Today's News

Saturday, March 3, 2001

Females suffer more knee injuries than males

By Catherine Rauch

Research continues to show that gender makes a difference when it comes to musculoskeletal problems.

Female athletes are four to six times more likely to suffer from a serious knee injury than male athletes playing the same sport. Women are also more likely to have body image and eating disorder problems making them more susceptible to osteoporosis. And, unlike the commonly held belief that osteoporosis only affects women, orthopaedic surgeons are seeing more of the condition in men.

These are some of the findings discussed at a press conference held Wednesday by a team of doctors including Edward M. Wojtys, MD, director of Med Sport at the University of Michigan, Ann Arbor; Jo A. Hannafin, MD, associate professor of orthopaedic surgery at Cornell University; and Freddie H. Fu, MD, chairman of the department of orthopaedic surgery at the University of Pittsburgh.

Joseph M. Lane, MD, professor of surgery at Cornell University in New York, moderated the discussion.

Women playing soccer or basketball, sports that involve lots of pivoting, are a much greater risk of injuring their anterior cruciate ligament of the knee than men, Dr. Wojtys said.

"We found that female athletes in the pivoting sports often had less muscle protection at the knee than their male counterparts," he said. "This lack of muscle protection, which helps absorb the load on the knee joint, may contribute to the injury susceptibility."

Pivoting isn't the only knee culprit for women.

Landing on a hard surface also causes more knee injuries in women than men, Dr. Fu said, citing his research with women basketball, soccer and net ball players. Net ball is a popular sport in Australia and New Zealand.

Women are six to eight times more likely to tear their anterior cruciate ligament when landing than men playing the same sport, Dr. Fu said, adding it's not clear exactly why. "There are multiple theories, differences in anatomy, hormonal differences."

Dr. Hannafin, who directs the Women's Sports Medicine Center at the Hospital for Special Surgery in New York, said women participating in sports are vulnerable to developing a condition known as the female athlete triad, which involves mild to severe eating disorders, amenorrhea, or an absence of menstrual periods, a greater risk for stress fractures and the development of osteoporosis.

Though huge improvements have been made in educating women athletes about the need to have a balanced diet and reasonable body weight, many women still feel pressure to be skinny and eat light, Dr. Hannafin said.

This in turn leads to eating disorders which can ultimately cause osteoporosis, Dr. Hannafin said, adding she recommends bone density testing for all at-risk women, despite their age. "The younger you can make the diagnosis, the better chance they have of catching up."

Dr. Hannafin also said recent research at her sport's center shows stress fractures of the pelvis and hip are red flags for osteoporosis. "Stress fractures predominantly in the cancellous bone," she said.

Women with stress fractures in these areas "had a very high probability of having abnormal bone density," whatever their age, she said. A number of different things could be causing the bone loss, she said.

Dr. Hannafin urges doctors to routinely test bone density on women with pelvic or hip stress fractures.

While men have a different pattern of osteoporosis than women, they are still at risk, Dr. Lane said. One in eight men will develop osteoporosis in his lifetime. A drug commonly used to treat prostate cancer increases the risk of bone loss because it interferes with gonadal hormones.

"It's important that awareness of osteoporosis among men is raised because men are much more likely to die from the complications of an osteoporosis-related fracture than women," he said.

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Last modified 03/March/2001 by IS