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Battle of the Sexes: Who Wins (or Loses) in ACL Ruptures?

Sports Training and ACL Reconstruction Should Focus on Unique Characteristics of the Female Knee

ROSEMONT, Ill., Jan. 8, 2013 /PRNewswire-USNewswire/ -- Female athletes are three times more likely to suffer from anterior cruciate ligament (ACL) ruptures, one of the most common knee injuries, compared to male athletes. The ACL is one of the four main ligaments within the knee that connect the femur (upper leg bone) to the tibia (lower leg bone). Recent research highlights the unique anatomical differences in the female knee that may contribute to higher injury rates, and should be taken into consideration during reconstructive surgery and sports training, according to a review article in the January 2013 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS).

"As female athletes have increased their participation in sports, many studies have shown the vulnerability of female athletes to ACL ruptures," said Karen Sutton, MD, assistant professor, Yale University Department of Orthopaedics and Rehabilitation, and lead author of the review article. "This devastating injury has a long recovery period and a slow return to sport. Thus, research has been done focusing on why women are more vulnerable to ACL injuries and how to prevent them."

Multiple, recent research studies also have found that preseason and ongoing neuromuscular training programs as part of an overall sports training program aimed specifically at improving knee stability when jumping, landing or pivoting can significantly decrease ACL injury risk among girls and women.

Unique anatomical features of female athletes such as a larger quadriceps angle ("Q angle")—the angle at which the femur meets the tibia—may cause a greater pull of the knee muscles during physical activity, and contribute to more ACL injuries among females.

Anatomical differences in the female knee should be taken into consideration during ACL reconstruction, said Dr. Sutton. Females are more likely than males to have a smaller, A-shaped intercondylar notch (the deep groove between the rounded ends of the femur bone), making ACL reconstruction more challenging, and possibly requiring altered surgical techniques.

"All female athletes, starting in adolescence, should learn appropriate training techniques," said Dr. Sutton. "This includes the appropriate way to land from a jump, increasing the strength of muscles that could have a protective affect on the ACL—core, gluteal, quadriceps and hamstring muscles, as well as working on the body's reaction to change of direction and change of speed."

Read about how Aimee Hartwell, Christina Gordon, and Joanne Donoghue overcame their sports-related ACL rupture injuries on ANationInMotion.org.

January 2013 Full JAAOS Table of Contents

  • Correspondence: Displaced Clavicle Fractures in Adolescents
  • Adjacent Segment Disease Following Cervical Spine Surgery
  • Mucopolysaccharide Disorders in Orthopaedic Surgery
  • Soft-tissue Management in Revision Total Shoulder Arthroplasty
  • Posterior Malleolus Fractures
  • Bone-Graft and Bone Graft Substitutes in Spine Surgery: Current Concepts and Controversies
  • On the Horizon from the ORS: Mensenchymal Stem Cell Transplantation
  • On the Horizon from the ORS: The Role of Metabolomics in Osteoarthritis Research

For more AAOS News, visit the News Bureau
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A Nation in Motion
More than one in four Americans have bone or joint health problems, making them the greatest cause of lost work days in the U.S. When orthopaedic surgeons restore mobility and reduce pain, they help people get back to work and to independent, productive lives. Orthopaedic surgeons provide the best value in American medicine in both human and economic terms and access to high-quality orthopaedic care keeps this "Nation in Motion." To learn more, to read hundreds of patient stories or to submit your own story, visit anationinmotion.org.

More information about the AAOS

SOURCE American Academy of Orthopaedic Surgeons

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