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. 1999 Apr-Jun;34(2):150–154.

Anterior Cruciate Ligament Injury in Female Athletes: Epidemiology

Mary Lloyd Ireland 1
PMCID: PMC1322904  PMID: 16558558

Abstract

Objective:

To present epidemiologic studies on anterior cruciate ligament (ACL) injuries in female athletes.

Data Sources:

MEDLINE was searched from 1978 to 1998 with the terms “anterior cruciate ligament” and “female athlete” among others. Additional sources were knowledge base and oral, didactic, and video presentations.

Data Synthesis:

Epidemiologic studies have focused on level of participation, specific sports, sex differences and contributing factors, injury mechanism, prevention programs, and outcomes studies. Female athletes have a significantly increased risk of noncontact ACL injuries over male athletes in soccer and basketball.

Conclusions/Recommendations:

I believe that appropriate intervention programs can reduce these alarming rates of ACL injuries.

Keywords: mechanism of injury, position of no return, outcomes studies, prevention programs

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arendt E., Dick R. Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med. 1995 Nov-Dec;23(6):694–701. doi: 10.1177/036354659502300611. [DOI] [PubMed] [Google Scholar]
  2. Barber-Westin S. D., Noyes F. R., Andrews M. A rigorous comparison between the sexes of results and complications after anterior cruciate ligament reconstruction. Am J Sports Med. 1997 Jul-Aug;25(4):514–526. doi: 10.1177/036354659702500415. [DOI] [PubMed] [Google Scholar]
  3. Beachy G., Akau C. K., Martinson M., Olderr T. F. High school sports injuries. A longitudinal study at Punahou School: 1988 to 1996. Am J Sports Med. 1997 Sep-Oct;25(5):675–681. doi: 10.1177/036354659702500515. [DOI] [PubMed] [Google Scholar]
  4. Bjordal J. M., Arnły F., Hannestad B., Strand T. Epidemiology of anterior cruciate ligament injuries in soccer. Am J Sports Med. 1997 May-Jun;25(3):341–345. doi: 10.1177/036354659702500312. [DOI] [PubMed] [Google Scholar]
  5. Caraffa A., Cerulli G., Projetti M., Aisa G., Rizzo A. Prevention of anterior cruciate ligament injuries in soccer. A prospective controlled study of proprioceptive training. Knee Surg Sports Traumatol Arthrosc. 1996;4(1):19–21. doi: 10.1007/BF01565992. [DOI] [PubMed] [Google Scholar]
  6. Cox J. S., Lenz H. W. Women midshipmen in sports. Am J Sports Med. 1984 May-Jun;12(3):241–243. doi: 10.1177/036354658401200315. [DOI] [PubMed] [Google Scholar]
  7. Daniel D. M., Stone M. L., Dobson B. E., Fithian D. C., Rossman D. J., Kaufman K. R. Fate of the ACL-injured patient. A prospective outcome study. Am J Sports Med. 1994 Sep-Oct;22(5):632–644. doi: 10.1177/036354659402200511. [DOI] [PubMed] [Google Scholar]
  8. DeHaven K. E., Lintner D. M. Athletic injuries: comparison by age, sport, and gender. Am J Sports Med. 1986 May-Jun;14(3):218–224. doi: 10.1177/036354658601400307. [DOI] [PubMed] [Google Scholar]
  9. DeLee J. C., Farney W. C. Incidence of injury in Texas high school football. Am J Sports Med. 1992 Sep-Oct;20(5):575–580. doi: 10.1177/036354659202000515. [DOI] [PubMed] [Google Scholar]
  10. Deibert M. C., Aronsson D. D., Johnson R. J., Ettlinger C. F., Shealy J. E. Skiing injuries in children, adolescents, and adults. J Bone Joint Surg Am. 1998 Jan;80(1):25–32. [PubMed] [Google Scholar]
  11. Demirdjian A. M., Petrie S. G., Guanche C. A., Thomas K. A. The outcomes of two knee scoring questionnaires in a normal population. Am J Sports Med. 1998 Jan-Feb;26(1):46–51. doi: 10.1177/03635465980260012401. [DOI] [PubMed] [Google Scholar]
  12. Dye S. F. The knee as a biologic transmission with an envelope of function: a theory. Clin Orthop Relat Res. 1996 Apr;(325):10–18. doi: 10.1097/00003086-199604000-00003. [DOI] [PubMed] [Google Scholar]
  13. Ettlinger C. F., Johnson R. J., Shealy J. E. A method to help reduce the risk of serious knee sprains incurred in alpine skiing. Am J Sports Med. 1995 Sep-Oct;23(5):531–537. doi: 10.1177/036354659502300503. [DOI] [PubMed] [Google Scholar]
  14. Ferretti A., Papandrea P., Conteduca F., Mariani P. P. Knee ligament injuries in volleyball players. Am J Sports Med. 1992 Mar-Apr;20(2):203–207. doi: 10.1177/036354659202000219. [DOI] [PubMed] [Google Scholar]
  15. Garrick J. G., Requa R. K. Girls' sports injuries in high school athletics. JAMA. 1978 May 26;239(21):2245–2248. [PubMed] [Google Scholar]
