktiv ansats samt en semistrukturerad intervjuguide. Fem fysioterapeuter som aktivt arbetade med främre korsbandsskador inkluderades. Intervjuerna analyserades utifrån innehållsanalys enligt Graneheim och Lundman. Resultat: Innehållsanalysen resulterade i ett tema; Psykosocial hälsa, en gråzon för fysioterapeuter med tre kategorier; Psykosociala faktorer påverkar patientens rehabilitering, En god rehabilitering kräver engagemang och ett helhetsperspektiv, Delad syn på betydelsen av psykosocial hälsa inom rehabilitering. Resultatet visar på en medvetenhet om att en korsbandsskada kan påverka patientens psykosociala hälsa negativt, men hur fysioterapeuterna arbetar med psykosocial hälsa skiljer sig åt. Slutsats: Psykosocial hälsa är en synlig faktor i rehabiliteringen av en främre korsbandsskada och är ett område där fysioterapeuterna saknar rutiner, resurser och tillräcklig kunskap. Det lyfts en delad åsikt hos fysioterapeuterna kring vem som ansvarar för patientens psykosociala hälsa. Den här studien illustrerar en brist på tydlighet kring fysioterapeutens roll vid psykosocial hälsa i rehabiliteringen och kan ligga till grund för framtida forskning.

<p>Ova studija je bila prospektivnog karaktera. Uz dopu&scaron;tenje etičkog komiteta Kliničkog centra Vojvodine istraživanje je sprovedeno na Klinici za ortopedsku hirurgiju i traumatologiju i obuhvatilo je 60 pacijenata mu&scaron;kog pola, koji su metodom slučajnog izbora na randomizirani način uključeni u ispitivanje, a koji se aktivno i profesionalno bave fudbalom, ko&scaron;arkom ili odbojkom,&nbsp; primljenih na Kliniku za ortopedsku hirurgiju radi artroskopske rekonstrukcije pokidanog prednjeg ukr&scaron;tenog ligamenta. U ispitivanje su uključeni samo oni pacijenti koji su dali potpisani informisani pristanak da učestvuju u ispitivanju, koji su zadovoljii sve kriterijume za uključivanje i koji nisu imali niti jedan kriterijum za isključivanje iz studije. Kriterijumi za uključivanje u studiju&nbsp; podrazumevali su sledeće: da je pacijent&nbsp; primljen na Kliniku za ortopedsku hirurgiju i traumatologiju Kliničkog centra Vojvodine u Novom Sadu radi operativnog lečenja prekida prednjeg ukr&scaron;tenog ligamenta kolena, da je potpisao informisani pristanak za uključivanje, da je starosne dobi od 18 do 45 godina, da se aktivno i profesionalno bave fizičkom aktivno&scaron;ću regulisanom pravilima (fudbal, odbojka, ko&scaron;arka). Kriterijumi za isključivanje pacijenata iz istraživanja bili su sledeći: prisustvo udružene povrede i spolja&scaron;njeg pobočnog ligamenta koja zahteva operativno lečenje, pojava težih op&scaron;te &ndash; hirur&scaron;kih komplikacija, želja pacijenta da bude isključen iz daljeg ispitivanja, bez obaveze da tu svoju odluku obrazloži. U prvoj fazi konstruisan je aparat, digitalni goniometar, uz pomoć kojeg je urađen eksperimentalni deo ovog ispitivanja i napravljena je baza podataka sa poljima za upis deskriptivnih i antropometrijskih parametara. Potom je uz pomoć aparata svim ispitanicima testirana sposobnost propriocepcije (JPS). Testiranje&nbsp; je obavljeno preoperativno na povređenom i nepovređenom ekstremitetu, u dva maha: odmah po zadavanju ciljnog ugla od 35&deg; i nakon 5 minuta. Druga faza je obavljena minimum 6 meseci nakon operativnog lečenja, hirur&scaron;kom, artroskopskom rekonstrukcijom pokidanog prednjeg ukr&scaron;tenog ligamenta kost-tetiva-kost tehnikom (bone-tendo-bone, BTB). Klinički pregled&nbsp; svakog pacijenta je podrazumevao proveru rezultata Lachman testa (pozitivan/negativan), Lysholm i IKDC bodovne skale za koleno i to preoperativno a potom i tokom postoperativnog kontrolnog pregleda. Po uzoru na mnoge sajtove renomiranih ortopedskih organizacija (http://www.orthopaedicscore.com/), naparavljen je on-line upitnik na Google drive-u gde su u elektronskom obliku prikupljani podaci za skale koje smo koristili. Dobijeni rezultati su za svaku skalu ponaosob potom prebacivani u Excel i dalje&nbsp; obrađivani adekvatnim statističkim alatkama u adekvatnom programu. U rezultatima je uočeno da dobijena razlika u preciznosti pozicioniranja potkolenice sa o&scaron;tećenim ligamentarnim aparatom kolena u odnosu na nepovređenu nogu pre hirur&scaron;ke rekonstrukcije prednjeg ukr&scaron;tenog ligamenta ne pokazuje statistički značajnu razliku. Međutim, postojala je statistički značajna razlika u brzini kojom se postiže zadati ugao, tj. povređena noga imala je veći intenzitet ugaonog uspona &scaron;to ukazuje na kvalitativne razlike u samom obrascu pokreta. Takođe, na ovom uzorku dobijeno je da postoji statistički značajna razlika u preciznosti pozicioniranja potkolenice sa o&scaron;tećenim ligamentarnim aparatom kolena u odnosu na nepovređenu nogu nakon hirur&scaron;ke rekonstrukcije prednjeg ukr&scaron;tenog ligamenta tj. pacijenti su nakon rekonstrukcije statistički značajno &raquo;prebacivali&laquo; zadatu vrednost od 35&deg;. Test pozicioniranja ekstremiteta za ovo ispitivanje konstruisanim aparatom se pokazao kao senzitivna i specifična dijagnostička procedura gubitka sposobnosti propriocepcije usled kidanja prednjeg ukr&scaron;tenog ligamenta.