Anatomical and hormonal risk factors associated with ACL injury in female athletes Print

Although intrinsic and extrinsic risk factors for ACL injury have been explored extensively, the anatomical and the hormonal risk factors associated with this injury in female athletes remain elusive. This systematic review summarizes all the relevant anatomical and hormonal risk factors regarding ACL injury. Electronic database literature searches of PubMed MEDLINE (1966– 2014), SCIENSEDIRECT (1982 – 2014) and SportDiscus (1985– 2014) were used for the systematic review to identify any studies in the literature that examined ACL injury risk factors. A total of 171 articles were included in the review, and 69 of these studies focused on anatomical and hormonal risk factors. Increase Q angle, knee recurvatum, subtalar pronation, knee laxity and smaller intercondylar notch are specific anatomical risk factors that associated with ACL injury in female athletes. The presence of estrogen and progesterone receptors on human ACL creates the possibility that sex hormones may influence on ACL injuries. The evidence showed female athletes due to higher levels of estrogen experienced ACL injury in late follicular phase of the menstrual cycle more than other phases. Therefore it is necessary to inform athletes about ACL injury risk factors and its prevention methods.