Evidence map›Paper›PMID 27653237›Full record

ReviewJournal of orthopaedic research : official publication of the Orthopaedic Research Society2016

New perspectives on ACL injury: On the role of repetitive sub-maximal knee loading in causing ACL fatigue failure.

Edward M Wojtys, Mélanie L Beaulieu, James A Ashton-Miller

Open access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 2 pooled it
4.7field-weighted citation impact, top 5% of its field
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

48 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.

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  9. Female Anterior Cruciate Ligaments Exhibit a Muted Mechanobiological Response to Mechanical Loading.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025
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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

3 authors at 2 institutions in 1 country.

Edward M WojtysMedSport, Department of Orthopedic Surgery, University of Michigan, Ann Arbor, Michigan, 48109.
Mélanie L BeaulieuBiomechanics Research Laboratory, Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, 48109.
James A Ashton-MillerBiomechanics Research Laboratory, Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, 48109.
University of Michigan–Ann Arbor · USMichigan Medicine · US

Funding

Research Education CoreP30AG024824 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Neil Alexander · 2004 to 2026
$29.2M
New Perspectives on ACL InjuryR01AR054821 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI ASHTON-MILLER, JAMES ANTHONY, WOJTYS, EDWARD M · 2007 to 2021
$3.1M
NIAMS NIH HHS R01 AR054821NIA NIH HHS P30 AG024824
6 · The paper itself

Abstract

In this paper, we review a series of studies that we initiated to examine mechanisms of anterior cruciate ligament (ACL) injury in the hope that these injuries, and their sequelae, can be better prevented. First, using the earliest in vitro model of a simulated single-leg jump landing or pivot cut with realistic knee loading rates and trans-knee muscle forces, we identified the worst-case dynamic knee loading that causes the greatest peak ACL strain: Combined knee compression, flexion, and internal tibial rotation. We also identified morphologic factors that help explain individual susceptibility to ACL injury. Second, using the above knee loading, we introduced a possible paradigm shift in ACL research by demonstrating that the human ACL can fail by a sudden rupture in response to repeated sub-maximal knee loading. If that load is repeated often enough over a short time interval, the failure tended to occur proximally, as observed clinically. Third, we emphasize the value of a physical exam of the hip by demonstrating how limited internal axial rotation at the hip both increases the susceptibility to ACL injury in professional athletes, and also increases peak ACL strain during simulated pivot landings, thereby further increasing the risk of ACL fatigue failure. When training at-risk athletes, particularly females with their smaller ACL cross-sections, rationing the number and intensity of worst-case knee loading cycles, such that ligament degradation is within the ACL's ability to remodel, should decrease the risk for ACL rupture due to ligament fatigue failure.© 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:2059-2068, 2016.

Indexed as

Anterior Cruciate LigamentAnterior Cruciate Ligament InjuriesCumulative Trauma DisordersHamstring MusclesHip JointHumansKnee JointRisk FactorsWeight-Bearinganterior cruciate ligamentfatigue failuremusclerepetitive loadingtibial rotation

Identifiers

PMID27653237
PMCPMC6362839
OpenAlexW2522611431

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.