</p> / <p>In this prospective study examined group consisted&nbsp; of&nbsp; 60&nbsp; male&nbsp; patients&nbsp; with&nbsp; an anterior&nbsp; cruciate&nbsp; ligament&nbsp; tear&nbsp; and&nbsp; all participants&nbsp;&nbsp; were&nbsp;&nbsp; at&nbsp;&nbsp; the&nbsp;&nbsp; time&nbsp;&nbsp; before injury&nbsp;&nbsp; actively&nbsp;&nbsp; playing&nbsp;&nbsp; afootball, basketball&nbsp; or&nbsp; volleyball.&nbsp; The&nbsp; study&nbsp; was conducted&nbsp; at&nbsp; the&nbsp; Clinic&nbsp; for&nbsp; Orthopaedic Surgery&nbsp;&nbsp;&nbsp; and&nbsp;&nbsp;&nbsp; Traumatology&nbsp;&nbsp;&nbsp; Clinical Center&nbsp; of&nbsp; Vojvodina&nbsp; in&nbsp; Novi&nbsp; Sad&nbsp; where participants&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; were&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; admitted&nbsp;&nbsp; for arthroscopic ligament reconstruction. All participants&nbsp; were&nbsp; informed&nbsp; of&nbsp; the&nbsp; study by&nbsp;&nbsp; their&nbsp;&nbsp; clinicians&nbsp;&nbsp; and&nbsp;&nbsp; gave&nbsp;&nbsp; written consent. Thee exclusion criteria were the following:&nbsp;&nbsp;&nbsp; occurrence&nbsp;&nbsp;&nbsp; of&nbsp;&nbsp;&nbsp; combined cruciate&nbsp; ligament&nbsp; with&nbsp; lateral&nbsp; collateral ligament&nbsp;&nbsp; injury&nbsp;&nbsp; that&nbsp;&nbsp; required&nbsp;&nbsp; surgical treatment;&nbsp; occurrence&nbsp; of&nbsp; more&nbsp; serious general&nbsp;&nbsp;&nbsp; surgical complications; the patient&rsquo;s&nbsp; wish&nbsp; to&nbsp; be&nbsp; excluded&nbsp; from further&nbsp; research&nbsp; without&nbsp; an&nbsp; obligation&nbsp; to give&nbsp;&nbsp; any&nbsp;&nbsp; further&nbsp;&nbsp; explanation&nbsp;&nbsp; to&nbsp;&nbsp; his decision.&nbsp; In&nbsp; the&nbsp; first&nbsp; stage&nbsp; of&nbsp; the&nbsp; study, an&nbsp; apparatus&nbsp; called&nbsp; digital&nbsp; goniometer was&nbsp;&nbsp; constructed,&nbsp;&nbsp; which&nbsp;&nbsp; was&nbsp;&nbsp; used&nbsp;&nbsp; to conduct&nbsp;&nbsp; the&nbsp;&nbsp; experimental&nbsp;&nbsp; part&nbsp;&nbsp; of&nbsp;&nbsp; the study,&nbsp; and&nbsp; a&nbsp; database&nbsp; with&nbsp; fields&nbsp; for inserting&nbsp; descriptive&nbsp; and&nbsp; anthropometric parameters was made. Next, by using the apparatus,&nbsp; all&nbsp; subjects&nbsp; were&nbsp; tested&nbsp; for proprioception&nbsp; ability&nbsp; (JPS).&nbsp; The&nbsp; tests were&nbsp; performed&nbsp; preoperatively&nbsp; on&nbsp; the injured&nbsp; and&nbsp; the&nbsp; uninjured&nbsp; limb&nbsp; in&nbsp; two instances:&nbsp; straight&nbsp; after&nbsp; determining&nbsp; the target&nbsp;&nbsp; angle&nbsp; of&nbsp;&nbsp; 35&deg;&nbsp; and&nbsp;&nbsp; 5&nbsp;&nbsp; minutes afterwards.&nbsp;&nbsp;&nbsp; The&nbsp;&nbsp;&nbsp; second&nbsp;&nbsp;&nbsp; stage&nbsp;&nbsp;&nbsp; was performed&nbsp; postoperatively&nbsp; in&nbsp; the&nbsp; same maner,&nbsp;&nbsp; following&nbsp;&nbsp; a&nbsp;&nbsp; minimal&nbsp;&nbsp; 6-month period&nbsp;&nbsp;&nbsp; after&nbsp;&nbsp;&nbsp; a&nbsp;&nbsp;&nbsp; surgical&nbsp;&nbsp;&nbsp; arthroscopic reconstruction&nbsp;&nbsp;&nbsp; of&nbsp;&nbsp;&nbsp; the&nbsp;&nbsp;&nbsp; torn&nbsp;&nbsp;&nbsp; anterior cruciate&nbsp; ligament&nbsp; by&nbsp; bone-tendon-bone (BTB) technique. The clinical evaluation of&nbsp; each&nbsp; patient&nbsp; involved&nbsp; Lachman&nbsp; test (positive / negative), Lysholm and IKDC scales,&nbsp;&nbsp; first&nbsp;&nbsp; pre-operatively&nbsp;&nbsp; and&nbsp;&nbsp; then during&nbsp;&nbsp; post-operative&nbsp; check&nbsp; up assessment.&nbsp; Following&nbsp; the&nbsp; example&nbsp; of many&nbsp; websites&nbsp; or&nbsp; eminent&nbsp; orthopaedic organisations (http://www.orthopaedicscore.com/),&nbsp;&nbsp; an online&nbsp;&nbsp; survey&nbsp;&nbsp; was&nbsp;&nbsp; made&nbsp;&nbsp; on&nbsp;&nbsp; Google Drive,&nbsp;&nbsp;&nbsp;&nbsp; where&nbsp;&nbsp;&nbsp;&nbsp; data&nbsp;&nbsp;&nbsp;&nbsp; was&nbsp;&nbsp;&nbsp;&nbsp; collected electronically&nbsp; for&nbsp; the&nbsp; scales&nbsp; used.&nbsp; The results were then transferred to Excel for each&nbsp; scale,&nbsp; to&nbsp; be&nbsp; further&nbsp; processed&nbsp; by using&nbsp;&nbsp; adequate&nbsp;&nbsp; statistic&nbsp;&nbsp; tools&nbsp;&nbsp; in&nbsp;&nbsp; an adequate&nbsp;&nbsp;&nbsp;&nbsp; programme.&nbsp;&nbsp;&nbsp;&nbsp; The&nbsp;&nbsp;&nbsp;&nbsp; results indicated&nbsp; that,&nbsp; when&nbsp; compared&nbsp; with&nbsp; the uninjured&nbsp; leg,&nbsp; a&nbsp; resulting&nbsp; disparity&nbsp; in precision&nbsp; of&nbsp; positioning&nbsp; the&nbsp; lower&nbsp; leg with&nbsp; a&nbsp; damaged&nbsp; ligament&nbsp; apparatus&nbsp; of the&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; knee&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; before&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; the&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; surgical reconstruction&nbsp; of&nbsp; the&nbsp; anterior&nbsp; cruciate ligament&nbsp; was&nbsp; not&nbsp; considered&nbsp; statistically significant.&nbsp;&nbsp;&nbsp; However,&nbsp;&nbsp;&nbsp; there&nbsp;&nbsp;&nbsp; was&nbsp; a statistically&nbsp; significant&nbsp; difference&nbsp; in&nbsp; the speed&nbsp;&nbsp; of&nbsp;&nbsp; attaining&nbsp;&nbsp; a&nbsp;&nbsp; specified&nbsp;&nbsp; angle which indicates qualitative differences in the&nbsp; motion&nbsp; pattern&nbsp; itself.