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Cited by 820Knee injuries and reconstruction techniquesSports injuries and preventionLower Extremity Biomechanics and Pathologies

Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement

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Renstrom, P, Ljungqvist, A, Arendt, E, Beynnon, B, Fukubayashi, T, Garrett, W, Georgoulis, T, Hewett, T E +12 more·2008·British Journal of Sports Medicine
DOI 10.1136/bjsm.2008.048934PMC PMC3920910
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Abstract

The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert clinicians and scientists to (1) review current evidence including data from the new Scandinavian ACL registries; (2) critically evaluate high-quality studies of injury mechanics; (3) consider the key elements of successful prevention programmes; (4) summarise clinical management including surgery and conservative management; and (5) identify areas for further research. Risk factors for female athletes suffering ACL injury include: (1) being in the preovulatory phase of the menstrual cycle compared with the postovulatory phase; (2) having decreased intercondylar notch width on plain radiography; and (3) developing increased knee abduction moment (a valgus intersegmental torque) during impact on landing. Well-designed injury prevention programmes reduce the risk of ACL for athletes, particularly women. These programmes attempt to alter dynamic loading of the tibiofemoral joint through neuromuscular and proprioceptive training. They emphasise proper landing and cutting techniques. This includes landing softly on the forefoot and rolling back to the rearfoot, engaging knee and hip flexion and, where possible, landing on two feet. Players are trained to avoid excessive dynamic valgus of the knee and to focus on the “knee over toe position” when cutting.

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Research works printed but not linked: 5

  1. [2]2. Lobenhoffer P. Injuries of the knee ligaments. II. Surgical therapy of anterior and posterior knee instability. Chirurg 1999;70:326-38 .
  2. [5]5. Johnson R. The ACL injury in Alpine skiing: the mechanism and epidemiology. Aviemore, UK: International Society of Skiing Safety, May 2007.
  3. [15]15. Griffin LY, Albohm MJ, Arendt EA, et al . Update on ACL prevention: theoretical and practical guidelines. Am J Sports Med 2006;34:1512-32 .
  4. [16]16. Slocumb G, Slocumb TD. Slope in dogs. Vet Clin North Am Small Anim Prac 1993;23:777-95.
  5. [25]25. Nguyen AD, Shultz SJ. Sex differences in lower extremity posture. J Orthop Sports Phys Ther 2007;37:389-98 .

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Authors
Renstrom, P., Ljungqvist, A., Arendt, E., Beynnon, B., Fukubayashi, T., Garrett, W., Georgoulis, T., Hewett, T. E., Johnson, R., Krosshaug, T., Mandelbaum, B., Micheli, L., Myklebust, G., Roos, E., Roos, H., Schamasch, P., Shultz, S., Werner, S., Wojtys, E., & Engebretsen, L.
Affiliations
  • International Olympic Committee (CH)
  • University of Minnesota (US)
  • University of Vermont (US)
  • Waseda University (JP)
  • Duke University (US)
  • University of Ioannina (GR)
  • Cincinnati Children's Hospital Medical Center (US)
  • Oslo Sports Trauma Research Center (NO)
  • Pepperdine University (US)
  • Boston Children's Hospital (US)
  • University of Southern Denmark (DK)
  • Lund University (SE)
  • University of North Carolina at Greensboro (US)
  • Karolinska Institutet (SE)
  • University of Michigan (US)
ORCID
Venue
British Journal of Sports Medicine
Publisher
BMJ
Published
2008-06
Volume
42
Issue
6
Pages
394-412
ISSN
  • 0306-3674 (ISSN-L)
  • 1473-0480
DOI
10.1136/bjsm.2008.048934
PMC
PMC3920910
OpenAlex
W2168570652
Cited by
820
References
147
Citations by year
2026: 21 · 2025: 35 · 2024: 46 · 2023: 43 · 2022: 41 · 2021: 53 · 2020: 50 · 2019: 43 · 2018: 39 · 2017: 41 · 2016: 53 · 2015: 60 · 2014: 53 · 2013: 50 · 2012: 57
FWCI
7.62
Type
journal article
Language
en
Open access
Locations
  • British Journal of Sports Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • NC Digital Online Collection of Knowledge and Scholarship (The University of North Carolina at Greensboro) (submittedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
Funders
National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR049735, R01AR055563, R01AR056259)
Topics
  • Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
Keywords
anterior cruciate ligament injury, female athletes, sex differences in injury risk, menstrual cycle, intercondylar notch width, knee abduction moment, landing technique, cutting methods, injury prevention programs, neuromuscular training, proprioceptive training, ACL surgery, conservative treatment, basketball, handball
MeSH terms
Anterior Cruciate Ligament Injuries, Adolescent, Adult, Athletic Injuries, Female, Humans, Knee Injuries, Male, Menstruation, Physical Education and Training, Risk Factors, Scandinavian and Nordic Countries, Sex Factors, Anterior Cruciate Ligament

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