Authors: Jefferson Brand, MD, Richard Hardy, Ed.D., LAT, CSCS, Christopher Butler, Ph.D., Emily Monroe, MD
Richard Hardy Ed.D., LAT, CSCS
111 17th Ave E #101, Alexandria, MN 56308
Office number: 320-589-6443
Cell number: 320-760-2031
Richard Hardy is a certified athletic trainer and coordinator of research at Heartland Orthopedic Specialists in Alexandria, MN. He is also contracted to the University of Minnesota Morris where he serves as an instructor and provides athletic training services.
Kinetic chain injuries and their relationship to subsequent ACL tears
Purpose: The relationship between previous kinetic chain injuries and the likelihood of anterior cruciate ligament (ACL) injuries remains under-explored. We compared the number of ankle injuries between subjects that had a surgically treated ACL tear to subjects that had a surgically treated shoulder injury (e.g., labral tear). We evaluated if a previous disruption of the lower kinetic chain (e.g., ankle injury) is a predisposing factor for ACL injuries. Our hypothesis was that ACL reconstruction patients will have a higher rate of previous ankle injuries than the control group (surgically treated labral tear).
Methods: Overall, 108 patients have undergone either ACL reconstruction or labral repair surgery. To insure similarity, we assessed Tegner activity level, knee alignment, and Beighton scale. Patients completed a questionnaire about demographics, ankle injury history, and the AOFAS Ankle-Hindfoot scale. ANOVA statistically tested demographic data. Fisher’s exact test was used to determine if differences in previous ankle injury rates existed between groups.
Results: Overall, 63 patients (34 males/29 females) had ACL reconstruction and 45 patients (36 males/9 females) in the control group had surgery for labral lesions. No statistical differences occurred (P>0.05) for demographic data (age, BMI), Tegner activity scale, knee alignment, Beighton scale, or AOFAS Ankle-Hindfoot scores for each ankle. This suggests that the groups were comparable. Previous ankle injuries were common in both groups but not statistically significant.
Conclusions: Comparing surgically ACL injured knees to surgically treated labral tears, there was no significant difference in the rate of previous ankle injury. Therefore, previous ankle injuries may not predispose nor protect against future anterior cruciate ligament injuries.
Applications in sport: The knee is a link in the kinetic chain between the hip and ankle joints. Due to this, dysfunction of the ankle or hip joints could negatively affect the function of the knee joint. Therefore, we set out to see if ankle injury history is a predisposing factor for tears of the ACL of the knee. Through our research, we found that this was not the case; ACL tears occur independently to the kinetic chain. (more…)