Relationship of incidence of anterior cruciate ligament injuries and body-built Index somatotype in Indian population


  • Sandeep Deore Department of Orthopaedic, Dr. D. Y. Patil Hospital, Navi Mumbai, Maharashtra, India
  • Sachin Kale Department of Orthopaedic, Dr. D. Y. Patil Hospital, Navi Mumbai, Maharashtra, India
  • Ajit Chalak Department of Orthopaedic, Dr. D. Y. Patil Hospital, Navi Mumbai, Maharashtra, India
  • Vanashree Nalawade Department of Orthopaedic, Dr. D. Y. Patil Hospital, Navi Mumbai, Maharashtra, India
  • Suraj S. Doshi Department of Orthopaedic, Dr. D. Y. Patil Hospital, Navi Mumbai, Maharashtra, India



ACL tear, Body built type, Somatotypes, Endomorph, Mesomorph, Ectomorph


Background: Incidence of ACL injuries and physical parameters like age, sex, height, weight and BMI has been studied intensely as a risk factor. Each of them poses as a different risk factor for occurrence of ACL injuries. But body-built index-somatotype considers relative proportions of fatness, muscle mass and skeletal architecture in terms of endomorphy, mesomorphy and ectomorphy in a single individual which neutralises variables like age, sex, BMI.

Methods: 100 patients were included in the study, excluding those with multiligament injuries, associated fractures around knee, mucoid degeneration of ACL and road traffic accident cases. Parameters such as skin fold thickness, circumference and epicondylar, condylar width was taken into consideration. Body built index was calculated in terms of endomorphy, mesomorphy and ectomorphy using the heath-carter anthropometric somatotype manual.

Results: We found that amongst all those have ACL injury, endomorphy was higher grade (5.49), followed by mesomorphy (4.75). Lesser grades of ectomorphs i.e., slender people were having ACL injuries. Though there was low margin of grading between the two, endomorphy was higher in ACL injured people followed by mesomorphy.

Conclusions: Endomorphs and mesomorphs have higher tendancy of ACL injury. Ectomorphs have lesser incidence of ACL injury.


Hashemi J, Mansouri H, Chandrashekar N, Slauterbeck JR, Hardy DM, Beynnon BD. