Anterior Cruciate Ligament (ACL) ruptures are one of the most common knee injuries and are three times more likely to happen in female athletes compared to males. Recent research in a review article in the Journal of the American Academy of Orthopaedic Surgeons(JAAOS) highlights the unique anatomical differences in the female knee that may contribute to higher injury rates, and should be taken into consideration during reconstructive surgery and sports training.
Pre-season training and on going neuromuscular training programs need to form part of an overall sports training program aimed specifically at improving knee stability when jumping, landing or pivoting, as these activities can significantly decrease ACL injury risk among girls and women.
The unique anatomical features of female athletes includes a larger quadriceps angle ("Q angle"), which is the angle at which the femur meets the tibia. The bigger angle may cause a greater pull of the knee muscles during physical activity, and contribute to more ACL injuries.
Karen Sutton, MD, assistant professor, Yale University Department of Orthopaedics and Rehabilitation said, "As female athletes have increased their participation in sports, many studies have shown the vulnerability of female athletes to ACL ruptures. This devastating injury has a long recovery period and a slow return to sport. Thus, research has been done focusing on why women are more vulnerable to ACL injuries and how to prevent them."
It is also suggested that due to anatomical differences in the female knee this should be taken into consideration during ACL reconstruction. Females are also more likely than males to have a smaller, A-shaped intercondylar notch (the deep groove between the rounded ends of the femur bone), making ACL reconstruction more challenging, and possibly requiring altered surgical techniques.