&nbsp; Furthermore, this&nbsp;&nbsp;&nbsp;&nbsp; sample&nbsp;&nbsp;&nbsp;&nbsp; study&nbsp;&nbsp;&nbsp;&nbsp; resulted&nbsp;&nbsp; in&nbsp; a statistically&nbsp; significant&nbsp; difference&nbsp; in&nbsp; the precision&nbsp;&nbsp; of&nbsp;&nbsp; positioning&nbsp;&nbsp; of&nbsp;&nbsp; lower leg&nbsp; with&nbsp;&nbsp;&nbsp;&nbsp; the&nbsp;&nbsp;&nbsp;&nbsp; damaged&nbsp;&nbsp; knee&nbsp; ligament apparatus&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; after&nbsp;&nbsp; the&nbsp;&nbsp; surgical reconstruction&nbsp; of&nbsp; the&nbsp; anterior&nbsp; cruciate ligament,&nbsp;&nbsp;&nbsp; when&nbsp;&nbsp;&nbsp; compared&nbsp;&nbsp;&nbsp; with&nbsp;&nbsp;&nbsp; the uninjured&nbsp; leg,&nbsp; i.e.&nbsp; after&nbsp;&nbsp; the reconstruction,&nbsp; the&nbsp; patients&nbsp;&nbsp; had&nbsp;&nbsp; a significantly&nbsp;&nbsp; higher&nbsp;&nbsp; degree&nbsp;&nbsp; of&nbsp;&nbsp; flexion than&nbsp;&nbsp; the&nbsp;&nbsp; targeted&nbsp;&nbsp; 35&deg;.&nbsp;&nbsp; The&nbsp;&nbsp; test&nbsp;&nbsp; for positioning&nbsp; extremities,&nbsp; performed&nbsp; with the&nbsp;&nbsp;&nbsp; specially&nbsp;&nbsp;&nbsp; constructed&nbsp;&nbsp;&nbsp; apparatus, proved&nbsp; to&nbsp; be&nbsp; a&nbsp; sensitive&nbsp; and&nbsp; specific diagnostic procedure for determining the loss&nbsp; of&nbsp; proprioceptic&nbsp; ability&nbsp; due&nbsp; to anterior cruciate ligament tear.</p>

<p>Osnovni cilj rekonstrukcije prednjeg ukr&scaron;tenog ligamenta kolena je dobijanje pune stabilnosti kolena u celom obimu pokreta. Bez obzira na razvoj operativne tehnike i rehabilitacije i dalje postoji jedan broj pacijenata koji nije u potpunosti zadovoljan rezultatom rekonstrukcije prednjeg ukr&scaron;tenog ligamenta kolena, te je potrebno izvr&scaron;iti ponovnu operaciju. Smatra se da je najče&scaron;ći uzrok rane ponovne nestabilnosti lo&scaron;a pozicija kalema, tj. pozicija tunela koja nije na anatomskom mestu. Većina hirurga koji se bave ovom problematikom procenjuju poziciju kalema u golenjači na osnovu standardnih radiograma: prednje-zadnje i bočne projekcije, &scaron;to svakako nije dovoljno precizno. U ekonomski&nbsp; razvijenim zemljama poziciju kalema određuju analizirajući snimke kompjuterizovane tomografije (CT) ili magnetne rezonance (MRI). Prvenstveno zbog smanjenja doze zračenja kojoj se izlažu pacijenti prilikom kompjuterizovane tomografije, ali i iz ekonomskih razloga bilo bi korisno razvijanje jednog lako dostupnog, jeftinog ali preciznog i jednostavnog metoda određivanja položaja kalema u golenjači. Osnovni cilj ovog istraživanja bio je da se dokaže značaj pozicije kalema u golenjači i mogućnost svakodnevne kliničke primene novorazvijenog kompjuterskog programa u cilju određivanja prostorne pozicije kalema u golenjači iz samo dva standardna radiograma. Studija je bila eksperimentalno-prospektivnog karaktera. Eksperimentalni deo istraživanja sproveden je na Fakultetu tehničkih nauka (FTN) u Novom Sadu na Departmanu za proizvodno ma&scaron;instvo gde je na osnovu standardnih RTG snimaka (prednje-zadnje i bočne projekcije) razvijen kompjuterski program za određivanje prostornog položaja kalema u golenjači. U cilju verifikacije novorazvijenog programa realizovano je prostorno određivanje položaja kalema u golenjači obradom standardnih RTG snimaka (prednje-zadnje i bočne projekcije) kod 10 pacijenata kod kojih je izvr&scaron;ena primarna rekonstrukcija prednjeg ukr&scaron;tenog ligamenta kolena. Dobijeni rezultati su upoređeni sa položajem kalema na CT snimcima koji su obezbeđeni za sve pacijente. Na taj način je eksperimentalnim putem utvrđena preciznost novorazvijenog softvera u određivanju prostornog položaja kalema u golenjači. Drugi deo istraživanja bilo je prospektivno kliničko ispitivanje koje je sprovedeno na Klinici za ortopedsku hirurgiju i traumatologiju Kliničkog centra Vojvodine u Novom Sadu. Ispitivanu grupu je činilo 120 pacijenata, oba pola, sa prekidom prednjeg ukr&scaron;tenog ligamenta levog ili desnog kolena. Metodom slučajnog izbora pacijenti su podeljeni u četiri grupe od po 30 pacijenata prema veličini sagitalnog ugla (S) bu&scaron;enja kanala u golenjači (S 60&ordm;-69,9&ordm; i S 70&ordm;-80&ordm;) i prema veličini transverzalnog ugla (T) bu&scaron;enja kanala u golenjači (T 60&ordm;-69,9&ordm; i T 70&ordm;-80&ordm;). Grupa I 30 pacijenata (S 60&ordm;-69,9&ordm; i T 60&ordm;-69,9&ordm;), grupa II 30 pacijenata (S 60&ordm;-69,9&ordm; i T 70&ordm;-80&ordm;), grupa III 30 pacijenata (S 70&ordm;-80&ordm; i T 60&ordm;-69,9&ordm;), grupa IV 30 pacijenata (S 70&ordm;-80&ordm; i T 70&ordm;-80&ordm;). Svi pacijenti su godinu dana nakon operacije pro&scaron;li klinička ispitivanja po bodovnim skalama (Tegner bodovna skala, Lysholm bodovna skala i IKDC standard) i artrometrijska merenja. Rezultati dobijeni merenjem položaja kalema u golenjači, kliničkim ispitivanjima i artrometrijskim merenjima poređani su unutar svake grupe posebno, a izvr&scaron;eno je i poređenje dobijenih rezultata između svih grupa. U ispitivanje