Saber Bahram, Bridger Daniel, Agrawal Devendra K
Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California USA.
J Orthop Sports Med. 2024;6(4):203-209. doi: 10.26502/josm.511500163. Epub 2024 Oct 4.
Anterior Cruciate Ligament (ACL) injuries are a prevalent concern in athletic population, particularly among female athletes who are disproportionately affected. The increased incidence of ACL injuries in females is attributed to a combination of anatomical, physiological, and biomechanical factors that influence knee stability. This review comprehensively explores these contributing factors, highlighting gender-specific anatomical differences such as wider pelvis, increased quadriceps (Q) angle, and steeper tibial slopes, all of which predispose females to greater knee valgus during dynamic activities. Furthermore, hormonal influences and greater ligament laxity are discussed as physiological contributors to increased ACL injury risk. Biomechanical factors such as reduced knee flexion, increased knee valgus, and altered muscle activation patterns further amplify the risk of ACL tears in female athletes. Despite extensive research, gaps remain in the understanding of how these factors interact and influence injury susceptibility. This article is focussed on the critical points in the current literature, analyzing key risk factors, and identifying future research directions that can inform more effective prevention strategies. A better understanding of these factors will ultimately contribute to reducing the incidence of ACL injuries among female athletes and improving long-term strength and stability of knee joint.
前交叉韧带(ACL)损伤是运动员群体中普遍关注的问题,在女性运动员中尤为突出,她们受到的影响更为严重。女性ACL损伤发生率增加归因于影响膝关节稳定性的解剖学、生理学和生物力学因素的综合作用。本综述全面探讨了这些促成因素,强调了特定性别的解剖学差异,如更宽的骨盆、增大的股四头肌(Q)角和更陡的胫骨坡度,所有这些因素都使女性在动态活动中更容易出现更大的膝外翻。此外,还讨论了激素影响和更大的韧带松弛度作为增加ACL损伤风险的生理因素。生物力学因素,如膝关节屈曲减少、膝外翻增加和肌肉激活模式改变,进一步加大了女性运动员ACL撕裂的风险。尽管进行了广泛研究,但在理解这些因素如何相互作用以及影响损伤易感性方面仍存在差距。本文聚焦于当前文献中的关键点,分析关键风险因素,并确定未来的研究方向,以为更有效的预防策略提供参考。更好地理解这些因素最终将有助于降低女性运动员ACL损伤的发生率,并改善膝关节的长期力量和稳定性。