Editorial Commentary: Moving on from studying only the ACL: The importance of sex differences in other orthopaedic injuries


  • Eric Berkson, MD




Sex differences, Women's Sports Medicine, Posterior Cruciate Ligament, ACL, PCL


Our understanding of the anterior cruciate ligament (ACL) has advanced to the point where we understand female-specific predisposing factors to injuries; we have begun to alter surgical reconstructive procedures for women; and we can leverage enhanced sex-specific understandings to improve rehabilitation and even to prevent injuries. While study of sex-specific differences in posterior cruciate ligament (PCL) injuries has just begun, it is our responsibility within the field of sports medicine to continue to advance our understanding of sex differences in PCL and other orthopaedic injuries and to promote future studies examining this topic. 


Arendt E, Dick R. Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med. 1995 Nov-Dec;23(6):694-701. doi: 10.1177/036354659502300611. PMID: 8600737.

Sutton KM, Bullock JM. Anterior cruciate ligament rupture: differences between males and females. J Am Acad Orthop Surg. 2013 Jan;21(1):41-50. doi: 10.5435/JAAOS-21-01-41. PMID: 23281470.

Zazulak BT, Paterno M, Myer GD, Romani WA, Hewett TE. The effects of the menstrual cycle on anterior knee laxity: a systematic review. Sports Med. 2006;36(10):847-62. doi: 10.2165/00007256-200636100-00004. PMID: 17004848.

Boden BP, Sheehan FT, Torg JS, Hewett TE. Noncontact anterior cruciate ligament injuries: mechanisms and risk factors. J Am Acad Orthop Surg. 2010 Sep;18(9):520-7. doi: 10.5435/00124635-201009000-00003. PMID: 20810933; PMCID: PMC3625971.

Renstrom P, Ljungqvist A, Arendt E, Beynnon B, Fukubayashi T, Garrett W, Georgoulis T, Hewett TE, Johnson R, Krosshaug T, Mandelbaum B, Micheli L, Myklebust G, Roos E, Roos H, Schamasch P, Shultz S, Werner S, Wojtys E, Engebretsen L. Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br J Sports Med. 2008 Jun;42(6):394-412. doi: 10.1136/bjsm.2008.048934. PMID: 18539658; PMCID: PMC3920910.

Montalvo AM, Schneider DK, Webster KE, Yut L, Galloway MT, Heidt RS Jr, Kaeding CC, Kremcheck TE, Magnussen RA, Parikh SN, Stanfield DT, Wall EJ, Myer GD. Anterior Cruciate Ligament Injury Risk in Sport: A Systematic Review and Meta-Analysis of Injury Incidence by Sex and Sport Classification. J Athl Train. 2019 May;54(5):472-482. doi: 10.4085/1062-6050-407-16. Epub 2019 Apr 22. PMID: 31009238; PMCID: PMC6602364.

Herzberg SD, Motu'apuaka ML, Lambert W, Fu R, Brady J, Guise JM. The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2017 Jul 21;5(7):2325967117718781. doi: 10.1177/2325967117718781. PMID: 28795075; PMCID: PMC5524267.

Armento A, Albright J, Gagliardi A, Daoud AK, Howell D, Mayer S. Patient expectations and perceived social support related to return to sport after anterior cruciate ligament reconstruction in adolescent athletes. Phys Ther Sport. 2021 Jan;47:72-77. doi: 10.1016/j.ptsp.2020.10.011. Epub 2020 Nov 4. PMID: 33197876.

Lisee CM, DiSanti JS, Chan M, Ling J, Erickson K, Shingles M, Kuenze CM. Gender Differences in Psychological Responses to Recovery After Anterior Cruciate Ligament Reconstruction Before Return to Sport. J Athl Train. 2020 Oct 1;55(10):1098-1105. doi: 10.4085/1062-6050-558.19. PMID: 32966569; PMCID: PMC7594607.

Thompson S, Salmon L, Waller A, Linklater J, Roe J, Pinczewski L. Twenty-year outcomes of a longitudinal prospective evaluation of isolated endoscopic anterior cruciate ligament reconstruction with patellar tendon autografts. Am J Sports Med. 2015 Sep;43(9):2164-74. doi: 10.1177/0363546515591263. Epub 2015 Jul 17. PMID: 26187130.

Getgood AMJ, Bryant DM, Litchfield R, Heard M, McCormack RG, Rezansoff A, et. al. Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial. Am J Sports Med. 2020 Feb;48(2):285-297. doi: 10.1177/0363546519896333. Epub 2020 Jan 15. PMID: 31940222.

Parsons JL, Coen SE, Bekker S. Anterior cruciate ligament injury: towards a gendered environmental approach. Br J Sports Med. 2021 Sep;55(17):984-990. doi: 10.1136/bjsports-2020-103173. Epub 2021 Mar 10. PMID: 33692033.

Schilaty ND, Bates NA, Hewett TE. Relative dearth of 'sex differences' research in sports medicine. J Sci Med Sport. 2018 May;21(5):440-441. doi: 10.1016/j.jsams.2017.10.028. Epub 2017 Nov 3. PMID: 29248307; PMCID: PMC5927370.

Gianakos AL, Szukics P, George N, Elkattawy S, LaPorte DM, Mulcahey MK. Sex-Specific Analysis at Two Time Points in Three High-Impact Orthopaedic Sports Medicine Journals. Arthrosc Sports Med Rehabil. 2020 Apr 28;2(3):e207-e212. doi: 10.1016/j.asmr.2020.02.002. PMID: 32548585; PMCID: PMC7283966.

Oganesyan R, Anderson M, Simeone FJ, Chang C and Tanaka MJ. Sex Differences in Posterior Cruciate Ligament Injuries. Journal of Women’s Sports Medicine. 2022 Apr;2(1):19-26. doi: 10.53646/jwsm.v2i1.11.

Webster KE, Hewett TE. Meta-analysis of meta-analyses of anterior cruciate ligament injury reduction training programs. J Orthop Res. 2018 Oct;36(10):2696-2708. doi: 10.1002/jor.24043. Epub 2018 Jun 13. PMID: 29737024.






Original Research

How to Cite

Editorial Commentary: Moving on from studying only the ACL: The importance of sex differences in other orthopaedic injuries. (2022). Journal of Women’s Sports Medicine, 2(1), 27-29. https://doi.org/10.53646/jwsm.v2i1.25

Similar Articles

1-10 of 37

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)

1 2 3 4 > >>