Male Athletes Show Higher Knee Frontal Moments Than Females During Cutting

Overview

This longitudinal study found that male athletes exhibit higher knee frontal plane moments (KFM) than female athletes during the impact phase of cutting maneuvers, despite females showing age-related increases in KFM. The findings challenge the hypothesis that adolescent females have higher KFM, a proposed risk factor for ACL injury.

Background

Anterior cruciate ligament (ACL) injuries are common and serious among athletes in sports requiring jumping and cutting, with a high incidence in young individuals, especially females during adolescence. ACL injuries often occur via non-contact mechanisms involving rapid changes in movement direction. Identifying biomechanical risk factors such as knee frontal plane moments during cutting maneuvers is critical for prevention. Previous studies have shown mixed results regarding sex differences and the role of KFM in ACL injury risk, often limited by short follow-up or inappropriate timing of measurements.

Data Highlights

Key Findings

• Male athletes demonstrated significantly higher peak knee frontal moments (KFM0-70) during cutting maneuvers than female athletes at both pre-adolescent and adolescent stages.
• Female athletes showed an age-related increase in KFM0-70 from pre-adolescence to adolescence, but values remained lower than males.
• The timing of peak KFM occurred within the first 70 milliseconds after ground contact, aligning with the critical injury timeframe for ACL rupture.
• Normalized trunk–foot distance at initial contact (NTFDIC) and frontal plane hip and knee angles were measured to understand biomechanical contributions but did not fully explain sex differences in KFM.
• The study challenges the hypothesis that adolescent females have higher KFM during cutting, suggesting other factors may contribute to their increased ACL injury risk.

Clinical Implications

Clinicians should consider that male athletes may experience higher knee frontal moments during cutting maneuvers, yet females still sustain more ACL injuries, indicating that KFM alone may not fully explain injury risk. Injury prevention programs should incorporate multifactorial assessments beyond frontal plane knee moments, including neuromuscular control and movement technique. Monitoring biomechanical changes during maturation remains important for targeted interventions.

Conclusion

This prospective study reveals that male athletes have higher knee frontal moments during cutting than females, despite females showing increases with age. These findings suggest that factors other than knee frontal moments contribute to the higher ACL injury risk observed in adolescent female athletes.

References

1. Hewett et al. 2005 -- Biomechanical measures predict ACL injury risk
2. Krosshaug et al. 2016 -- Knee valgus moment and ACL injury risk
3. Leppänen et al. 2017 -- Knee valgus moment during drop jump tasks
4. Study Article -- Male Athletes Exhibit Higher Knee Frontal Moments Than Female Athletes During Cutting Maneuvers' Impact Phase