Evidence map›Paper›PMID 24687011›Full record

ArticleBritish journal of sports medicine2015

High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: is PFP itself a predictor for subsequent ACL injury?

Gregory D Myer, Kevin R Ford, Stephanie L Di Stasi, Kim D Barber Foss, Lyle J Micheli, Timothy E Hewett

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of sports medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

90 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Trial
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article

30 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Gregory D MyerDivision of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA The Sports Health and Performance Institute, OSU Sports Medicine, Ohio State University Medical Center, Columbus, Ohio, USA The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA.
Kevin R FordDivision of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA Department of Physical Therapy, School of Health Sciences, High Point University, High Point, North Carolina, USA.
Stephanie L Di StasiThe Sports Health and Performance Institute, OSU Sports Medicine, Ohio State University Medical Center, Columbus, Ohio, USA.
Kim D Barber FossDivision of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Lyle J MicheliThe Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA.
Timothy E HewettDivision of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA The Sports Health and Performance Institute, OSU Sports Medicine, Ohio State University Medical Center, Columbus, Ohio, USA The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA Departments of Physiology and Cell Biology, Family Medicine and of Orthopaedic Surgery and Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA.

Funding

Neuromuscular Intervention Targeted to Mechanisms of ACL Load in Female AthletesR01AR055563 · NIAMS · OHIO STATE UNIVERSITY · PI BATES, NATHANIEL ANDREW, KRYCH, AARON · 2008 to 2022
$5.9M
Multi-faceted Approach to Modeling ACL Injury MechanismsR01AR056259 · NIAMS · OHIO STATE UNIVERSITY · PI HEWETT, TIMOTHY E · 2009 to 2017
$4.9M
IDENTIFYING FEMALE ATHLETES AT HIGH RISK FOR ACL INJURYR01AR049735 · NIAMS · CINCINNATI CHILDRENS HOSP MED CTR · PI HEWETT, TIMOTHY E · 2004 to 2008
$2.6M
NIAMS NIH HHS R01 AR049735NIAMS NIH HHS R01-AR049735NIAMS NIH HHS R01 AR055563NIAMS NIH HHS R01-AR05563NIAMS NIH HHS R01 AR056259NIAMS NIH HHS R01-AR056259
6 · The paper itself

Abstract

backgroundIdentifying risk factors for knee pain and anterior cruciate ligament (ACL) injury can be an important step in the injury prevention cycle.

objectiveWe evaluated two unique prospective cohorts with similar populations and methodologies to compare the incidence rates and risk factors associated with patellofemoral pain (PFP) and ACL injury.

methodsThe 'PFP cohort' consisted of 240 middle and high school female athletes. They were evaluated by a physician and underwent anthropometric assessment, strength testing and three-dimensional landing biomechanical analyses prior to their basketball season. 145 of these athletes met inclusion for surveillance of incident (new) PFP by certified athletic trainers during their competitive season. The 'ACL cohort' included 205 high school female volleyball, soccer and basketball athletes who underwent the same anthropometric, strength and biomechanical assessment prior to their competitive season and were subsequently followed up for incidence of ACL injury. A one-way analysis of variance was used to evaluate potential group (incident PFP vs ACL injured) differences in anthropometrics, strength and landing biomechanics. Knee abduction moment (KAM) cut-scores that provided the maximal sensitivity and specificity for prediction of PFP or ACL injury risk were also compared between the cohorts.

resultsKAM during landing above 15.4 Nm was associated with a 6.8% risk to develop PFP compared to a 2.9% risk if below the PFP risk threshold in our sample. Likewise, a KAM above 25.3 Nm was associated with a 6.8% risk for subsequent ACL injury compared to a 0.4% risk if below the established ACL risk threshold. The ACL-injured athletes initiated landing with a greater knee abduction angle and a reduced hamstrings-to-quadriceps strength ratio relative to the incident PFP group. Also, when comparing across cohorts, the athletes who suffered ACL injury also had lower hamstring/quadriceps ratio than the players in the PFP sample (p<0.05).

conclusionsIn adolescent girls aged 13.3 years, >15 Nm of knee abduction load during landing is associated with greater likelihood of developing PFP. Also, in girls aged 16.1 years who land with >25 Nm of knee abduction load during landing are at increased risk for both PFP and ACL injury.

Indexed as

Anterior Cruciate Ligament InjuriesAdolescentAthletic InjuriesBasketballBiomechanical PhenomenaFemaleHumansKnee InjuriesKnee JointMovementMuscle, SkeletalPatellofemoral Pain SyndromeProspective StudiesRisk FactorsACLBiomechanicsChildren's injuriesEpidemiologyKnee injuries

Identifiers

PMID24687011
PMCPMC4182160

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.