Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Anterior Cruciate Ligament Rupture: Differences Between Males and Females

Sutton, Karen M. MD; Bullock, James Montgomery MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: January 2013 - Volume 21 - Issue 1 - p 41–50
doi: dx.doi.org/10.5435/JAAOS-21-01-41
Review Article

The rate of anterior cruciate ligament (ACL) rupture is three times higher in female athletes than in male athletes. Intrinsic factors such as increased quadriceps angle and increased posterior tibial slope may predispose girls and women to ACL injury. Compared with males, females have smaller notch widths and smaller ACL cross-sectional area; however, no conclusive correlation between ACL size and notch dimension exists, especially in relation to risk of ACL injury. Female athletes who land with the knees in inadequate flexion and in greater-than-normal valgus and external rotation are at increased risk of ACL injury. No conclusive link has been made between ACL injury and the menstrual cycle. Neuromuscular intervention protocols have been shown to reduce the rate of injury in girls and women. Females are more likely than males to have a narrow A-shaped intercondylar notch, and special surgical considerations are required in such cases. Following ACL reconstruction, female athletes are more likely than male athletes to rupture the contralateral ACL; however, males and females are equally likely to rupture the reconstructed knee. Although self-reported outcomes in the first 2 years following reconstruction are worse for females than for males, longer-term studies demonstrate no difference between males and females.

From the Department of Orthopaedics and Rehabilitation, Yale University, New Haven, CT.

Dr. Sutton or an immediate family member serves as an unpaid consultant to Advanced Orthopedic Technologies and SportsMD. Neither Dr. Bullock nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

© 2013 by American Academy of Orthopaedic Surgeons
You currently do not have access to this article

To access this article:

Note: If your society membership provides full-access, you may need to login on your society website