su uključeni samo oni pacijenti koji su dali potpisani informisani pristanak da učestvuju u ispitivanju nakon detaljnog upoznavanja sa planiranom procedurom. Svaki pacijent je bio informisan o svrsi i načinu sprovođenja istraživanja, kao i o pregledima i merenjima koja će biti vr&scaron;ena. Statističkom analizom rezultata utvrđeno je da veličina gre&scaron;ke prostornog određivanja položaja kalema u golenjači posle rekonstrukcije prednjeg ukr&scaron;tenog ligamenta kolena novorazvijenim kompjuterskim programom nije statistički značajna, a kompjutersko određivanje položaja kalema u golenjači omogućava iste rezultate kao i CT snimci. Sumiranjem zaključaka nakon sveobuhvatne analize dobijenih rezultata istraživanja, može se zaključiti da pozicija kalema u golenjači posle rekonstrukcije prednjeg ukr&scaron;tenog ligamenta kolena utiče na postoperativni funkcionalni rezultat.</p> / <p>The main goal of reconstruction of the anterior cruciate ligament of the knee is to obtain complete knee stability in the full range of movement. Regardless of the development of operational techniques and rehabilitation, there is still a number of patients who are not completely satisfied with the result of reconstruction of the anterior cruciate ligament, and a re-operation is required. It is believed that the most common cause of the instability is the bad position of the graft, i.e. position of the tunnel that is not at the anatomical place insertion. Most surgeons who deal with this problem evaluate the position of the graft in the tibia based on standard radiograms: anterior-posterior and lateral projections, which is not precise enough. In economically developed countries, the position of the graft is determined by analyzing images of computerized tomography (CT) or magnetic resonance (MRI). Primarily due to a decrease in the radiation dose exposed to patients during computerized tomography, but also for economic reasons, it would be useful to develop an easily accessible, inexpensive but precise and simple method for determining the position of the graft in the tibia. The main goal of this examination was to prove the significance of the position of the graft and the possibility of daily clinical use of the newly developed computer program in order to determine in-space position of the graft in only two standard radiograms. The study was experimental-prospective. The experimental part of the research was conducted at the Faculty of Technical Sciences (FTN) in Novi Sad at the Department of Production Engineering, where a computer program for determining in-space position of the graft in the tibia was developed on the basis of standard RTG images (anterior-posterior and lateral projections). In order to verify the newly developed program, in-space determination of the position of the graft in the tibia by processing standard RTG images (anterior-posterior and lateral projections) was performed in 10 patients in which the primary reconstruction of the anterior cruciate ligament was performed. The obtained results were compared with the position of the grafts on CT images provided to all patients. In this way, the accuracy of newly developed software in determining in-space position of the graft in the tibia was determined experimentally. The second part of the study was a prospective clinical trial conducted at the Clinic for Orthopedic Surgery and Traumatology at the Clinical Center of Vojvodina in Novi Sad. The investigated group consisted of 120 patients, both sexes, with a break of the anterior cruciate ligament of the left or right knee. By random selection, patients were divided into four groups of 30 patients according to the size of the sagital angle (S) of the tunnel drilling in the tibia (S 60&ordm;-69,9&ordm; and S 70&ordm;-80&ordm;) and according to the transversal angle (T) of the drill tunnel in the tibia ( T 60&ordm;-69.9&ordm; and T 70&ordm;-80&ordm;). Group I 30 patients (S 60&ordm;-69.9&ordm; and T 60&ordm;-69.9&ordm;), group II 30 patients (S 60&ordm;-69.9&ordm; and T 70&ordm;-80&ordm;), group III 30 patients (S 70&ordm;-80&ordm; and T&ordm;60&ordm; -69.9&ordm;), group IV 30 patients (S 70&ordm;-80&ordm; and T 70&ordm;-80&ordm;). All of the patients underwent clinical trials by scales (Tegner score scale, Lysholm score scale and IKDC standard) and arthrometric measurements one year after surgery. The results obtained by measuring the position of the graft in the tibia, clinical trials and arthrometric measurements were classified separately in each group, and obtained results were compared between all groups. The study included only those patients who gave signed informed consent to participate in the study after being thoroughly informed about planned procedure. Each patient was informed about the purpose and method of conducting the research, as well as the examinations and measurements to be performed. Statistical analysis of the results showed that the size of the error in measuring in-space determination of the position of the graft in tibia after reconstruction of the anterior cruciate ligament of the knee by a newly developed computer program was not statistically significant, and the computer determination of the position of the graft in the tibia provides the same results as the CT images. Summarizing the conclusions after a comprehensive analysis of the obtained results of the study, it can be concluded that the position of the graft in tibia after reconstruction of the anterior cruciate ligament affects the postoperative functional result.</p>

