No abstract

The incidence of noncontact anterior cruciate ligament injuries in young to middle-aged athletes remains high. Despite early diagnosis and appropriate operative and nonoperative treatments, posttraumatic degenerative arthritis may develop. In a meeting in Atlanta, Georgia (January 2005), sponsored by the American Orthopaedic Society for Sports Medicine, a group of physicians, physical therapists, athletic trainers, biomechanists, epidemiologists, and other scientists interested in this area of research met to review current knowledge on risk factors associated with noncontact anterior cruciate ligament injuries, anterior cruciate ligament injury biomechanics, and existing anterior cruciate ligament prevention programs. This article reports on the presentations, discussions, and recommendations of this group.

Core stability has an important role in injury prevention. Future study may reveal that differences in postural stability partially explain the gender bias among female athletes.

Study Design: Cross-sectional. Objectives: To determine if females with anterior knee pain are more likely to demonstrate hip abduction or external rotation weakness than a similar, asymptomatic, age-matched control group. Background: Diminished hip strength has been implicated as being contributory to lower-extremity malalignment and patellofemoral pain. The identification of reliable and consistent patterns of weakness in this population may assist health care professionals establish a more effective treatment plan. Methods and Measures: Hip abduction and external rotation isometric strength measurements were recorded for the injured side of 15 female subjects with patellofemoral joint pain (mean ± SD age, 15.7 ± 2.7 years; age range, 12-21 years). These were compared with strength measurements from the corresponding hip of 15 age-matched female control subjects (mean ± SD age, 15.7 ± 2.7 years; age range, 12-21 years). All strength measurements were made using hand-held dynamometers. Results: Subjects with patellofemoral pain demonstrated 26% less hip abduction strength (PϽ.001) and 36% less hip external rotation strength (PϽ.001) than similar age-matched controls. Conclusions:The results indicate that young women with patellofemoral pain are more likely to demonstrate weakness in hip abduction as well as external rotation than age-matched women who are not symptomatic. J Orthop Sports Phys Ther. 2003;33:671-676. Key Words: anterior knee pain, hip abduction, hip external rotation, knee, patella P atellofemoral joint pain (PFP) remains one of the most common orthopaedic complaints among adolescents and young adults, with reported incidence rates among athletes greater than 25%. 2,26,31,38 It has also been reported that females, as compared with their male counterparts, are significantly more likely to experience PFP. 9,35 Typically, patients complain of generalized retropatellar symptoms that present insidiously and tend to be exacerbated by prolonged sitting or repetitive weight-bearing activities over a flexed knee. Unfortunately for these individuals, this pain often becomes a chronic condition that may fail to respond to conservative measures. Willson, Joyner Sportsmedicine Institute, 601 Perimeter Dr., Suite 110, Lexington, Current literature suggests that, in the absence of direct trauma, the etiology of PFP is multifactorial. Factors related directly to the patellofemoral joint, including vastus medialis obliquus insufficiency, decreased hamstring, quadriceps, or iliotibial band flexibility, patella alta, and femoral anteversion, have received the most attention.

No abstract

Using instruments suitable for a clinical setting, females were found to have greater FPPA and generally decreased trunk, hip, and knee isometric torque. Hip external rotation strength was most closely associated with the frontal plane projection angle.

EditorialThe female ACL: Why is it more prone to injury?Female athletes tear their anterior cruciate ligaments (ACL) at an alarmingly higher rate in certain sports including basketball, team handball, and soccer. The participation in sports by girls has increased dramatically, in recent times.1 The rapidly increasing numbers of females participating impacts the number of injuries. However, the rates of ACL injuries in comparable sports of basketball and soccer have remained alarmingly high with change in male-to-female ratios over the last 10 years. 2 The incidence of female to male is 3.5 times greater in basketball and 2.8 times greater in soccer. 3 The typical mechanism of injury is a rapid but awkward stop and anticipation of lateral movements. 4 The ACL tears in 70 ms.Dynamic movement patterns are very important factors contributing to ACL injury. 5 The extrinsic or changeable factors are controlled by the player and coaches. The intrinsic differences between male and female athletes that would explain why women tear the ACL two to eight times more frequently than men.

Female athletes are at increased risk for certain sports-related injuries, particularly those involving the knee. Factors that contribute to this increased risk are the differences in sports undertaken and in gender anatomy and structure. Gender differences include baseline level of conditioning, lower extremity alignment, physiological laxity, pelvis width, tibial rotation and foot alignment. Sports like gymnastics and cheerleading create a noncontact environment, but can result in significant knee injuries. In quick stopping and cutting sports, females have an increased incidence of anterior cruciate ligament (ACL) injury by noncontact mechanisms. Patellofemoral (PF) disorders are also very common in female athletes. Awareness of these facts helps the sports medicine professional make an accurate diagnosis and institute earlier treatment-focused rehabilitation with or without surgery. Further prospective and retrospective research is needed in areas of epidemiology, mechanisms, severity and types of knee injuries. The goal is to lessen the severity of certain knee injuries and to prevent others.