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ACL tears occur the same way in women and men

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Women are two to four times more likely than men to tear the anterior cruciate ligament (ACL) in their knee, but new research shows that the cause of this injury is no different between the sexes.

The study by Duke Health comes after previous research had suggested women are more susceptible to ACL tears because their knees move differently.

Led by biomedical engineer Louis DeFrate, the Duke team used a forensic approach to reconstruct injuries by examining bone bruises on the knees of 15 men and 15 women with torn ACLs.

“Based on watching videos of athlete injuries, previous researchers have suggested that females may have a different mechanism of injury than males,” DeFrate said. “But it’s difficult to determine the precise position of the knee and the time of injury through footage.”

Instead, the new study used MRI scans taken within a month of the ACL rupture and identified bruises on the surface of the two large bones that collide when the ACL tears — the femur and the tibia. The researchers then used 3-D modelling and computer algorithms to reconstruct the position of the knee when the injury occurred.

The results, published online in the American Journal of Sports Medicine, suggest that males and females have the same position of injury.

The ACL can tear if you stop or change direction suddenly, or if you land awkwardly from a jump. Normally you’ll hear or feel a pop in the knee and the joint will then give way. You’ll feel a sudden pain and the knee will usually begin to swell in a few hours.

Because an ACL tear can be a serious injury for athletes, sports programmes have made considerable efforts to devise strategies for athletes to protect the ACL with strengthening and proper landing techniques.

DeFrate hopes that his ongoing research into ACL injuries will lead to improvements in treatment and training on how to prevent such injuries, especially in those at highest risk.