Knee joint kinematics during the sidestep cutting maneuver: potential for injury in women

McLEAN, SCOTT G.; NEAL, ROBERT J.; MYERS, PETER T.; WALTERS, MEGAN R.

Medicine & Science in Sports & Exercise: July 1999 - Volume 31 - Issue 7 - pp 959-968
Clinical Sciences: Clinically Relevant

Knee joint kinematics during the sidestep cutting maneuver: potential for injury in women. Med. Sci. Sports Exerc., Vol. 31, No. 7, pp. 959-968, 1999.

Purpose: There is a paucity of data describing female lower limb biomechanics during "high risk" movements linked to noncontact ACL injury. This study compared, across gender, knee kinematics associated with sidestepping maneuvers to provide insight into why women display a significantly higher incidence of this injury than do men.

Methods: Thirty participants (16 men, 14 women) had bilateral knee joint kinematic data recorded while sidestepping. A custom software package (JTMOTION) quantified maximum, minimum, and range of motion during stance for each of the three clinical knee joint rotations (flexion/extension, adduction/abduction and external/internal rotation) over 20 (leg × condition × trial (5)) trials.

Results: Gender differences possessed limited clinical significance with all maximum values well within safe ranges of knee motion. Women did, however, display increased intertrial variability for axial rotation patterns during cutting compared with men. This variability was thought to be unaffected by gender, with experience level found statistically (P < 0.01) to be the major determinant of knee kinematic variability during sidestepping. Hence, the level of exposure to sidestep cutting may have a large impact on the subsequent risk of ACL injury when one performs these maneuvers.

Conclusions: Gender differences in knee motions during cutting did not contribute to the increased risk of noncontact ACL injury in women compared with men. The reasons for this increased incidence, therefore, remain unclear. The potential relationship between gender and other parameters linked to ACL injury such as joint geometry, ligament morphology, and physical conditioning requires further investigation.

Department of Human Movement Studies, The University of Queensland, Brisbane, AUSTRALIA, 4072; and Brisbane Orthopaedic and Sports Medicine Centre, The Holy Spirit Hospital, Brisbane, AUSTRALIA 4000

Submitted for publication July 1997.

Accepted for publication November 1998.

The authors acknowledge the technical assistance of Dr. Michael MacDonald from the Department of Human Movement Studies, Queensland University of Technology. We also acknowledge the assistance of Brian O'Shea (Australian Rugby Union), Damien Hearn (Queensland Rugby Union), and Greg Brown (Queensland Soccer Federation) in acquiring subjects for the research.

This work was partially funded by a grant provided by the Australian Rugby Union. The comments and suggestions by the reviewers are gratefully acknowledged.

Address for Correspondence: Scott McLean, Department of Human Movement Studies, The University of Queensland, St Lucia, Brisbane, QLD, Australia 4072. E-mail: scotm@hms.uq.edu.au.

© 1999 Lippincott Williams & Wilkins, Inc.