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Understanding and Preventing Noncontact Anterior Cruciate Ligament Injuries

A Review of the Hunt Valley II Meeting, January 2005

Letha Y. Griffin, MD, PhD^*,,1, Marjorie J. Albohm, MS, ATC², Elizabeth A. Arendt, MD^,3, Roald Bahr, MD, PhD^,4, Bruce D. Beynnon, PhD^5,, Marlene DeMaio, CAPT, MC, USN^,6, Randall W. Dick, MSc⁷, Lars Engebretsen, MD, PhD⁴, William E. Garrett, MD, PhD, Jr^,8, Jo A. Hannafin, MD, PhD^,9, Tim E. Hewett, PhD¹⁰, Laura J. Huston, MSc^,11, Mary Lloyd Ireland, MD¹², Robert J. Johnson, MD⁵, Scott Lephart, PhD, ATC¹³, Bert R. Mandelbaum, MD¹⁴, Barton J. Mann, PhD^,15, Paul H. Marks, MD¹⁶, Stephen W. Marshall, PhD^,17, Grethe Myklebust, PhD⁴, Frank R. Noyes, MD¹⁸, Christopher Powers, PhD^,19, Clarence Shields, MD, Jr²⁰, Sandra J. Shultz, PhD, ATC^,21, Holly Silvers, MPT²², James Slauterbeck, MD^,5, Dean C. Taylor, MD²³, Carol C. Teitz, MD^,24, Edward M. Wojtys, MD^,25 and Bing Yu, PhD^,26

From the ¹ Peachtree Orthopaedic Clinic, Atlanta, Georgia, ² OrthoIndy, Indianapolis, Indiana, ³ Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, ⁴ Oslo Sports Trauma Research Center, University of Sport and Physical Education, Oslo, Norway, ⁵ Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington, Vermont, ⁶ Department of Orthopaedics, Bone and Joint/Sports Medicine Institute, Naval Medical Center, Portsmouth, Virginia, ⁷ NCAA, National Collegiate Athletic Association, Indianapolis, Indiana, ⁸ Department of Orthopaedics, Duke University Medical Center, Durham, North Carolina, ⁹ Hospital for Special Surgery, New York, New York, ¹⁰ Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, ¹¹ Vanderbilt Orthopaedic Institute Medical Center East, Nashville, Tennessee, ¹² Kentucky Sports Medicine Clinic, Lexington, Kentucky, ¹³ Neuromuscular Research Laboratory, UPMC Center for Sports Medicine, Pittsburgh, Pennsylvania, ¹⁴ Santa Monica Orthopaedic and Sports Medicine Group, Santa Monica, California, ¹⁵ American Orthopaedic Society for Sports Medicine, Rosemont, Illinois, ¹⁶ University of Toronto, Ontario, Canada, ¹⁷ Department of Epidemiology, School of Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, ¹⁸ Cincinnati Sportsmedicine Research & Education Foundation, Cincinnati, Ohio, ¹⁹ Department of Biokinesiology & Physical Therapy, University of Southern California, Los Angeles, California, ²⁰ Kerlan-Jobe Orthopaedic Clinic, Westchester, Los Angeles, California, ²¹ Department of Exercise and Sport Science, University of North Carolina, Greensboro, North Carolina, ²² Santa Monica Orthopaedic and Sports Medicine Research Foundation, Santa Monica, California, ²³ TRIA Orthopaedic Center, Minneapolis, Minnesota, ²⁴ U of W Sports Medicine Clinic, University of Washington, Seattle, Washington, ²⁵ MedSport, University of Michigan, Ann Arbor, Michigan, ²⁶ Division of Physical Therapy, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina

^* Address correspondence to Letha Y. Griffin, MD, PhD, Peachtree Orthopaedic Clinic, 2045 Peachtree Road, Suite 700, Atlanta, GA 30309 (e-mail: lethagriff{at}aol.com).

The incidence of noncontact anterior cruciate ligament injuries in young to middle-aged athletes remains high. Despite early diagnosis and appropriate operative and nonoperative treatments, posttraumatic degenerative arthritis may develop. In a meeting in Atlanta, Georgia (January 2005), sponsored by the American Orthopaedic Society for Sports Medicine, a group of physicians, physical therapists, athletic trainers, biomechanists, epidemiologists, and other scientists interested in this area of research met to review current knowledge on risk factors associated with noncontact anterior cruciate ligament injuries, anterior cruciate ligament injury biomechanics, and existing anterior cruciate ligament prevention programs. This article reports on the presentations, discussions, and recommendations of this group.

Key Words: anterior cruciate ligament (ACL) injuries • injury prevention • athletic injuries • knee injuries

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