SynthesisSports medicine - open2024
Differences in Biomechanical Determinants of ACL Injury Risk in Change of Direction Tasks Between Males and Females: A Systematic Review and Meta-Analysis.
Synthesis in Sports medicine - open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effectiveness and analgesic effect of local infiltration analgesia and femoral nerve block after anterior cruciate ligament reconstruction: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2025Pooled it
- Pooled it
- The impact of 6-week flywheel eccentric training on sprint speed and change-of-direction of female basketball players.PloS one · 2025Trial
- Risk Factors Associated with Anterior Cruciate Ligament Injuries in Athletes During Physical Activity According to Sex: A Scoping Review.Sports (Basel, Switzerland) · 2026Review
- Wearable sensor assessment of neuromuscular latency: revealing the strength-timing trade-off in female soccer.BMC sports science, medicine & rehabilitation · 2026Article
- The effect of mixed fatigue on knee biomechanics and muscle activation during sidestep cutting in elite soccer players.BMC sports science, medicine & rehabilitation · 2026Article
- Dynamic change of direction, isometric strength, and psychological readiness in final phase ACLR athletes: an integrated approach.BMC musculoskeletal disorders · 2025Article
- Classifiers of anterior cruciate ligament status in female and male adolescents using return-to-activity criteria.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Alterations in the Neuromuscular Control Mechanism of the Legs During a Post-Fatigue Landing Make the Lower Limbs More Susceptible to Injury.Bioengineering (Basel, Switzerland) · 2025Article
- Exploring Lower Limb Biomechanical Differences in Competitive Aerobics Athletes of Different Ability Levels During Rotational Jump Landings.Bioengineering (Basel, Switzerland) · 2025Article
- Short Foot Exercises as a Preventive Strategy for ACL Injury in Women with Dynamic Knee Valgus.Medical journal of the Islamic Republic of Iran · 2025Article
- Knee and ankle biomechanics during recovery from primary, secondary, and bilateral anterior cruciate ligament injuries: a quasi-experimental study.Sao Paulo medical journal = Revista paulista de medicina · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChange of direction (COD) movements are associated with non-contact anterior cruciate ligament (ACL) injuries in multidirectional sports. Females appear at increased risk compared to males, which could be attributable to whole body kinematic strategies and greater multiplanar knee joint loads (KJLs) during COD which can increase ACL loading.
objectiveThe aim of this systematic review and meta-analysis was to examine and quantitatively synthesise the evidence for differences between males and females regarding KJLs and their biomechanical determinants (whole body kinematic strategies determining KJLs) during COD tasks.
methodsDatabases including SPORTDiscus, Web of Science, and PubMed were systematically searched (July 2021-June 2023) for studies that compared differences in knee joint loads and biomechanical determinants of KJLs during COD between males and females. Inclusion criteria were: (1) females and males with no prior history of ACL injury (18-40 years); (2) examined biomechanical determinants of KJLs and/ or KJLs during COD tasks > 20°; (3) compared ≥ 1 outcome measure between males and females. Studies published between 2000 and 2023 examining a cutting task > 20° with a preceding approach run that compared KJLs or the whole body multiplanar kinematics associated with them, between sexes, using three-dimensional motion analysis.
resultsThis meta-analysis included 17 studies with a pooled sample size of 451 participants (227 males, 224 females). Meta-analysis revealed females displayed significantly less peak knee flexion during stance (SMD: 0.374, 95% CI 0.098-0.649, p = 0.008, I
conclusionNo differences were observed in KJLs between males and females despite females displaying greater knee abduction at IC and less peak knee flexion during the stance phase of CODs, which are visual characteristics of non-contact ACL injury. Further research is required to examine if this translates to a similar injury risk, considering morphological differences in strain characteristics of the ACL between males and females. This observation may in part explain the disproportionate ACL injury incidence in female multidirectional athletes. Further higher quality controlled research is required whereby participants are matched by skill training history, resistance training history and strength status to ensure an appropriate comparison between males and females.
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