Introdução: Na reconstrução anatômica do ligamento cruzado anterior (LCA) com banda simples, o diâmetro dos túneis não preenche totalmente sua área de origem e inserção. Estudos recentes sugerem que a banda anteromedial teria um papel dominante na função estabilizadora do LCA em qualquer grau de flexão, o que favoreceria o posicionamento dos túneis nessa região. No entanto, ao se buscar reproduzir a função das duas bandas com um enxerto simples, a escolha mais intuitiva é posicioná-lo na região central. O posicionamento inadequado do enxerto poderá resultar em uma instabilidade residual, mais evidente em indivíduos com alta demanda funcional, como é o caso de esportistas. Retomar a prática esportiva no mesmo nível não depende somente da estabilidade isolada do joelho, é preciso que o equilíbrio postural seja reestabelecido. O objetivo deste estudo foi comparar o posicionamento do enxerto na região anteromedial ou central na origem e inserção do LCA. Métodos: Trata-se de um estudo clínico prospectivo e randomizado, incluindo 42 esportistas (Tegner > 5) com lesão do LCA alocados para serem submetidos àreconstrução anatômica na posição anteromedial (22 pacientes - Grupo AM) ou central (20 pacientes - Grupo C). O desfecho primário foi obtido pelo valor médio da oscilação do centro de pressão (CP) de cada indivíudo no plano mediolateral (Xavg) avaliado na plataforma de força com apoio monopodálico simulando a posição de chute aos 6 meses de pós-operatório, enquanto os demais parâmetros de posturografia, escalas de Tegner, Lysholm, IKDC subjetivo, hop test e avaliação isocinética foram considerados desfechos secundários. Todos os resultados foram avaliados aos 6 e 12 meses, com exceção da escala de Tegner, avaliada somente aos 12 meses. Resultados: Na avaliação dos dados de posturografia fornecidos pela plataforma de força, o grupo C apresentou melhores resultados quando comparados ao grupo AM em três parâmetros de oscilação mediolateral do CP: valor médio (Xavg) na posição de chute aos 6 meses (-0,43 ± 0,15cm vs. -0,87 ± 0,18cm respectivamente, p < 0,05), deslocamento máximo (Xmax) na posição de apoio monopodálico simples aos 12 meses (1,05 ± 0,18cm vs. 1,28 ± 0,31 cm respectivamente, p < 0,05) e valor médio na posição de flexão do joelho aos 6 meses (0,31 + 1,35cm vs. -1,03 + 1,18cm respectivamente, p < 0,05). O grupo C também apresentou melhores resultados quando comparado ao grupo AM nas seguintes avaliações: índice de simetria do hop test aos 6 meses (93 ± 7% vs. 84 ± 17% respectivamente, p < 0,05) e aos 12 meses (100 ± 7% vs. 92 ± 7% respectivamente, p < 0,05) e deficit do pico de torque na velocidade angular de 60o/s aos 6 meses (12,55 ± 9,77 Nm vs. 22,9 ± 17,89 Nm respectivamente, p < 0,05). Conclusões: A reconstrução anatômica do LCA na posição central apresentou melhores resultados em três parâmetro de posturografia relacionados a oscilação no plano mediolateral (incluindo o desfecho primário), melhor índice de simetria no hop test e menor deficit do pico de torque na velocidade angular de 60o/s aos 6 meses, quando comparados à reconstrução na posição anteromedial. Não houve diferença significante quanto ao número de complicações / Introduction: Bone tunnel diameters in anatomical single-bundle anterior cruciate reconstruction cannot fulfill the footprint area. The latest studies have suggested that the anteromedial bundle might play a dominant role in ACL function at any flexion degree. This fact could support placing the bone tunnel on the anteromedial bundle footprint. However, positioning the graft at the center of the footprint could be a more efficient way to mimic part of the two-bundle function. Improper graft positioning may result in residual instability, particularly in individuals with higher functional demand, such as sport practitioners. Returning to their sport at the same level as before their injury could not be defined by knee stability alone; a global evaluation provided by more comprehensive parameters, such as postural balance, should also be included. The main purpose of this study is to compare grafts on anteromedial or central area positions in an ACL footprint. Methods: A prospective, randomized clinical study included 42 sports practitioners (Tegner > 5) with ACL injury undergoing anatomic ACL reconstruction on the anteromedial footprint (22 patients - AM group) or at the central footprint area (20 patients - Group C). The primary outcome was based on a mean center pressure (CP) mediolateral oscillation parameter analysis of each individual simulating a kicking motion on a force plate. Other posturography parameters, Tegner, Lysholm and IKDC subjective scales, a