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Cited by 404Knee injuries and reconstruction techniquesSports injuries and preventionLower Extremity Biomechanics and Pathologies

The Effects of Generalized Joint Laxity on Risk of Anterior Cruciate Ligament Injury in Young Female Athletes

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Myer, Gregory D., Ford, Kevin R., Paterno, Mark V., Nick, Todd G., Hewett, Timothy E.·2008·The American Journal of Sports Medicine
DOI 10.1177/0363546507313572PMC PMC3407802
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Abstract

Background: Women who participate in high-risk sports suffer anterior cruciate ligament injury at a 4- to 6-fold greater rate than men. Purpose: To prospectively determine if female athletes with decreased passive knee joint restraint (greater joint laxity) and greater side-to-side differences in knee laxity would be at increased risk of anterior cruciate ligament injury. Study Design: Case control study; Level of evidence, 3. Methods: From 1558 female soccer and basketball players who were prospectively screened, 19 went on to tear their anterior cruciate ligaments. Four height- and mass-matched control subjects were selected from the uninjured screened athletes for comparison with each of the 19 injured subjects, making a total of 95 subjects (19 injured; 76 uninjured). Generalized joint-laxity tests and anterior-posterior tibiofemoral translation were quantified using the CompuKT knee arthrometer. A multivariable logistic regression model was constructed to determine predictors of anterior cruciate ligament injury status from recorded laxity measures. Results: A multivariable logistic regression model (chi-square = 18.6; P = .002) used the independent variables laxity measures of knee hyperextension ( P = .02), wrist and thumb to forearm opposition ( P = .80), fifth-finger hyperextension > 90° ( P = .71), side-to-side differences in anterior-posterior tibiofemoral translation ( P = .002), and prior knee injury ( P = .22) to predict anterior cruciate ligament-injury status. The validated C statistic, or validated area under the receiver operating characteristic curve, was 0.72. For every 1.3-mm increase in side-to-side differences in anterior-posterior knee displacement, the odds of anterior cruciate ligament–injured status increased 4-fold (95% confidence interval, 1.68–9.69). A positive measure of knee hyperextension increased the odds of anterior cruciate ligament-injured status 5-fold (95% confidence interval, 1.24–18.44). Conclusion: The current results indicate that increased knee-laxity measures may contribute to increased risk of anterior cruciate ligament injury. The methods to quantify knee joint laxity in this report may be used in conjunction with measures of neuromuscular control of the knee joint to identify high-risk female athletes with high accuracy. Once high-risk female athletes are identified, they may be targeted to the appropriate interventions to reduce injury risk.

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Authors
Myer, G. D., Ford, K. R., Paterno, M. V., Nick, T. G., & Hewett, T. E.
Affiliations
Cincinnati Children's Hospital Medical Center (US)
Corresponding author
Myer, Gregory D.
ORCID
Venue
The American Journal of Sports Medicine
Publisher
SAGE Publications
Published
2008-03-07
Volume
36
Issue
6
Pages
1073-1080
ISSN
  • 0363-5465 (ISSN-L)
  • 1552-3365
DOI
10.1177/0363546507313572
PMC
PMC3407802
OpenAlex
W2101122071
Cited by
404
References
78
Citations by year
2026: 14 · 2025: 29 · 2024: 25 · 2023: 20 · 2022: 20 · 2021: 16 · 2020: 19 · 2019: 15 · 2018: 27 · 2017: 19 · 2016: 26 · 2015: 33 · 2014: 24 · 2013: 29 · 2012: 21
FWCI
23.54
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • The American Journal of Sports Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR049735, 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, generalized joint laxity, female athletes, knee hyperextension, injury prediction, soccer players, basketball players, neuromuscular control, sex differences in sports injury
MeSH terms
Anterior Cruciate Ligament Injuries, Adolescent, Athletic Injuries, Basketball, Female, Humans, Informed Consent, Joint Instability, Knee Injuries, Prospective Studies, Risk Factors, Soccer, Logistic Models, Case-Control Studies

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