genetic predisposition to ACL tears

When patients tear their ACL, they often ask me the question: “Why them?”

I explain there are multiple factors associated with the risk of tearing your ACL, the most common being landing sports and in particular landing or twisting in a specific way. However, why one person may tear their ACL ahead of another is also multifactorial and we know there are risk factors including having poor neuromuscular control of the knee.

In my years as an orthopaedic surgeon specialising in knee injuries, I have seen a number of families where several members of the same family have torn their anterior cruciate ligaments and indeed in one family I had the mother and both daughters all tear their ligament within six months of each other!

There is more and more evidence to point to a genetic predisposition to tearing your ACL, although identifying this in advance of the injury is almost impossible. This recent research in the British Journal of Sports Medicine outlines the high genetic contribution to anterior cruciate ligament and is another area that we should look at in families where one individual has sustained a cruciate rupture.

Perhaps the whole family should undergo an ACL rupture preventive exercise programme?