Knee joint kinematics during the sidestep cutting maneuver: potential for injury in women

Abstract

Gender differences in knee motions during cutting did not contribute to the increased risk of noncontact ACL injury in women compared with men. The reasons for this increased incidence, therefore, remain unclear. The potential relationship between gender and other parameters linked to ACL injury such as joint geometry, ligament morphology, and physical conditioning requires further investigation.

Sagittal plane biomechanics cannot injure the ACL during sidestep cutting

“…Specifically, all simulated variables fell within the pre-defined criteria of two standard deviations from the measured data. The lower limb joint kinematics quantified during sidestep cutting for each subject were also consistent with those reported previously (Colby et al, 2000;McLean et al, 1999McLean et al, , 2004aNeptune et al, 1999). Based on these results, optimized models RMS fit error corresponds to the average difference in terms of SD�s between simulated and measured data.…”

“…However, the above differences are consistent with those observed previously for gender comparisons of lower limb joint kinematics during sidestep cutting (Malinzak et al, 2001;McLean et al, 2004a,b) and jump landing (Ford et al, 2003) tasks. Such differences are suggested to stem from concomitant gender-based differences in lower limb anatomy (McLean et al, 1999) and NMC during movement execution (Boden et al, 2000;Griffin et al, 2000;McLean et al, 2004a). These assertions appear substantiated considering that in the current case, lower limb alignment and initial con tact (NMC) conditions for each model were subject spe cific.…”

“…5) also suggests that this variable may be an important contrib utor to the gender disparity observed in the risk of ACL injury. Recent kinematic (Ford et al, 2003;Malinzak et al, 2001;McLean et al, 1999McLean et al, , 2004a and prospective (Hewett et al, 2004) studies similarly propose knee val gus and valgus loading to be key predictors of ACL in jury in females. The means by which lower limb NMC parameters may manifest in terms of valgus loading dur ing movements such as sidestep cutting requires further investigation.…”

“…Approach speeds were monitored and re -1 quired to fall between 4.5 and 5.5 m s , reflecting speeds at which these movements are typically executed in the game situation (McLean et al, 1999). Sidestep cutting angles were required to be 35°-55° from the original direction of motion, again reflecting values typ ically demonstrated in the game situation, and adopted previously (McLean et al, 2004a,b).…”

“…1). Specifi cally, subjects were required to land and sidestep cut off the right leg, such that that the cutting action moved the subject forward and to the left of the force plate at the appropriate angle (McLean et al, 1999(McLean et al, , 2004a) (see Fig. 1).…”