hop test and an isokinetic evaluation were considered as secondary outcomes. All results were evaluated at 6 and 12 months, with the exception of the Tegner scale, which was evaluated only at 12 months. Results; Group C presented better results in three posturography parameters when compared with Group AM: mean mediolateral plane oscillation with kicking position at 6 months (-0,43 ± 0,15cm vs. -0,87 ± 0,18cm respectively, p < 0.05), maximum CP lateral displacement with the one leg standing position at 12 months (1,05 ± 0,18cm vs. 1,28 ± 0,31 cm respectively, p < 0.05) and mean mediolateral plane oscillation with knee flexed position (0.31 ± 1.35 cm vs. -1.03 ± 1.18 cm respectively, p < 0.05) and). Group C also presented better results in the following evaluations: symmetry index in the hop test at 6 months (93 ± 7% vs. 84 ± 17% respectively, p < 0.05) and at 12 months (100 ± 7% vs. 92 ± 7%, respectively, p < 0.05) and torque peak deficit on angular velocity of 60 o/s at 6 months (12.55 ± 9.77 Nm vs. 22.9 ± 17, 89 Nm respectively, p < 0.05). CONCLUSION: Anatomic single bundle ACL reconstruction in the center of the ACL footprint shows better results compared with the anteromedial ACL footprint area in three posturography parameters related to coronal plane balance, index of symmetry in the hop test and the peak of torque deficit on an angular velocity of 60 o/s at 6 months. Surgical complications were similar in both groups

Introdução: Na reconstrução anatômica do ligamento cruzado anterior (LCA) com banda simples, o diâmetro dos túneis não preenche totalmente sua área de origem e inserção. Estudos recentes sugerem que a banda anteromedial teria um papel dominante na função estabilizadora do LCA em qualquer grau de flexão, o que favoreceria o posicionamento dos túneis nessa região. No entanto, ao se buscar reproduzir a função das duas bandas com um enxerto simples, a escolha mais intuitiva é posicioná-lo na região central. O posicionamento inadequado do enxerto poderá resultar em uma instabilidade residual, mais evidente em indivíduos com alta demanda funcional, como é o caso de esportistas. Retomar a prática esportiva no mesmo nível não depende somente da estabilidade isolada do joelho, é preciso que o equilíbrio postural seja reestabelecido. O objetivo deste estudo foi comparar o posicionamento do enxerto na região anteromedial ou central na origem e inserção do LCA. Métodos: Trata-se de um estudo clínico prospectivo e randomizado, incluindo 42 esportistas (Tegner > 5) com lesão do LCA alocados para serem submetidos àreconstrução anatômica na posição anteromedial (22 pacientes - Grupo AM) ou central (20 pacientes - Grupo C). O desfecho primário foi obtido pelo valor médio da oscilação do centro de pressão (CP) de cada indivíudo no plano mediolateral (Xavg) avaliado na plataforma de força com apoio monopodálico simulando a posição de chute aos 6 meses de pós-operatório, enquanto os demais parâmetros de posturografia, escalas de Tegner, Lysholm, IKDC subjetivo, hop test e avaliação isocinética foram considerados desfechos secundários. Todos os resultados foram avaliados aos 6 e 12 meses, com exceção da escala de Tegner, avaliada somente aos 12 meses. Resultados: Na avaliação dos dados de posturografia fornecidos pela plataforma de força, o grupo C apresentou melhores resultados quando comparados ao grupo AM em três parâmetros de oscilação mediolateral do CP: valor médio (Xavg) na posição de chute aos 6 meses (-0,43 ± 0,15cm vs. -0,87 ± 0,18cm respectivamente, p < 0,05), deslocamento máximo (Xmax) na posição de apoio monopodálico simples aos 12 meses (1,05 ± 0,18cm vs. 1,28 ± 0,31 cm respectivamente, p < 0,05) e valor médio na posição de flexão do joelho aos 6 meses (0,31 + 1,35cm vs. -1,03 + 1,18cm respectivamente, p < 0,05). O grupo C também apresentou melhores resultados quando comparado ao grupo AM nas seguintes avaliações: índice de simetria do hop test aos 6 meses (93 ± 7% vs. 84 ± 17% respectivamente, p < 0,05) e aos 12 meses (100 ± 7% vs. 92 ± 7% respectivamente, p < 0,05) e deficit do pico de torque na velocidade angular de 60o/s aos 6 meses (12,55 ± 9,77 Nm vs. 22,9 ± 17,89 Nm respectivamente, p < 0,05). Conclusões: A reconstrução anatômica do LCA na posição central apresentou melhores resultados em três parâmetro de posturografia relacionados a oscilação no plano mediolateral (incluindo o desfecho primário), melhor índice de simetria no hop test e menor deficit do pico de torque na velocidade angular de 60o/s aos 6 meses, quando comparados à reconstrução na posição anteromedial. Não houve diferença significante quanto ao número de complicações / Introduction: Bone tunnel diameters in anatomical single-bundle anterior cruciate reconstruction cannot fulfill the footprint area. The latest studies have suggested that the anteromedial bundle might play a dominant role in ACL function at any flexion degree. This fact could support placing the bone tunnel on the anteromedial bundle footprint. However, positioning the graft at the center of the footprint could be a more efficient way to mimic part of the two-bundle