Leg Dominance Is a Risk Factor for Noncontact Anterior Cruciate Ligament Injuries in Female Recreational Skiers

Background: In recreational alpine skiing, the knee joint accounts for about one third of all injuries in male and female skiers. However, female recreational skiers have twice the knee injury incidence of male skiers, and the anterior cruciate ligament (ACL) injury risk is 3 times greater in female skiers. Purpose: To evaluate whether leg dominance is a risk factor for noncontact ACL injuries in female recreational skiers. Study Design: Cohort study; Level of evidence, 3. Methods: The relationships between leg dominance, side of knee injury, and gender were analyzed in 65 male and 128 female skiers suffering from a noncontact ACL rupture. Results: Anterior cruciate ligament ruptures of the left knee occurred more frequently in female than in male recreational skiers (68% vs 48%, P = .006). For both genders, in 90%, the right leg was the preferred kicking leg. With regard to leg dominance, female skiers suffered more often from ACL ruptures of their nondominant leg than male skiers (63% vs 45%, P = .020). An adjusted odds ratio of 2.0 (95% confidence interval, 1.0-3.8) was calculated. Conclusion: Female skiers showed a 2-fold higher risk of suffering from an ACL rupture on their nondominant leg. Therefore, leg dominance seems to be a risk factor for noncontact ACL injuries in female recreational skiers.