Anterior cruciate ligament (ACL) injuries continue to present in epidemic-like proportions, carrying significant shortand\r\nlonger-term debilitative effects. With females suffering these injuries at a higher rate than males, an abundance\r\nof research focuses on delineating the sex-specific nature of the underlying injury mechanism. Examinations of sexdimorphic\r\nlower-limb landing mechanics are common since such factors are readily screenable and modifiable.\r\nThe purpose of this paper was to critically review the published literature that currently exists in this area to gain\r\ngreater insight into the aetiology of ACL injuries in females and males. Using strict search criteria, 31 articles\r\ninvestigating sex-based differences in explicit knee and/or hip landing biomechanical variables exhibited during\r\nvertical landings were selected and subsequently examined. Study outcomes did not support the generally\r\naccepted view that significant sex-based differences exist in lower-limb landing mechanics. In fact, a lack of\r\nagreement was evident in the literature for the majority of variables examined, with no sex differences evident\r\nwhen consensus was reached. The one exception was that women were typically found to land with greater peak\r\nknee abduction angles than males. Considering knee abduction increases ACL loading and prospectively predicts\r\nfemale ACL injury risk, its contribution to sex-specific injury mechanisms and resultant injury rates seems plausible.\r\nAs for the lack of consensus observed for most variables, it may arise from study-based variations in test\r\npopulations and landing tasks, in conjunction with the limited ability to accurately measure lower-limb mechanics\r\nvia standard motion capture methods. Regardless, laboratory-based comparisons of male and female landing\r\nmechanics do not appear sufficient to elucidate causes of injury and their potential sex-specificity. Sex-specific in\r\nvivo joint mechanical data, if collected accurately, may be more beneficial when used to drive models (e.g.,\r\ncadaveric and computational) that can additionally quantify the resultant ACL load response. Without these steps,\r\nsex-dimorphic landing mechanics data will play a limited role in identifying the aetiology of ACL injuries in women\r\nand men.
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