Anterior Cruciate Ligament Injury - Epidemiology

Epidemiology

Mountcastle et al. performed a study on gender difference in ACL tears in relationship with physical activities. The researchers performed an epidemiology study on young athletic populations. Previous studies found that women that participate in the same physical activities as men are more at risk for ACL injuries. The authors hypothesize that the frequency rate for males and females in the athletic and college aged population is the same. The study looked at college graduation classes from 1994-2003 at major institutions. The players who received a whole tear were examined for apparatus of injury and the type of sport they played when the injury occurred. The authors calculated the accident rate, opinion of danger, gender incidents, class year, and the accident rate differentiating men and women. There were 353 ACL injuries in 10 classes during the span of the study. The researchers calculated a 4-year accident proportion of 3.24 per 100 students for men, and 3.51 for women. Overall, the ACL injury rate not including male-only sports was substantially greater in women with an incidence ratio of 1.51 (pg 5). Women are more likely to get injured at gymnastics courses with an incidence ratio of 5.67; with an indoor obstacle course test the rate is 3.72; and there is a 2.42 incidence ratio on basketball. The authors concluded that there is slim gender difference in gender ACL tear. On the other hand, there were significant gender differences in ACL injury rates when particular specific sports and physical activities were compared.

A notable finding is that women are three times more likely to have an ACL injury than men, due to variations of hormone levels and greater ligament strength in men than in women. Most importantly, there is substantial difference in neuromuscular coordination and control in landing—women have less hip and knee flexion. Women also have wider Q angles than men, and this combined with their weakened hip strength makes them more prone to an ACL tear. You especially see this with Women's Basketball and Volleyball. Athletic trainers and team physicians advise female athletes to adapt an ACL conditioning program.