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We have previously reported on gender differences in injury patterns at a large Utah ski resort. A total of 7307 injuries during 1989 to 1995 (53% men, 47% women) have been treated at the emergency clinic at the resort base. This study was an attempt to determine if there are factors related to skier demographics or conditions surrounding a knee injury that might be relevant to attempts to reduce the high incidence of these injuries. An analysis of our prospective data including 817 knee injuries over the past three ski seasons indicated that there are significant differences in demographics and injury descriptions between men and women who seriously injure their knee. Knee injury type and degree of ligamentous rupture were compared to gender, age, skier ability, direction of fall, and binding release as reported by the skier immediately following the injury. Only those injuries sustained while skiing were included. A total of 536 women and 281 men sustained knee injuries, with 55% and 43%, respectively, of these injuries being a Grade III rupture of the anterior cruciate ligament (ACL). There was a statistically significant difference in the number of knee injuries compared to all injuries between men and women (p < 0.01). Within the knee injury group, neither age nor direction of fall significantly influenced the type or degree of knee injury, while there was a significant difference between men and women related to a binding release surrounding an injury event. Isolated ACL injuries occurred much more often in advanced skiers than in beginners, while ACL rupture coupled with other soft tissue injury, particularly to the medial collateral ligament (MCL) were significantly more common in beginners. Detailed information regarding the circumstances surrounding these injuries can be especially useful in determining how to teach people what positions and fall situations are typically the most dangerous, or in providing equipment manufacturers with information needed to try to modulate loads to certain parts of the body under certain skiing situations. Future research will continue to analyze these disparities between the sexes in percentage of knee injuries to total injuries and in the significant lack of binding releases in women sustaining knee injuries.
alpine skis, injury, sports equipment, ski injuries, epidemiology, gender differences, injury mechanisms
Director of Research, Orthopedic Biomechanics Institute, Salt Lake City, UT
Senior research coordinator, registered nurse, The Orthopedic Specialty Hospital, Salt Lake City, UT