TY - JOUR
T1 - The 2012 ABJS nicolas andry award
T2 - The sequence of prevention: A systematic approach to prevent anterior cruciate ligament injury knee
AU - Hewett, Timothy E.
AU - Myer, Gregory D.
AU - Ford, Kevin R.
AU - Paterno, Mark V.
AU - Quatman, Carmen E.
N1 - Funding Information:
One of more of the authors has received funding from the National Institutes of Health grants R01-AR049735 (TEH), R01-AR056259 (TEH), R01-AR055563 (TEH), and R03-AR057551 (KRF); The Orthopaedic Research and Education Foundation (OREF) (TEH); National Football League Charities (TEH); University of Toledo College of Medicine Pre-Doctoral Fellowship (CEQ); and the American College of Sports Medicine Foundation Plus One Active Research Grant on Wellness Using Internet Technology (CEQ). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. This work was performed at Cincinnati Children’s Hospital Medical Center, Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH, USA.
PY - 2012/10
Y1 - 2012/10
N2 - Background: ACL injuries are common, often devastating injuries that lead to short-term disability and long-term sequelae, many of which lack effective treatment, such as osteoarthritis. Therefore, prevention of ACL injury is currently the only effective intervention for these life-altering sequelae, while much of the literature has a rehabilitative focus. Questions/Purposes: The primary long-term purpose of our multidisciplinary collaborative research team has been to develop ACL injury prevention programs by determining which factors related to ACL injury should be altered, followed by how and when they should be altered. Methods: Our primary study objectives were to determine: (1) modifiable risk factors; (2) how these factors can best be modified; and (3) when is the best time to diminish these risk factors. Throughout the course of various studies, we determined the modifiable factors related to increased ACL injury risk. Our research team then focused on exploring numerous ways to augment these factors to maximize prevention efforts. We developed a sequence of prevention models that provide a framework to monitor progress toward the ultimate goal of preventing ACL injuries. Results: The modifiable factors shown in our work include biomechanical and neuromuscular functionality. When targeted in physical training, we have determined that these factors can be enhanced to effectively aid in the prevention of ACL injuries. Preliminary data have shown that childhood and early adolescence may be valuable periods to implement such training. Conclusions: Current evidence has led to the evolution of clinical assessment tools for high-risk athletes and interventions for large populations and specific high-risk individuals. Targeted intervention implemented at the specified developmental stage of highest risk may be the final step toward the maximal reduction of ACL injury risk in young athletes.
AB - Background: ACL injuries are common, often devastating injuries that lead to short-term disability and long-term sequelae, many of which lack effective treatment, such as osteoarthritis. Therefore, prevention of ACL injury is currently the only effective intervention for these life-altering sequelae, while much of the literature has a rehabilitative focus. Questions/Purposes: The primary long-term purpose of our multidisciplinary collaborative research team has been to develop ACL injury prevention programs by determining which factors related to ACL injury should be altered, followed by how and when they should be altered. Methods: Our primary study objectives were to determine: (1) modifiable risk factors; (2) how these factors can best be modified; and (3) when is the best time to diminish these risk factors. Throughout the course of various studies, we determined the modifiable factors related to increased ACL injury risk. Our research team then focused on exploring numerous ways to augment these factors to maximize prevention efforts. We developed a sequence of prevention models that provide a framework to monitor progress toward the ultimate goal of preventing ACL injuries. Results: The modifiable factors shown in our work include biomechanical and neuromuscular functionality. When targeted in physical training, we have determined that these factors can be enhanced to effectively aid in the prevention of ACL injuries. Preliminary data have shown that childhood and early adolescence may be valuable periods to implement such training. Conclusions: Current evidence has led to the evolution of clinical assessment tools for high-risk athletes and interventions for large populations and specific high-risk individuals. Targeted intervention implemented at the specified developmental stage of highest risk may be the final step toward the maximal reduction of ACL injury risk in young athletes.
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U2 - 10.1007/s11999-012-2440-2
DO - 10.1007/s11999-012-2440-2
M3 - Article
C2 - 22744203
AN - SCOPUS:84866353092
SN - 0009-921X
VL - 470
SP - 2930
EP - 2940
JO - Clinical Orthopaedics and Related Research
JF - Clinical Orthopaedics and Related Research
IS - 10
ER -