Abstract
ACL injury is one of the most frequent and costly injuries in sports, and is a major risk factor for early knee osteoarthritis. Although female gender is a major risk factor for ACL injury, differences in the injury mechanism between males and females have not yet been determined. The goal of this review was to determine whether there is any evidence of gender differences in the mechanisms of ACL injury. MRI studies demonstrated that the location of bone bruises after ACL injury was similar between genders and that males demonstrated more extensive damage in the joint, suggesting the involvement of higher energy but not a difference in injury mechanism. Video analyses of the process of ACL injury has shown common body positions at the time of injury, but failed to reveal differences in the joint motions between genders. Therefore, the mechanism of ACL injury is likely to be similar across genders.
Highlights
75,000 [1,2,3,4] to more than 250,000 [5] incidents of anterior cruciate ligament (ACL) tear occur annually in the United States and approximately 200,000 ACL reconstructions are performed annually in the United States [6]
The objectives of this review article are to: (1) summarise current information on the mechanism of ACL injury, including how risk factors are associated with the injury mechanism; and (2) determine whether there is a gender difference in the mechanism of ACL injury, so that future directions can be proposed for research to clarify the mechanism(s) of ACL injury in each gender
Belanger et al tested the effects of exercise and hormonal cycle on ACL laxity using a KT-2000 arthrometer with an anterior force of 134N in 27 female athletes [86], and found that there were no significant differences in anterior laxity among the follicular, ovulatory, and luteal phases of the menstrual cycle or between pre- and post-exercise conditions
Summary
75,000 [1,2,3,4] to more than 250,000 [5] incidents of anterior cruciate ligament (ACL) tear occur annually in the United States and approximately 200,000 ACL reconstructions are performed annually in the United States [6]. The risk of an ACL tear is 2-10 times higher in female athletes than in their male counterparts [7,10,11,21,31,32,33,34,35,36]. Female athletes have 2.4 times higher risk of ACL injury in soccer and 4.1 times higher risk in basketball than male athletes as reported by Arendt and Dick [10] based on the injury reports from the National Collegiate Athletic Association (NCAA). Identifying the exact mechanism of ACL injury should play an essential role in establishing efficient and effective prevention programs, by which sports participation for female athletes can be promoted without a higher risk of injury. Epidemiological and risk factors studies have not identified any gender differences in the ACL injury mechanism that would contribute to a higher risk in female athletes. The objectives of this review article are to: (1) summarise current information on the mechanism of ACL injury, including how risk factors are associated with the injury mechanism; and (2) determine whether there is a gender difference in the mechanism of ACL injury, so that future directions can be proposed for research to clarify the mechanism(s) of ACL injury in each gender
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