Date of Award


Document Type


Degree Name

Master of Physician Assistant Studies


Physician Assistant Education

First Advisor

Rahnea Sunseri


An anterior cruciate ligament (ACL) tear is the most severe ligament injury to the knee in athletics. Female athletes are at a greater risk for ACL tears than males. A report of National Collegiate Athletic Association (NCAA) injury statistics declared that women's basketball players were six times more likely to sustain an ACL tear than their male equivalents. Gender variances that may provide justification for this include anatomic features, as well as distinctive differences in strength between genders.1 Anatomic features include one main variance between the sexes, which is the lower extremity alignment. Alignment of the hip, knee, and ankle is thought to play a significant role in the load distribution of the knee and the tension placed on the ligament structures during athletic competition. Lower extremity alignment has been declared as a risk factor for acute and chronic lower extremity injuries, including patellofemoral syndrome and anterior cruciate ligament injuries 2 Another anatomic feature given credibility as a risk for ACL injuries is the Quadricep angle (Q-angle).1 The Q-angle, which has been repeatedly researched, is defined as an angle created by a line from the anterior superior iliac spine to the patella center and a line from the patella center to the tibial tuberosity (see the diagram below). An increase in the Q-angle is an element of the misalignment mechanism at the knee and lower extremity extension, and can be a cause of overuse injuries. An increased Q-angle has been linked with patellofemoral pain syndrome, knee joint hypermobility, chondromalacia patellae, recurrent subluxation of the patella, and anterior cruciate ligament tears. The causes for an increased Q-angles among females are related to increased pelvic width, shorter femur length, or more laterally placed tibial tuberosity.4 Whether an increased Q angle compared to a normal Q angle in female athletes increases their risk for ACL tears during athletic is relevant to female athletes. If this association is confirmed, then these athletes can be advised of their increased risk of an ACL tear during competition.

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Griffin_Presentation Slides.pptx (877 kB)
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