The mechanism and cause of anterior cruciate ligament tear in the Korean military environment
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Purpose: Anterior cruciate ligament (ACL) injury is very common but few studies have analyzed the injury mechanism and cause of ACL tear in a specific environment such as a military institution. The purpose of this study was to analyze the injury mechanism and cause of ACL injury in the military environment. Additionally, this study could provide outcomes that may aid future studies on prevention of ACL injury in military personnel. Materials and methods: This study retrospectively analyzed 168 patients who sustained ACL tear while in military service and underwent ACL reconstruction surgery in a military hospital. Analysis of the injury mechanism and the cause was evaluated by analyzing the medical records. Knee magnetic resonance imaging analysis was also conducted for further evaluation of associated injury. Results: The majority of ACL injuries in the military environment occurred through non-contact injury. Changing direction (46.4%) was the most common lower-leg position, followed by landing with the knee in a valgus position (26.8%). The activity undertaken at the time of injury was exercise in 76.2% of cases and military training/daily activities in 23.8% of cases. The incidence of ACL injury was higher in the soldier compared to the officer group during exercise (P = 0.017). Soccer was the most common activity at the time of injury (54.1%), followed by military training/daily activities, futsal, and basketball. The most common injury time was between 30 and 60 min after the start of exercise. Commonly associated injury sites were the medial meniscus and the medial collateral ligament. Conclusions: The main mechanism of ACL injury occurring in the military environment was non-contact injury, especially on changing the direction of the lower leg. Soccer was the most frequent activity at the time of the injury. These findings suggested that preventive strategies against ACL injury in the military environment could effectively reduce the incidence of ACL injury.
Abstract
Purpose: Anterior cruciate ligament (ACL) injury is very common but few studies have analyzed the injury mechanism and cause of ACL tear in a specific environment such as a military institution. The purpose of this study was to analyze the injury mechanism and cause of ACL injury in the military environment. Additionally, this study could provide outcomes that may aid future studies on prevention of ACL injury in military personnel. Materials and methods: This study retrospectively analyzed 168 patients who sustained ACL tear while in military service and underwent ACL reconstruction surgery in a military hospital. Analysis of the injury mechanism and the cause was evaluated by analyzing the medical records. Knee magnetic resonance imaging analysis was also conducted for further evaluation of associated injury. Results: The majority of ACL injuries in the military environment occurred through non-contact injury. Changing direction (46.4%) was the most common lower-leg position, followed by landing with the knee in a valgus position (26.8%). The activity undertaken at the time of injury was exercise in 76.2% of cases and military training/daily activities in 23.8% of cases. The incidence of ACL injury was higher in the soldier compared to the officer group during exercise (P = 0.017). Soccer was the most common activity at the time of injury (54.1%), followed by military training/daily activities, futsal, and basketball. The most common injury time was between 30 and 60 min after the start of exercise. Commonly associated injury sites were the medial meniscus and the medial collateral ligament. Conclusions: The main mechanism of ACL injury occurring in the military environment was non-contact injury, especially on changing the direction of the lower leg. Soccer was the most frequent activity at the time of the injury. These findings suggested that preventive strategies against ACL injury in the military environment could effectively reduce the incidence of ACL injury.