  16. Gomez E., DeLee J. C., Farney W. C. Incidence of injury in Texas girls' high school basketball. Am J Sports Med. 1996 Sep-Oct;24(5):684–687. doi: 10.1177/036354659602400521. [DOI] [PubMed] [Google Scholar]
  17. Gray J., Taunton J. E., McKenzie D. C., Clement D. B., McConkey J. P., Davidson R. G. A survey of injuries to the anterior cruciate ligament of the knee in female basketball players. Int J Sports Med. 1985 Dec;6(6):314–316. doi: 10.1055/s-2008-1025861. [DOI] [PubMed] [Google Scholar]
  18. Hefti F., Müller W. Heutiger Stand der Evaluation von Kniebandläsionen. Das neue IKDC-Knie-Evaluationsblatt. Orthopade. 1993 Nov;22(6):351–362. [PubMed] [Google Scholar]
  19. Hefti F., Müller W. Heutiger Stand der Evaluation von Kniebandläsionen. Das neue IKDC-Knie-Evaluationsblatt. Orthopade. 1993 Nov;22(6):351–362. [PubMed] [Google Scholar]
  20. Hewett T. E., Stroupe A. L., Nance T. A., Noyes F. R. Plyometric training in female athletes. Decreased impact forces and increased hamstring torques. Am J Sports Med. 1996 Nov-Dec;24(6):765–773. doi: 10.1177/036354659602400611. [DOI] [PubMed] [Google Scholar]
  21. Hutchinson M. R., Ireland M. L. Knee injuries in female athletes. Sports Med. 1995 Apr;19(4):288–302. doi: 10.2165/00007256-199519040-00006. [DOI] [PubMed] [Google Scholar]
  22. Irrgang J. J., Snyder-Mackler L., Wainner R. S., Fu F. H., Harner C. D. Development of a patient-reported measure of function of the knee. J Bone Joint Surg Am. 1998 Aug;80(8):1132–1145. doi: 10.2106/00004623-199808000-00006. [DOI] [PubMed] [Google Scholar]
  23. Jensen J. E., Conn R. R., Hazelrigg G., Hewett J. E. Systematic evaluation of acute knee injuries. Clin Sports Med. 1985 Apr;4(2):295–312. [PubMed] [Google Scholar]
  24. Johnson R. J., Ettlinger C. F., Campbell R. J., Pope M. H. Trends in skiing injuries. Analysis of a 6-year study (1972 to 1978). Am J Sports Med. 1980 Mar-Apr;8(2):106–113. doi: 10.1177/036354658000800209. [DOI] [PubMed] [Google Scholar]
  25. Johnson R. J. The anterior cruciate ligament problem. Clin Orthop Relat Res. 1983 Jan-Feb;(172):14–18. [PubMed] [Google Scholar]
  26. Kettelkamp D. B., Thompson C. Development of a knee scoring scale. Clin Orthop Relat Res. 1975;(107):93–99. doi: 10.1097/00003086-197503000-00011. [DOI] [PubMed] [Google Scholar]
  27. Lindenfeld T. N., Schmitt D. J., Hendy M. P., Mangine R. E., Noyes F. R. Incidence of injury in indoor soccer. Am J Sports Med. 1994 May-Jun;22(3):364–371. doi: 10.1177/036354659402200312. [DOI] [PubMed] [Google Scholar]
  28. Lysholm J., Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med. 1982 May-Jun;10(3):150–154. doi: 10.1177/036354658201000306. [DOI] [PubMed] [Google Scholar]
  29. Mohtadi N. Development and validation of the quality of life outcome measure (questionnaire) for chronic anterior cruciate ligament deficiency. Am J Sports Med. 1998 May-Jun;26(3):350–359. doi: 10.1177/03635465980260030201. [DOI] [PubMed] [Google Scholar]
  30. Oliphant J. G., Drawbert J. P. Gender differences in anterior cruciate ligament injury rates in wisconsin intercollegiate basketball. J Athl Train. 1996 Jul;31(3):245–247. [PMC free article] [PubMed] [Google Scholar]
  31. Pickett J. C., Altizer T. J. Injuries of the ligaments of the knee. A study of types of injury and treatment in 129 patients. Clin Orthop Relat Res. 1971 May;76:27–32. doi: 10.1097/00003086-197105000-00007. [DOI] [PubMed] [Google Scholar]
  32. Sgaglione N. A., Del Pizzo W., Fox J. M., Friedman M. J. Critical analysis of knee ligament rating systems. Am J Sports Med. 1995 Nov-Dec;23(6):660–667. doi: 10.1177/036354659502300604. [DOI] [PubMed] [Google Scholar]
  33. Shapiro E. T., Richmond J. C., Rockett S. E., McGrath M. M., Donaldson W. R. The use of a generic, patient-based health assessment (SF-36) for evaluation of patients with anterior cruciate ligament injuries. Am J Sports Med. 1996 Mar-Apr;24(2):196–200. doi: 10.1177/036354659602400214. [DOI] [PubMed] [Google Scholar]
  34. Tegner Y., Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985 Sep;(198):43–49. [PubMed] [Google Scholar]
  35. Vangsness C. T., Jr, Mac P., Requa R., Garrick J. Review of outcome instruments for evaluation of anterior cruciate ligament reconstruction. Bull Hosp Jt Dis. 1995;54(1):25–29. [PubMed] [Google Scholar]
  36. Zelisko J. A., Noble H. B., Porter M. A comparison of men's and women's professional basketball injuries. Am J Sports Med. 1982 Sep-Oct;10(5):297–299. doi: 10.1177/036354658201000507. [DOI] [PubMed] [Google Scholar]

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