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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ELimited range of hip internal rotation has been associated with an increased risk for anterior cruciate ligament (ACL) injury, whereby the hips of ACL-injured patients rotated 12.6\u00b0 less than those of noninjured individuals [Gomes JL et al. \u003Cem\u003EArthroscopy\u003C\/em\u003E 2008]. This article discusses the underlying mechanism of injury to the ACL associated with decreased internal rotation of the hip.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EM\u00e9lanie Beaulieu, MSc, a doctoral student at the University of Michigan School of Kinesiology, Ann Arbor, Michigan, USA, reported on the underlying mechanism of injury to the anterior cruciate ligament (ACL) associated with decreased internal rotation of the hip.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ELimited range of hip internal rotation has been associated with an increased risk for ACL injury, whereby the hips of ACL-injured patients rotated 12.6\u00b0 less than those of noninjured individuals [Gomes JL et al. \u003Cem\u003EArthroscopy\u003C\/em\u003E 2008]. The most common cause is femoroacetabular impingement, a condition in which 1 or both bones of the hip joint are abnormally shaped. This deformity can produce abnormal contact between the bones, which progressively damages the joint. The prevalence of femoroacetabular impingement is 6% to 25% in individuals who are asymptomatic [Monazzam S et al. \u003Cem\u003EBone Joint J\u003C\/em\u003E 2013; Reichenbach S et al. \u003Cem\u003EArthr Care Res\u003C\/em\u003E 2010] but exceeds 60% in patients with pathological hips [Beck M et al. \u003Cem\u003EJ Bone Joint Surg Br\u003C\/em\u003E 2005]. Affected individuals are predominantly young (eg, college athletes) and have an increased risk for early osteoarthritis of the hip.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe study was grounded in 2 hypotheses. The first posited that as internal femoral rotation decreases, the magnitude of peak ACL strain increases. The second was that women have greater peak ACL strain than do men, regardless of the range of internal femoral rotation.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003ETwenty knee specimens, 10 each from men and women, were harvested from fresh, unembalmed cadavers and tested. The donors were similar in age (men, 59.9 \u00b1 6.6 years; women, 55.2 \u00b1 10.5 years), with men being predictably taller (men, 1.77 \u00b1 .05 m; women, 1.67 \u00b1 .06 m), heavier (men, 81.3 \u00b1 8.2 kg; women 60.5 \u00b1 8.3 kg), and with greater body mass indexes (men, 25.9 \u00b1 2.3 kg\/m\u003Csup\u003E2\u003C\/sup\u003E; women 21.6 \u00b1 3.1 kg\/m\u003Csup\u003E2\u003C\/sup\u003E) than women. Each knee was dissected to leave the joint capsule and associated tendons of the quadriceps, hamstrings, and gastrocnemii intact. Each knee specimen was inverted and positioned in a testing apparatus, diagrammed in \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E. The device was designed to subject the specimen to forces that simulate a jump landing at twice body weight, including a twist of the knee (ie, internal tibial torque). The forces, moments, and motion produced during the landings were measured. Also, ACL strain was measured using a device called a differential variable reluctance displacement transducer, which was placed on the anteromedial bundle of the ACL. For each knee specimen, 4 conditions of internal femoral rotation were simulated, ranging from locked to free rotation (\u223c3\u00b0\u201315\u00b0).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/23\/9\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Diagram of the Testing Apparatus\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-916581762\u0022 data-figure-caption=\u0022Diagram of the Testing Apparatus\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/23\/9\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/23\/9\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/23\/9\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14780\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EDiagram of the Testing Apparatus\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EAM-ACL=anteromedial anterior cruciate ligament; BW=body weight; DVRT=differential variable reluctance transducer.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from M Beaulieu, MSc.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EAs expected, peak ACL strain increased as internal femoral rotation was decreased during the simulated pivot landings. Furthermore, the female ACLs experienced greater peak strain than did the male ACLs, irrespective of the range of internal femoral rotation.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThe researchers surmised that the cause of the increased ACL strain is the increased internal rotation and anterior translation of the knee joint that occur. The authors postulated that screening for a limited range of hip internal rotation might be helpful in identifying athletes with increased risk for ACL injury. These athletes may benefit most from participating in ACL injury prevention programs.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/23\/9.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzowod\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzowod\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}