function. Improper graft positioning may result in residual instability, particularly in individuals with higher functional demand, such as sport practitioners. Returning to their sport at the same level as before their injury could not be defined by knee stability alone; a global evaluation provided by more comprehensive parameters, such as postural balance, should also be included. The main purpose of this study is to compare grafts on anteromedial or central area positions in an ACL footprint. Methods: A prospective, randomized clinical study included 42 sports practitioners (Tegner > 5) with ACL injury undergoing anatomic ACL reconstruction on the anteromedial footprint (22 patients - AM group) or at the central footprint area (20 patients - Group C). The primary outcome was based on a mean center pressure (CP) mediolateral oscillation parameter analysis of each individual simulating a kicking motion on a force plate. Other posturography parameters, Tegner, Lysholm and IKDC subjective scales, a hop test and an isokinetic evaluation were considered as secondary outcomes. All results were evaluated at 6 and 12 months, with the exception of the Tegner scale, which was evaluated only at 12 months. Results; Group C presented better results in three posturography parameters when compared with Group AM: mean mediolateral plane oscillation with kicking position at 6 months (-0,43 ± 0,15cm vs. -0,87 ± 0,18cm respectively, p < 0.05), maximum CP lateral displacement with the one leg standing position at 12 months (1,05 ± 0,18cm vs. 1,28 ± 0,31 cm respectively, p < 0.05) and mean mediolateral plane oscillation with knee flexed position (0.31 ± 1.35 cm vs. -1.03 ± 1.18 cm respectively, p < 0.05) and). Group C also presented better results in the following evaluations: symmetry index in the hop test at 6 months (93 ± 7% vs. 84 ± 17% respectively, p < 0.05) and at 12 months (100 ± 7% vs. 92 ± 7%, respectively, p < 0.05) and torque peak deficit on angular velocity of 60 o/s at 6 months (12.55 ± 9.77 Nm vs. 22.9 ± 17, 89 Nm respectively, p < 0.05). CONCLUSION: Anatomic single bundle ACL reconstruction in the center of the ACL footprint shows better results compared with the anteromedial ACL footprint area in three posturography parameters related to coronal plane balance, index of symmetry in the hop test and the peak of torque deficit on an angular velocity of 60 o/s at 6 months. Surgical complications were similar in both groups

<p>Ispitivanu grupu činilo je 1247 ispitanika sa povredama prednje ukr&scaron;tene veze kolena koji su operativno lečeni u periodu 2012.-2017. godina na Klinici za ortopedsku hirurgiju i traumatologiju Kliničkog centra Vojvodine. Ciljevi istraživanja bili su utvrđivanje uticaja nivoa sportske aktivnosti i mehanizama povređivanja na nastanak povreda prednje ukr&scaron;tene veze kolena, zatim uticaj spolja&scaron;njih faktora rizika (vrsta sporta, rang takmičenja, vrsta podloge, trening ili utakmica, period treninga) na nastanak povreda prednje ukr&scaron;tene veze kolena, odnosno uticaj unutra&scaron;njih faktora rizika (pol, starost, BMI) na nastanak povreda ove strukture kolena. Od ukupnog broja ispitanika njih 517 (41,5%) su činili aktivni sportisti, a 730 (58,5%) rekreativci. Značajnu većinu u posmatranom uzorku su činili mu&scaron;karci (82,6%), osobe starosti od 16 do 25 godina (62,6%) i normalno uhranjenje osobe (62%). Do povrede prednje ukr&scaron;tene veze do&scaron;lo je kod njih 504 (40,5%) prilikom aktivnog bavljenja sportom, dok su se povrede prilikom rekreativnog bavljenja sportom dogodile kod 741 ispitanika (59,5%). Među aktivnim sportistima, vi&scaron;e od dve trećine se takmičilo na internacionalnom ili republičkom nivou, odnosno u najvi&scaron;im rangovima takmičenja. Kontaktnim kolektivnim sportovima (fudbal, ko&scaron;arka i rukomet) bavilo se 77,9% ispitanika. Nekontaktnim sportovima kao &scaron;to su odbojka, borilački sportovi i skijanje bavilo se 22,1% ispitanika, pri čemu je najveći broj povreda nastao prilikom igranja fudbala (51,3%). Statistički značajno vi&scaron;e povreda (i prilikom aktivnog i prilikom rekreativnog bavljenja sportom) je nastalo bez direktnog kontakta (nekontaktne povrede koje su činile 78,7% povreda), pri čemu je najveći broj povreda nastao usled promene pravca i ritma kretanja. Kod aktivnih sportista najvi&scaron;e povreda dogodilo se na utakmicama (73,8%), slede povrede na treningu (24,1%), dok se na rekreaciji povredilo svega 2,1% ispitanika. Značajno vi&scaron;e povreda dogodilo se na sredini bavljenja sportskom aktivno&scaron;ću (47,4%) u odnosu na povrede na zagrevanju, početku, odnosno kraju sportske aktivnosti. Povrede su značajno če&scaron;će nastajale na travi (42%) i parketu (28%), nego na drugim vrstama podloge. Najveći broj ispitanika povredio se noseći patike prilikom bavljenja sportskom aktivno&scaron;ću. Postoje značajne razlike u kontekstu povređivanja u zavisnosti od pola ispitanika. Žene su u značajno većem procentu povređivane prikom aktivnog bavljenja sportom, dok su se mu&scaron;karci če&scaron;će povređivali na rekreaciji. Žene su se