Sex-Based Differences in Common Sports Injuries

Cordelia W. Carter, MD; Mary Lloyd Ireland, MD; Anthony E. Johnson, MD; William N. Levine, MD; Scott Martin, MD; Asheesh Bedi, MD; Elizabeth G. Matzkin, MD


J Am Acad Orthop Surg. 2018;26(13):447-454. 

In This Article


Sex-based differences are common in medicine, occurring at both the micro (cellular) and macro (whole organism) levels. Some sex-based differences in musculoskeletal medicine are fairly well characterized, such as those seen in patients with degenerative joint disease of the knee and fragility fractures of the hip. Despite these initial successes in advancing knowledge of sexual dimorphism in the field of orthopaedic surgery, research that strives to detect, describe, and delineate sex-based differences in musculoskeletal disease is a field of study that remains in its infancy, both at the bench and in the clinics.

Our review of the existing literature on sex-based differences in common sports injuries demonstrates the continued need for focused efforts at studying these differences because ultimately, a patient's sex will likely affect his or her clinical outcome. It is critical that we continue to enhance our understanding of the differences among patients and the role these differences play in mediating each patient's experience of, and treatment outcomes for, various musculoskeletal diseases—including stress fracture, ACL injury, shoulder instability, FAI, and concussion. Devising scientific studies that investigate sex-specific hypotheses (eg, do females with ACL injury have lower reinjury rates after quadriceps autograft reconstruction than males?) may lead to the development of evidence-based sex-specific treatment algorithms for various sports injuries and, ultimately, to improved musculoskeletal care for all athletes.