Acl Injury Epidemiology in Female Athletes

Anterior cruciate ligament injury occurs with a 4to 6-fold greater incidence in female athletes compared with male athletes playing the same landing and cutting sports. The elevated risk of ACL injury in women, coupled with the 10-fold increase in high school and 5-fold increase in collegiate sport participation in the past 30 years, has led to a rapid rise in ACL injuries in female athletes. This increase in ACL injury in the female sports population has fueled intense examination of the mechanisms responsible for the gender disparity in these debilitating sports injuries. Rupture of the ACL is costly, with conservative estimates of surgery and rehabilitation at $17 000 to $25 000 per injury. This cost is in addition to potential loss of entire seasons of sports participation, loss of scholarship funding, lowered academic performance, long-term disability, and significantly greater risk of radiographically diagnosed osteoarthritis. The mechanism underlying gender disparity in ACL injury risk is likely multifactorial in nature. Several theories have been proposed to explain the mechanisms underlying the gender difference in ACL injury rates. These theories include related extrinsic (physical and visual perturbations, bracing, and shoe-surface interaction) and intrinsic (anatomical, hormonal, neuromuscular, and biomechanical differences between genders) variables. Identification of both extrinsic and intrinsic risk factors associated with the ACL injury mechanism provides direction for targeted prophylactic treatment to high-risk individuals.