Evidence map›Paper›PMID 29318174›Full record

ArticleOrthopaedic journal of sports medicine2017

Sagittal Plane Hip, Knee, and Ankle Biomechanics and the Risk of Anterior Cruciate Ligament Injury: A Prospective Study.

Mari Leppänen, Kati Pasanen, Tron Krosshaug, Pekka Kannus, Tommi Vasankari, Urho M Kujala, Roald Bahr, Jarmo Perttunen, Jari Parkkari

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Orthopaedic journal of sports medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 7 pooled it
9.7field-weighted citation impact, top 1% 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

61 citing papers in PubMed, 7 syntheses or guidelines pooled it, 149 citations in OpenAlex.

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  17. Competitive floorball over the last decade: a scoping review.Frontiers in sports and active living · 2026
    Review
  18. Article
  19. Boosting the clinical use of ground reaction forces in anterior cruciate ligament injury prevention: The 'CUTtheACL' study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025
    Article
  20. Interpretable prediction of knee joint loading during tennis serves based on GNN-GRU model and layer-wise relevance propagation.Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine · 2025
    Article

1 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

9 authors at 4 institutions in 2 countries.

Mari LeppänenTampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.
Kati PasanenTampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.
Tron KrosshaugOslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
Pekka KannusUKK Institute, Tampere, Finland.
Tommi VasankariUKK Institute, Tampere, Finland.
Urho M KujalaFaculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Roald BahrOslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
Jarmo PerttunenTampere University of Applied Sciences, Tampere, Finland.
Jari ParkkariTampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.
Urho Kaleva Kekkonen Institute · FIOslo Sports Trauma Research Center · NOTampere University of Applied Sciences · FIUniversity of Jyväskylä · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStiff landings with less knee flexion and high vertical ground-reaction forces have been shown to be associated with an increased risk of anterior cruciate ligament (ACL) injury. The literature on the association between other sagittal plane measures and the risk of ACL injuries with a prospective study design is lacking. PURPOSE: To investigate the relationship between selected sagittal plane hip, knee, and ankle biomechanics and the risk of ACL injury in young female team-sport athletes. STUDY

designCase-control study; Level of evidence, 3.

methodsA total of 171 female basketball and floorball athletes (age range, 12-21 years) participated in a vertical drop jump test using 3-dimensional motion analysis. All new ACL injuries, as well as match and training exposure data, were recorded for 1 to 3 years. Biomechanical variables, including hip and ankle flexion at initial contact (IC), hip and ankle ranges of motion (ROMs), and peak external knee and hip flexion moments, were selected for analysis. Cox regression models were used to calculate hazard ratios (HRs) with 95% CIs. The combined sensitivity and specificity of significant test variables were assessed using a receiver operating characteristic (ROC) curve analysis.

resultsA total of 15 noncontact ACL injuries were recorded during follow-up (0.2 injuries/1000 player-hours). Of the variables investigated, landing with less hip flexion ROM (HR for each 10° increase in hip ROM, 0.61 [95% CI, 0.38-0.99];

conclusionLanding with less hip flexion ROM and a greater peak external knee flexion moment was associated with an increased risk of ACL injury in young female team-sport players. Studies with larger populations are needed to confirm these findings and to determine the role of ankle flexion ROM as a risk factor for ACL injury. Increasing knee and hip flexion ROMs to produce soft landings might reduce knee loading and risk of ACL injury in young female athletes.

Indexed as

anterior cruciate ligamentbiomechanicsfemalerisk factorsteam sports

Identifiers

PMID29318174
PMCPMC5753918
OpenAlexW2778236555

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.