Jason Corban

Background: Anterior cruciate ligament (ACL) tears can be a source of significant morbidity, with the potential for career-altering implications for athletes who sustain them. Specific knee biomechanics during a drop vertical jump have been shown to be associated with an increased risk for ACL injury in collegiate varsity athletes. Presently, the evolution of these kinematics from preseason to postseason is not well-understood. Purpose: To compare preseason and postseason knee biomechanics during a drop vertical jump in collegiate varsity athletes and identify changes in ACL injury risk. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 114 collegiate athletes were prospectively enrolled. Of these 114, 67 athletes (male, 21 [31%]; female, 46 [69%]) completed properly captured preseason and postseason drop vertical jumps tracked by an affordable motion capture system. Initial coronal (IC), peak coronal (PC), and peak sagittal (PS) angles of the knee were compared between preseason and postseason using the Wilcoxon signed-rank test and paired-samples t test. Athletes at high risk for ACL injury were identified based on published cutoff angles: IC angle >2.96°, PC angle >6.16°, and PS angle P = .03) and mean PC angle (MD, 0.76; P = .04); however, mean IC angle remained in the high-risk range. There was a nonsignificant reduction in mean PS angle, which remained within the high-risk range (MD, 3.96; P = .24). Conclusion: Our study demonstrated that female collegiate varsity athletes demonstrate higher risk knee biomechanics in comparison with their male counterparts. Even with improved biomechanics as their season advances, female athletes have a persistently low PS angle, leaving them at high risk of ACL injury. Using a portable and reliable motion capture system may facilitate monitoring knee kinematics, which could translate into a tool for ACL injury prevention in athletes.

Background: Anterior cruciate ligament (ACL) injuries can pose significant challenges for athletes, leading to significant morbidity, loss of playing time, and impaired performance. Neuromuscular training programs, such as the FIFA 11+, have shown promise in reducing the risk of lower extremity injuries in this high-risk population. Purpose/Hypothesis: The purpose of this study was to evaluate the effect of the FIFA 11+ program on lower extremity biomechanics during a drop vertical jump (DVJ) and to determine whether it modifies the athlete's risk of an ACL injury. It was hypothesized that the FIFA 11+ program would positively affect lower limb biomechanics during a DVJ in varsity athletes by decreasing initial coronal (IC) and peak coronal (PC) knee abduction angles while increasing peak sagittal (PS) knee flexion angles. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 36 collegiate varsity athletes (72 knees) were recruited for this investigation. The intervention group included female and male soccer players who incorporated the FIFA 11+ program into their pregame warm-up. The control group consisted of female hockey players who participated in a “standard” warm-up. The FIFA 11+ program was conducted twice weekly over 10 weeks. Biomechanical data before and after the intervention during DVJs, captured using a motion sensor, were compared between the intervention and control groups. Results: The intervention group showed a significant reduction in PC angles from high risk to low risk and a significant decrease in PS angles, while IC angles remained unchanged. Conversely, the control group showed a significant increase in IC angles from low risk to high risk, with no notable changes in PC and PS angles. Conclusion: This study demonstrated that the FIFA 11+ program effectively reduced PC knee abduction angles, with a decrease in this parameter indicating an overall shift from high- to low-risk biomechanics in the intervention group. Additionally, worsening postseason knee biomechanics in the control group highlighted that the injury risk increased throughout the season when a targeted neuromuscular training program was not incorporated into pregame warm-ups. This suggests that the FIFA 11+ program mitigates key biomechanical risk factors for noncontact ACL injuries.

Instability following reverse shoulder arthroplasty (RSA) is a notable complication, with challenges arising from various surgical and patient-specific factors that negatively impact the glenohumeral compressive forces necessary for RSA stability. This paper introduces a novel glenoid-anchor cerclage technique to address the instability in high-risk RSA cases. By placing an all-suture anchor superiorly above the glenosphere and integrating it through a transosseous tunnel through the greater tuberosity, this method serves as an adjunct for improving stability by counteracting superior and anterior translation. Here, we detail our preferred procedural steps, preoperative considerations, and postoperative management for this approach, emphasizing its potential to reduce recurrent instability.