Long-term participation in vigorous physical activity increases the risk of acute and chronic injuries to the knee. Two specific types of injury strongly associated with subsequent knee osteoarthritis (OA) are cruciate ligament damage and meniscal tears. Many clinical studies have discussed the high frequency of noncontact ACL injuries, for example, from jump landings. Axial compressive loading of the knee during landing from a jump can generate approximately 6–8 times bodyweight. With the tibial plateau having an inherent posterior slope of 10–15°, these loads can produce an anterior shift of the tibia during jump landings that result in isolated rupture of the anterior cruciate ligament (ACL) in the laboratory.1 These studies have shown acute damages in the articular cartilage and underlying subchondral and trabecular bone in the human cadaver joint.2 Clinically, in over 80% of ACL injury cases, characteristic osteochondral lesions occur in the posterolateral aspect of the tibia and/or anterolateral aspect of the lateral femoral condyle, potentially due to these levels of joint compressive loads.3

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