najče&scaron;će povređivale na rukometu, mu&scaron;karci na fudbalu. U odnosu na mu&scaron;karce, kod žena su povrede znatno ređe nastajale prilikom direktnog kontakta, a kad je u pitanju mesto povređivanja, žene su se če&scaron;će nego mu&scaron;karci povređivale na treningu. Preko 50% žena je povređeno na parketu, dok se najveći broj mu&scaron;karaca povredio na travi. Ispitanici sa prekomernom telesnom masom značajno če&scaron;će su se povređivali prilikom rekreacije, dok su se normalno uhranjeni če&scaron;će povređivali prilikom aktivnog bavljenja sportom. Faktori rizika za nastanak povreda prednje ukr&scaron;tene veze su brojni i specifični, odnosno da za svaku populacionu kategoriju postoje rizici, ali se uočava da su u svim sportovima, na svim podlogama i kod svih ispitanika povrede najče&scaron;će nastajale nekontaknim mehanizmom povređivanja. Formiranjem registra povređenih omogućilo bi se bolje razumevanje faktora rizika i njihovog međusobnog uticaja, kao i definisanje profila osoba pod najvećim rizikom za nastanak povrede prednje ukr&scaron;ene veze kolena. Na taj način obezbedile bi se potrebne informacije za planiranje preventivnih programa usmerenih na smanjenje rizika od povređivanja i omogućilo bi se sprovođenje odgovarajućih mera selektivne prevencije.</p> / <p>The study group consisted of 1247 respondents with anterior cruciate ligament injuries who were surgically treated in the period 2012-2017. at the Clinic for Orthopedic Surgery and Traumatology of the Clinical Center of Vojvodina. The objectives of the study were to determine the impact of sports activity levels and injury mechanisms on the occurrence of anterior cruciate ligament injuries, then the impact of external risk factors (type of sport, competition rank, type of surface, training or match, training period) on the occurrence of anterior cruciate ligament injuries and the influence of internal risk factors (gender, age, BMI) on the occurrence of injuries of this knee structure. Out of the total number of respondents 517 (41.5%) were active athletes, and 730 (58.5%) were recreational athletes. A significant majority in the observed group were men (82.6%), persons aged 16 to 25 years (62.6%) and normal BMI respondents (62%). Anterior cruciate ligament injury occurred in 504 of them (40.5%) during active sports, while injuries during recreational sports occurred in 741 respondents (59.5%). Among active athletes, more than two thirds competed at the international or national level- in the highest ranks of the competition. Contact collective sports (football, basketball and handball) were practiced by 77.9% of respondents. 22.1% of respondents practiced non-contact sports such as volleyball, martial arts sports and skiing. The largest number of injuries occurring while playing football (51.3%). Statistically significantly more injuries (both during active and recreational sports) occurred without direct contact (noncontact injuries-78,7% of total injuries number), with the largest number of injuries caused by changes in the direction and rhythm of movement. Among active athletes, most injuries occurred in matches (73.8%), followed by injuries in training (24.1%), while only 2.1% of respondents were injured in recreation. Significantly more injuries occurred in the middle of engaging in sports activity (47.4%) compared to injuries during the warm-up, beginning and end of sports activity. Injuries occurred significantly more often on grass (42%) and floor (28%) than on other types of surfaces. Most of the respondents were injured wearing sneakers while doing sports. There are significant differences in the context of injury depending on the gender of the respondents. A significantly higher percentage of women were injured during active sports, while men were more often injured during recreational sport activities. Women were most often injured in handball, men in football. Compared to men, injuries were much less common in women during direct contact, and when it comes to the place of injury, women were injured more often than men during training acitivities. Over 50% of women were injured on the floor, while the largest number of men were injured on the grass. Subjects with overweight were significantly more likely to be injured during recreational sport acitivites, while those with normal BMI were more likely to be injured during active sports. Risk factors for anterior cruciate ligament injuries are numerous and specific and there are risks for each population category, but it is noticed that in all sports, on all surfaces and in all subjects, injuries were most often caused by a noncontact injury mechanism. The formation of a Register of injuries would enable a better understanding of risk factors and their mutual influence, as well as the definition of the profile of persons at greatest risk for the occurrence of an anterior cruciate ligament injury. This would provide the necessary information for planning prevention programs aimed at reducing the risk of injury and would enable the implementation of appropriate selective prevention measures.</p>