참고문헌 (31)
- Carow SD, "Risk of lower extremity injury in a military cadet population after a supervised injury-prevention program", J Athl Train, 51(11), pp.905~918 (2016)
- Hewett TE, "Mechanisms, prediction, and prevention of ACL injuries: cut risk with three sharpened and validated tools", J Orthop Res, 34(11), pp.1843~1855 (2016)
- Kaeding CC, "Epidemiology and diagnosis of anterior cruciate ligament injuries", Clin Sports Med, 36(1), pp.1~8 (2017)
- Hewett TE, "The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study", Am J Sports Med, 27(6), pp.699~706 (1999)
- Toth AP, "Anterior cruciate ligament injuries in the female athlete", J Gend Specif Med, 4(4), pp.25~34 (2001)
- Kuikka PI, "Knee injuries related to sports in young adult males during military service - incidence and risk factors", Scand J Med Sci Sports, 23(3), pp.281~287 (2013)
- Johnston JT, "Video analysis of anterior cruciate ligament tears in professional American football athletes", Am J Sports Med, 46(4), pp.862~868 (2018)
- Griffin LY, "Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies", J Am Acad Orthop Surg, 8(3), pp.141~150 (2000)
- Griffin LY, "Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II meeting, January 2005", Am J Sports Med, 34(9), pp.1512~1532 (2006)
- Peterson JR, "Anterior cruciate ligament injury: mechanisms of injury and strategies for injury prevention", Phys Med Rehabil Clin N Am, 25(4), pp.813~828 (2014)
- Grooms DR, "Neuroscience application to noncontact anterior cruciate ligament injury prevention", Sports Health, 8(2), pp.149~152 (2016)
- Kobayashi H, "Mechanisms of the anterior cruciate ligament injury in sports activities: a twenty-year clinical research of 1,700 athletes", J Sports Sci Med, 9(4), pp.669~675 (2010)
- Brophy RH, "Defending puts the anterior cruciate ligament at risk during soccer: a gender-based analysis", Sports Health, 7(3), pp.244~249 (2015)
- Walden M, "Three distinct mechanisms predominate in non-contact anterior cruciate ligament injuries in male professional football players: a systematic video analysis of 39 cases", Br J Sports Med, 49(22), pp.1452~1460 (2015)
- Shimokochi Y, "Mechanisms of noncontact anterior cruciate ligament injury", J Athl Train, 43(4), pp.396~408 (2008)
- Kim SY, "Knee kinematics during noncontact anterior cruciate ligament injury as determined from bone bruise location", Am J Sports Med, 43(10), pp.2515~2521 (2015)
- Kiapour AM, "Strain response of the anterior cruciate ligament to uniplanar and multiplanar loads during simulated landings: implications for injury mechanism", Am J Sports Med, 44(8), pp.2087~2096 (2016)
- Andersen KA, "Musculoskeletal lower limb injury risk in army populations", Sports Med Open, 2, pp.22~ (2016)
- Owens BD, "Incidence of anterior cruciate ligament injury among active duty U.S. military servicemen and servicewomen", Mil Med, 172(1), pp.90~91 (2007)
- Lohmander LS, "High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury", Arthritis Rheum, 50(10), pp.3145~3152 (2004)
- Lohmander LS, "The long-term consequence of anterior cruciate ligament and meniscus injuries:osteoarthritis", Am J Sports Med, 35(10), pp.1756~1769 (2007)
- Mandelbaum BR, "Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up", Am J Sports Med, 33(7), pp.1003~1010 (2005)
- Hewett TE, "The 2012ABJS Nicolas Andry Award: the sequence of prevention: a systematic approach to prevent anterior cruciate ligament injury", Clin Orthop Relat Res, 470(10), pp.2930~2940 (2012)
- Chappell JD, "Effect of fatigue on knee kinetics and kinematics in stop-jump tasks", Am J Sport Med, 33(7), pp.1022~1029 (2005)
- McLean SG, "Impact of fatigue on gender-based high-risk landing strategies", Med Sci Sport Exer, 39(3), pp.502~514 (2007)
- Borotikar BS, "Combined effects of fatigue and decision making on female lower limb landing postures:central and peripheral contributions to ACL injury risk", Clin Biomech (Bristol, Avon), 23(1), pp.81~92 (2008)
- McLean SG, "Fatigue-induced ACL injury risk stems from a degradation in central control", Med Sci Sports Exerc, 41(8), pp.1661~1672 (2009)
- Wojtys EM, "New perspectives on ACL injury: on the role of repetitive sub-maximal knee loading in causing ACL fatigue failure", J Orthop Res, 34(12), pp.2059~2068 (2016)
- Jones BH, "Epidemiology of injuries associated with physical training among young men in the army", Med Sci Sports Exerc, 25(2), pp.197~203 (1993)
- Finestone A, "Overuse injuries in female infantry recruits during low-intensity basic training", Med Sci Sports Exerc, 40(11 Suppl), pp.S630~S635 (2008)
- Cowan DN, "Musculoskeletal injuries among overweight army trainees: incidence and health care utilization", Occup Med (Lond), 61(4), pp.247~252 (2011)