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British Journal of Sports Medicine logoLink to British Journal of Sports Medicine
. 2005 Jun;39(6):355–362. doi: 10.1136/bjsm.2005.018598

Evaluation of a two dimensional analysis method as a screening and evaluation tool for anterior cruciate ligament injury

S McLean 1, K Walker 1, K Ford 1, G Myer 1, T Hewett 1, A J van den Bogert 1
PMCID: PMC1725240  PMID: 15911607

Abstract

Background: Increased knee valgus predicts the risk of anterior cruciate ligament (ACL) injury, particularly in women. Reducing injury rates thus relies on detecting and continually evaluating people with relatively large valgus motions.

Objectives: To examine the potential of a two dimensional (2D) video analysis method for screening for excessive valgus.

Methods: Ten female and 10 male National Collegiate Athletic Association basketball players had three dimensional (3D) knee valgus and two dimensional (2D) frontal plane knee angle quantified during side step, side jump, and shuttle run tasks. 3D valgus was quantified from external marker coordinates using standard techniques, and 2D data were obtained from both the frontal plane projections of these coordinates (2D-Mot) and manual digitisation of digital video footage (2D-Cam). A root mean square (RMS) error was calculated between 2D-Mot and 2D-Cam data to evaluate the reliability of the latter. Correlations between 2D-Cam and 3D data (intersubject and intrasubject) were also conducted, and regression slope and r2 values obtained.

Results: 2D-Cam and 2D-Mot data were consistent for side step (RMS = 1.7°) and side jump (RMS = 1.5°) movements. Between subjects, 2D-Cam and 3D data correlated well for the side step (r2 = 0.58) and side jump (r2 = 0.64). Within subjects, 2D-Cam and 3D data correlated moderately for the side step (r2 = 0.25 (0.19)) and side jump (r2 = 0.36 (0.27)).

Conclusions: The 2D-Cam method can be used to screen for excessive valgus in elite basketball players, particularly for movements occurring primarily in the frontal plane. This method may also be a useful training evaluation tool when large reductions in dynamic valgus motions are required.

