The Relationship Between Isometric Hip Strength and Incidence of Noncontact Anterior Cruciate Ligament Injuries in Female Athletes: A Critically Appraised Topic

Clinical Scenario: Noncontact anterior cruciate ligament (ACL) injuries are prevalent among athletes in multiplanar sports, especially females. Hip strength may contribute to the incidence of these injuries due to dynamic movement patterns at the knee. Clinical Question: Does hip strength impact the incidence of noncontact ACL injuries in female athletes? Summary of Key Findings: A literature search was conducted on the relationship between hip strength and noncontact ACLs. Three prospective studies measuring isometric hip strength and recording the number of noncontact ACL injuries that occurred within a time period were included. One study demonstrated lower isometric hip adductor-to-abductor ratio was associated with noncontact ACL injuries. Two studies demonstrated those with noncontact ACL injuries had greater isometric hip abduction strength. Clinical Bottom Line: Evidence suggests that greater isometric hip strength and low hip adductor-to-abductor strength ratio may be a risk factor that is associated with noncontact ACL injuries in females. Future research should investigate the impact of hip strength on the incidence of noncontact ACL injuries, across all genders. Strength of Recommendation: Based on the Center of Evidence-Based Medicine, these studies provide Level 3 evidence that hip strength is associated with the risk of noncontact ACL injuries in females.