Lateralization of anterior cruciate ligament injuries of the knee - analysis by sex, sports activity, type of sport, and injury mechanism

• Published in: Medicinski pregled Vol. 78; no. 1-2; pp. 18 - 23
• Main Authors: Milinkov, Milan, Obradovic, Mirko, Milankov, Vukadin, Ninkovic, Srdjan
• Format: Journal Article
• Language: English
• Published: 2025
• ISSN: 0025-8105; 1820-7383
• DOI: 10.2298/MPNS2502018M

Introduction. Anterior cruciate ligament injuries represent a major concern among athletes, with recent studies suggesting that sex, sport type, and injury mechanism influence their incidence and characteristics. This study aimed to investigate the lateralization of anterior cruciate ligament injuries and assess associations between the injured side and sex, level of sports activity, sport type, injury mechanism, and playing surface. Material and Methods. A retrospective analysis was performed on 1,011 athletes with confirmed anterior cruciate ligament injury. Data were obtained from medical records and included variables as sex, injury side, level of sports activity, type of sport, injury mechanism, and playing surface. Associations were analyzed using chi-square tests. Results. A statistically significant association was found between sex and injury side (p = 0.0066), with females more frequently sustaining injuries to the left knee and males to the right. Professional athletes had a significantly higher incidence of right-sided injuries compared to recreational athletes (p = 0.005). Among sports, rugby and american football showed a predominance of right knee injuries (76.2%), while volleyball exhibited a higher rate of left-sided injuries (71.4%). Contact injuries were more common on the right side (62.7%), whereas non-contact injuries predominantly affected the left side. Injuries occurring on grass surfaces were significantly more frequent on the right side (p = 0.028). Conclusion. Sex, level of sports activity, type of sport, and playing surface are significantly associated with the lateralization of anterior cruciate ligament injuries. These findings may contribute to improved better understanding of injury risk factors and inform targeted prevention strategies. Further studies incorporating leg dominance are recommended to refine injury risk assessments.