Gender differences in noncontact anterior cruciate ligament injuries

Anterior cruciate ligament (ACL) injuries happen two to eight times more frequently in women than in men. This article reviews the epidemiology of ACL injuries and examines potential contributing factors, including ligamentous laxity, hormonal differences, biomechanical alignment, intercondylar notch width, conditioning, experience, skill, and differences in muscle strength and recruitment. The possibility of preventative programs decreasing the incidence of ACL injury is also explored, and brief discussions regarding indications for surgery and graft choice are presented. Recommendations from a consensus panel of experts are also covered, providing a well-rounded overview of the latest in ACL research.