B Zazulak, T Hewett, N Reeves, B Goldberg and J Cholewicki.
Female athletes are known to be at more risk of ACL injury than males in the same high-risk sports. Decreased trunk stability may compromise dynamic knee stability. This prospective, cohort study tested the following hypotheses; 1) Increased trunk displacement after sudden force release would be associated with increased knee injury risk; 2) Lateral displacement would be the strongest predictor of knee ligament injury; 3)Logistic regression of factors related to core stability would accurately predict knee, ligament and ACL injury risk; 4) Predictive values would differ between genders. Subjects were college athletes (n=277), all were tested prospectively for trunk displacement after sudden force release. The results showed that 25 athletes (11 female, 14 male) sustained knee injuries over a three year period. Trunk displacement was greater in these injured athletes than in non-injured athletes. Lateral displacement was the strongest predictor of ligament injury. Factors that could be used to predict knee injury are trunk displacement, proprioception, and a history of low back pain in females. Only history of low back pain was a significant predictor of knee injury in males. The authors concluded that factors related to core stability predicted risk of athletic knee, ligament and ACL injury with a high level of sensitivity and moderate specificity in female but not male athletes.
American Journal of Sports Medicine, 2007, 35, 1123-1130