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First published on December 9, 2004, doi:10.1177/0363546504265678
This version was published on January 1, 2005
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The American Journal of Sports Medicine 33:23-28 (2005)
© 2005 American Orthopaedic Society for Sports Medicine

The Familial Predisposition Toward Tearing the Anterior Cruciate Ligament

A Case Control Study

R. Kevin Flynn, MSc*, Cheryl L. Pedersen, MSc*, Trevor B. Birmingham, PhD*, Alexandra Kirkley, MD{dagger}, Dianne Jackowski, MSc{ddagger} and Peter J. Fowler, MD*,§

From the * Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada, and the {ddagger} Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada

§ Address correspondence to Peter J. Fowler, MD, Fowler Kennedy Sport Medicine Clinic, 3M Centre, University of Western Ontario, London, Ontario N6A 3K7, Canada.

Purpose: A study of 171 surgical cases and 171 matched controls was conducted to investigate whether a familial predisposition toward tearing the anterior cruciate ligament of the knee exists.

Study Design: Case control study; Level of evidence, 3.

Methods: Patients who were diagnosed with an anterior cruciate ligament tear were matched by age (within 5 years), gender, and primary sport to subjects without an anterior cruciate ligament tear. All 342 subjects completed a questionnaire detailing their family history of anterior cruciate ligament tears.

Results: When controlling for subject age and number of relatives, participants with an anterior cruciate ligament tear were twice as likely to have a relative (first, second, or third degree) with an anterior cruciate ligament tear compared to participants without an anterior cruciate ligament tear (adjusted odds ratio = 2.00; 95% confidence interval, 1.19–3.33). When the analysis was limited to include only first-degree relatives, participants with an anterior cruciate ligament tear were slightly greater than twice as likely to have a first-degree relative with an anterior cruciate ligament tear compared to participants without an anterior cruciate ligament tear (adjusted odds ratio = 2.24; 95% confidence interval, 1.24–4.00).

Conclusions: Findings are consistent with a familial predisposition toward tearing the anterior cruciate ligament.

Clinical Relevance: Future research should concentrate on identifying the potentially modifiable risk factors that may be passed through families and developing strategies for the prevention of anterior cruciate ligament injuries.

Key Words: anterior cruciate ligament (ACL) • familial predisposition • risk factor • case control • questionnaire




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