Medical Surveillance Monthly Report (MSMR). Volume 9, Number 7, November/December 2003
ARMED FORCES HEALTH SURVEILLANCE CENTER SILVER SPRING MD
Pagination or Media Count:
The knee is a hinge joint whose stability and function are maintained by four ligaments that attach the femur to the tibia. The cruciate ligaments anterior and posterior are short fibrous cords that cross each other inside the joint. They prevent forward and backward movements of the tibia under the femur and guide the tibia over the end of the femur throughout the knees range of motion. When cruciate ligaments are torn, the knee loses stability. If complete tears are not repaired, there are increased risks of damage to the shock absorbing structures cartilage of the knee and, eventually, increased risks of arthritis. Injuries to cruciate ligaments typically occur during sudden hyperextensions, hyperflexions, and twists of the knee e.g., flat-footed landings from falls and jumps, sudden stopping from running, twisting falls. Not surprisingly, participants in sports that require running with sudden stops, quick changes of direction, jumping, twisting, and falling e.g., basketball, soccer, volleyball, football, rugby, lacrosse, alpine skiing have relatively high risks of cruciate ligament tears. Numerous recent medical and popular press reports have focused attention on tears of cruciate particularly anterior ligaments of the knee, especially among young female athletes. Military physical and tactical training activities chiefly under heavy loads such as forced marches, cross country runs, obstacle courses, and parachute landing falls are inherently hazardous to the cruciate ligaments of the knee. Based on reviews of hospitalizations for physical training and sportsrelated injuries of US Army soldiers from 1989-1994, Lauder and colleagues reported that the knee and the anterior cruciate ligament ACL were the most frequently injured body area and body part, respectively. During the period 1991-1997, Gwinn and colleagues documented 159 incident ACL injuries among midshipmen at the U.S. Naval Academy.
- Anatomy and Physiology