Motion Analysis Technologies for ACL Injury Prevention: From Laboratory Assessment to Field-Based Clinical Screening

Anterior cruciate ligament (ACL) injuries remain a leading cause of morbidity in athletic populations, with 70-80% occurring through non-contact mechanisms driven by biomechanical risk factors including knee valgus (>10°), low knee flexion (<30°), tibial internal rotation (>20°), and loading asymmetry (>15°), yet implementation of evidence-based neuromuscular training (which reduces injury risk by 50-70%) remains limited due to barriers in identifying at-risk individuals through accessible field-based screening. This narrative review synthesizes motion analysis technologies spanning laboratory-based optical systems (marker-based), wearable inertial measurement units (IMUs), computer vision and marker-less pose estimation, force plate and pressure-sensitive insole systems, and integrated drone-based field assessment platforms to address this critical gap. We present a three-tier clinical screening framework that progresses from basic anthropometric and single-plane video analysis to multi-modal biomechanical assessment using real-time kinematic feedback. As an illustrative example of emerging field-deployable technology, an integrated drone-based motion capture and smart insole system combining 4K video capture, AI-driven 3D motion reconstruction, and plantar pressure mapping is described to demonstrate how laboratory-quality biomechanical assessment can be achieved in ecologically valid field settings. This evidence-based review addresses current gaps between laboratory research and practical field deployment, with emphasis on cost-effectiveness, accessibility, and clinical utility for ACL injury prevention in diverse sporting environments.