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Dr. Frank Thomas, St. Luke's Hospital



ACL injuries in female athletes more likely; minimally invasive surgery can help

According to the latest statistics from the United States Census Bureau, approximately 3,172,000 female athletes participate in high school sports each year, while another 186,000 participate in NCAA sports.

There is a hefty price being paid by some unfortunate female athletes as anatomy, physiology and body mechanics may play a role in certain injuries occurring.

Specifically, female athletes are up to eight times more likely to suffer an anterior cruciate ligament (ACL) injury compared to their male counterparts. In addition, one out of every ten female athletes will likely suffer an ACL injury during her athletic career.

The ACL is one of the major ligaments that connect the bones in the knee joint. These ligaments, made of strong connective tissue, help stabilize the joint while minimizing stress to the area. The ACL in particular helps limit the rotational movement in the knee, thereby protecting the meniscus, which is cartilage that cushions the space between the bones in the knee. When you hear that someone has a "torn ACL," that typically means they have suffered a complete tear, as partial tears are less common.

The causes of a woman's increased risk for an ACL injury are thought to include wider hips, the size of the notch where the ligament connects to the upper leg and the tendency for a woman's knees to bend inward while landing during jumping activities. A recent study suggested that women also tend to have different nerve impulses than men, thereby affecting the mechanics of the knee. Unfortunately, women who have suffered an ACL injury are at higher risk for developing arthritis later in life.

Treatment for a torn ACL typically involves arthroscopic, or minimally invasive, techniques where a surgeon will replace the damaged ligament by grafting it with a tendon from other areas around the knee or from a cadaver. This is usually performed as an outpatient procedure, and athletes can resume normal activity within four to six months in most cases. Vigorous post-operative rehabilitation is essential to the success of this procedure.

Dr. Frank Thomas specializes in orthopedic surgery and sports medicine at St. Luke's Hospital. For more information, call 314-275-7800.

This article was published in the St. Louis Post-Dispatch on June 14, 2012.