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Selected References

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  1. Andriacchi T. P., Alexander E. J., Toney M. K., Dyrby C., Sum J. A point cluster method for in vivo motion analysis: applied to a study of knee kinematics. J Biomech Eng. 1998 Dec;120(6):743–749. doi: 10.1115/1.2834888. [DOI] [PubMed] [Google Scholar]
  2. Arendt E., Dick R. Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med. 1995 Nov-Dec;23(6):694–701. doi: 10.1177/036354659502300611. [DOI] [PubMed] [Google Scholar]
  3. Bell A. L., Pedersen D. R., Brand R. A. A comparison of the accuracy of several hip center location prediction methods. J Biomech. 1990;23(6):617–621. doi: 10.1016/0021-9290(90)90054-7. [DOI] [PubMed] [Google Scholar]
  4. Cappozzo A., Catani F., Croce U. Della, Leardini A. Position and orientation in space of bones during movement: anatomical frame definition and determination. Clin Biomech (Bristol, Avon) 1995 Jun;10(4):171–178. doi: 10.1016/0268-0033(95)91394-t. [DOI] [PubMed] [Google Scholar]
  5. Chappell Jonathan D., Yu Bing, Kirkendall Donald T., Garrett William E. A comparison of knee kinetics between male and female recreational athletes in stop-jump tasks. Am J Sports Med. 2002 Mar-Apr;30(2):261–267. doi: 10.1177/03635465020300021901. [DOI] [PubMed] [Google Scholar]
  6. Della Croce Ugo, Leardini Alberto, Chiari Lorenzo, Cappozzo Aurelio. Human movement analysis using stereophotogrammetry. Part 4: assessment of anatomical landmark misplacement and its effects on joint kinematics. Gait Posture. 2005 Feb;21(2):226–237. doi: 10.1016/j.gaitpost.2004.05.003. [DOI] [PubMed] [Google Scholar]
  7. Ford Kevin R., Myer Gregory D., Hewett Timothy E. Valgus knee motion during landing in high school female and male basketball players. Med Sci Sports Exerc. 2003 Oct;35(10):1745–1750. doi: 10.1249/01.MSS.0000089346.85744.D9. [DOI] [PubMed] [Google Scholar]
  8. Frank C. B., Jackson D. W. The science of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am. 1997 Oct;79(10):1556–1576. doi: 10.2106/00004623-199710000-00014. [DOI] [PubMed] [Google Scholar]
  9. Griffin L. Y., Agel J., Albohm M. J., Arendt E. A., Dick R. W., Garrett W. E., Garrick J. G., Hewett T. E., Huston L., Ireland M. L. Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg. 2000 May-Jun;8(3):141–150. doi: 10.5435/00124635-200005000-00001. [DOI] [PubMed] [Google Scholar]
  10. Grood E. S., Suntay W. J. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. 1983 May;105(2):136–144. doi: 10.1115/1.3138397. [DOI] [PubMed] [Google Scholar]
  11. Hewett T. E., Lindenfeld T. N., Riccobene J. V., Noyes F. R. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. Am J Sports Med. 1999 Nov-Dec;27(6):699–706. doi: 10.1177/03635465990270060301. [DOI] [PubMed] [Google Scholar]
  12. Hewett T. E., Stroupe A. L., Nance T. A., Noyes F. R. Plyometric training in female athletes. Decreased impact forces and increased hamstring torques. Am J Sports Med. 1996 Nov-Dec;24(6):765–773. doi: 10.1177/036354659602400611. [DOI] [PubMed] [Google Scholar]
  13. Hewett Timothy E., Myer Gregory D., Ford Kevin R., Heidt Robert S., Jr, Colosimo Angelo J., McLean Scott G., van den Bogert Antonie J., Paterno Mark V., Succop Paul. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med. 2005 Feb 8;33(4):492–501. doi: 10.1177/0363546504269591. [DOI] [PubMed] [Google Scholar]
  14. Leardini Alberto, Chiari Lorenzo, Della Croce Ugo, Cappozzo Aurelio. Human movement analysis using stereophotogrammetry. Part 3. Soft tissue artifact assessment and compensation. Gait Posture. 2005 Feb;21(2):212–225. doi: 10.1016/j.gaitpost.2004.05.002. [DOI] [PubMed] [Google Scholar]
  15. Lephart Scott M., Abt John P., Ferris Cheryl M. Neuromuscular contributions to anterior cruciate ligament injuries in females. Curr Opin Rheumatol. 2002 Mar;14(2):168–173. doi: 10.1097/00002281-200203000-00014. [DOI] [PubMed] [Google Scholar]
  16. Lohmander L. S., Ostenberg A., Englund M., Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum. 2004 Oct;50(10):3145–3152. doi: 10.1002/art.20589. [DOI] [PubMed] [Google Scholar]
  17. Lu T. W., O'Connor J. J. Bone position estimation from skin marker co-ordinates using global optimisation with joint constraints. J Biomech. 1999 Feb;32(2):129–134. doi: 10.1016/s0021-9290(98)00158-4. [DOI] [PubMed] [Google Scholar]
  18. Maletius W., Messner K. Eighteen- to twenty-four-year follow-up after complete rupture of the anterior cruciate ligament. Am J Sports Med. 1999 Nov-Dec;27(6):711–717. doi: 10.1177/03635465990270060501. [DOI] [PubMed] [Google Scholar]
  19. Malinzak R. A., Colby S. M., Kirkendall D. T., Yu B., Garrett W. E. A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clin Biomech (Bristol, Avon) 2001 Jun;16(5):438–445. doi: 10.1016/s0268-0033(01)00019-5. [DOI] [PubMed] [Google Scholar]
  20. McLean S. G., Su A., van den Bogert A. J. Development and validation of a 3-D model to predict knee joint loading during dynamic movement. J Biomech Eng. 2003 Dec;125(6):864–874. doi: 10.1115/1.1634282. [DOI] [PubMed] [Google Scholar]
  21. McLean Scott G., Huang Xuemei, Su Anne, Van Den Bogert Antonie J. Sagittal plane biomechanics cannot injure the ACL during sidestep cutting. Clin Biomech (Bristol, Avon) 2004 Oct;19(8):828–838. doi: 10.1016/j.clinbiomech.2004.06.006. [DOI] [PubMed] [Google Scholar]
  22. McLean Scott G., Lipfert Susanne W., van den Bogert Antonie J. Effect of gender and defensive opponent on the biomechanics of sidestep cutting. Med Sci Sports Exerc. 2004 Jun;36(6):1008–1016. doi: 10.1249/01.mss.0000128180.51443.83. [DOI] [PubMed] [Google Scholar]
  23. Myer Gregory D., Ford Kevin R., Palumbo Joseph P., Hewett Timothy E. Neuromuscular training improves performance and lower-extremity biomechanics in female athletes. J Strength Cond Res. 2005 Feb;19(1):51–60. doi: 10.1519/13643.1. [DOI] [PubMed] [Google Scholar]
  24. Myklebust G., Maehlum S., Holm I., Bahr R. A prospective cohort study of anterior cruciate ligament injuries in elite Norwegian team handball. Scand J Med Sci Sports. 1998 Jun;8(3):149–153. doi: 10.1111/j.1600-0838.1998.tb00185.x. [DOI] [PubMed] [Google Scholar]
  25. Myklebust Grethe, Engebretsen Lars, Braekken Ingeborg Hoff, Skjølberg Arnhild, Olsen Odd-Egil, Bahr Roald. Prevention of anterior cruciate ligament injuries in female team handball players: a prospective intervention study over three seasons. Clin J Sport Med. 2003 Mar;13(2):71–78. doi: 10.1097/00042752-200303000-00002. [DOI] [PubMed] [Google Scholar]
  26. Persson T. A marker-free method for tracking human lower limb segments based on model matching. Int J Biomed Comput. 1996 Apr;41(2):87–97. doi: 10.1016/0020-7101(95)01161-7. [DOI] [PubMed] [Google Scholar]
  27. Scheirman G. L., Risenhoover S. A., Dillman B. B. The peak performance system for dynamic gait analysis. Clin Podiatr Med Surg. 1993 Jul;10(3):529–538. [PubMed] [Google Scholar]
  28. Woltring H. J., Huiskes R., de Lange A., Veldpaus F. E. Finite centroid and helical axis estimation from noisy landmark measurements in the study of human joint kinematics. J Biomech. 1985;18(5):379–389. doi: 10.1016/0021-9290(85)90293-3. [DOI] [PubMed] [Google Scholar]
  29. Zeller Brian L., McCrory Jean L., Kibler W. Ben, Uhl Timothy L. Differences in kinematics and electromyographic activity between men and women during the single-legged squat. Am J Sports Med. 2003 May-Jun;31(3):449–456. doi: 10.1177/03635465030310032101. [DOI] [PubMed] [Google Scholar]

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