Revue de littérature : la rupture du ligament croisé antérieur : particularités féminines

We know that female athletes practicing pivoting sports have a higher risk of anterior cruciate ligament (ACL) injury compared to male. Many series confirm that the risk is four to seven times higher among female athletes at the same sporting level. Furthermore, most ACL injuries in female athletes occur during a noncontact episode, typically during deceleration, lateral pivoting or landing. A literature review confirms the higher incidence of ACL injuries among women in the pivot sports with or without contact. This sex difference can be explained by external and internal risk factors. The external risk factors are competition in games versus training, footwear and playing surfaces, protective equipment and physical preparation. The internal risk factors are anatomical risk factors: anatomy of the notch, posterior tibial slope, hyperlaxity, biomechanical factors: kinematics and kinetics of the knee, neuromuscular risk factors and hormonal risk factors. Indeed, the hormonal factors (estrogen, relaxin, progesterone and testosterone) seem to be responsible, especially during the ovulatory phase of the menstrual cycle. This study confirms that female athletes have a higher risk of ACL injuries compared to male athletes. A better knowledge of the external and internal risk factors, such as the injury mechanism and the hormonal factors may help in the future prevent these injuries.