Clinical Orthopaedics and Related Research®

, Volume 470, Issue 10, pp 2930–2940

The 2012 ABJS Nicolas Andry Award: The Sequence of Prevention: A Systematic Approach to Prevent Anterior Cruciate Ligament Injury

  • Timothy E. Hewett
  • Gregory D. Myer
  • Kevin R. Ford
  • Mark V. Paterno
  • Carmen E. Quatman
Society Awards

DOI: 10.1007/s11999-012-2440-2

Cite this article as:
Hewett, T.E., Myer, G.D., Ford, K.R. et al. Clin Orthop Relat Res (2012) 470: 2930. doi:10.1007/s11999-012-2440-2

Abstract

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.

Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • Timothy E. Hewett
    • 1
    • 2
    • 3
    • 4
    • 5
    • 6
  • Gregory D. Myer
    • 1
    • 3
    • 4
    • 5
    • 7
  • Kevin R. Ford
    • 4
    • 8
    • 9
  • Mark V. Paterno
    • 4
    • 10
  • Carmen E. Quatman
    • 1
    • 4
  1. 1.Departments of Physiology & Cell Biology and Orthopaedic SurgeryThe Ohio State University Sports Medicine Sports Health & Performance InstituteColumbus USA
  2. 2.Family Medicine, School of Allied Medical Professions and Biomedical EngineeringThe Ohio State UniversityColumbusUSA
  3. 3.Athletic Training Division, School of Allied Medical Professions and Biomedical EngineeringThe Ohio State UniversityColumbusUSA
  4. 4.Cincinnati Children’s Hospital Medical Center, Sports Medicine Biodynamics Center and Human Performance LaboratoryCincinnatiUSA
  5. 5.Departments of Pediatrics, Orthopaedic SurgeryUniversity of Cincinnati College of MedicineCincinnatiUSA
  6. 6.Department of Biomedical EngineeringUniversity of Cincinnati College of MedicineCincinnatiUSA
  7. 7.Rocky Mountain University of Health Professions, Departments of Athletic Training, Sports OrthopaedicsPediatric Science and Health Promotion and WellnessProvoUSA
  8. 8.Department of Physical Therapy, School of Health SciencesHigh Point UniversityHigh PointUSA
  9. 9.Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiUSA
  10. 10.Department of Occupational Therapy and Physical TherapyCincinnati Children’s Hospital Medical CenterCincinnatiUSA

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