Mechanisms and Risk Factors for Noncontact ACL Injury in Age Mature Athletes Who Engage in Field Or Court Sports: A Summary of the Literature Since 1980

Epidemiological data show that in the last 10 years alone the incidence and rate of anterior cruciate ligament (ACL) injuries have not changed appreciably. Furthermore, many ACL injuries appear to be noncontact in nature and sustained while engaging in some field or court sport. Thus, the need to investigate novel methods and adopt training strategies to prevent ACL injuries is paramount. To do so, however, requires an understanding of the mechanisms and risk factors for the injury. The aim of this review was to investigate the mechanisms and risk factors for noncontact ACL injuries in age mature athletes who compete in field or court sports. A search of the entire MEDLINE database for biomedicine was performed, and an iterative reference check was also conducted. A total of 87 articles disclosed met the eligibility criteria. Articles were grouped into 'themes'; 'anatomical and biomechanical mechanisms and risk factors', 'intrinsic mechanisms and risk factors', and 'extrinsic mechanisms and risk factors'. In this review, it is concluded that there are still a number of risk factors and mechanisms for noncontact ACL injury that are not well understood. However, the importance of dynamic knee joint stability is highlighted. It is also suggested that novel methods for preventing ACL injury be investigated and developed.