Are Young Women More Susceptible to ACL Tears

The knee joint acts as a hinge between the thigh and the shin bone, thereby providing seamless locomotion. The femur and the tibia are connected at the knee by the help of four major ligaments, namely, Medial and Lateral Collateral ligaments and Anterior and Posterior Cruciate Ligaments. These four ligaments acts as a strong junction and allows all kinds of physical movement, among which, the ACL or the Anterior Cruciate Ligament is more prone to physical injury.

Though acute injury to the Anterior Cruciate Ligament has more chances of complete curing, ACL tear can cause life-changing damage to either sexes. However, several case studies based on equal number of men and women provide strong evidence stating women to be more prone to ACL tears than that of men. Although minor ACL injuries can be cured with conservative treatments, any tear occurring in the region requires immediate ACL reconstruction surgery. The cause of tear, trauma, and injury remains the same in either sex and might require multiple surgeries depending on the extent of damage. However, in extreme cases requiring multiple surgical procedures, the sufferer needs to opt for better medical travel destinations in order to avail cheaper facilities. As compared to the major countries, ACL reconstruction surgery in India, is not only cheap but also highly competent, and is thus chosen by thousands of athletes worldwide.

a. What is an ACL Tear?

ACL tear is extremely common among athletes who indulge in sports requiring heavy physical activities. ACL tear can be partial or complete depending on the damage incurred. Tear in the ligament occurs due to sudden jerk withstanding the impact of which, is beyond the strength of the ligament. This leads to broken or impaired contact between the thigh bone and the shin bone causing extreme pain to the sufferer. This is very common in athletes who play soccer, football, volleyball, badminton, long jump or high jump, etc., where the player’s physical strength and balance mostly relies on the quadriceps and the hamstrings. Where minor injuries can be cured with months of physical therapy, complete tear requires immediate ACL reconstruction surgery.

b. What are the causes of ACL Tear?

ACL injury results from sudden exposure to exaggerated physical strain withstanding which is beyond the body's capability. The extent of damage resulting depends on the type of impact received by the ligament. Hence, here are some of the common causes that lead to ACL tear in most of the athletes.

• ACL tear is most common among sportsmen who indulge in strenuous physical activities. It can occur due to a sudden jerk experienced during long or high jumps, or tackling football on field, or landing with full body weight in an inappropriate position.

• Tear in the ACL may occur due to anti-clockwise twisting off the thigh bone and the shin bone or twisting of both the bones in opposite direction.

• Any kind of trauma or physical shock from the back or the sides of the knee can result in ligament tear.

• Swift turning off the unprepared body having the complete weight on one knee may also cause irreparable injury.

• Overextension of leg or the knee joint beyond the withstanding capability of the ligament may also lead to tear.

c. Body Structure of Women leading to ACL

For years, the reason behind women being almost 4 to 6 times more prone to ACL tears than men, has been extremely controversial. The biological reason stated behind this is that, the strength of the hamstrings in women is fairly less compared to that of the quadriceps. On the contrary, the quadriceps in women are functionally predominant in case of rigorous physical activities involving the lower limbs. This makes the hamstrings biologically ineffective in terms of protecting the tibia from major injury.

Apart from that, many researches link the biomechanics of the knee in both the sex during landing after a heavy jump. Women tend to land straighter and thus focus more physical strain on the ligaments than that of men, which makes them more susceptible to ACL tear. This is also indirectly linked to the Q-angular protrusion of the quadriceps which exposes the ACL to physical injuries more frequently.

d. Candidates for ACL Reconstruction Surgery

Candidacy for ACL reconstruction surgeries or knee arthroscopy is extremely important. Hence, candidates who may be eligible for surgery are:

• Adults who are actively involved in physical activities, or are professional athletes.

• Individuals experiencing pain in knee for prolonged period.

• Sufferers for whom conservative treatments did not yield any suitable result.

• Children who have suffered injury and are experiencing delayed healing due to closure of growth plates.

• Adults who experience frequent and painful twisting of the knee, and shakiness and are physically incapable of continuing regular activities.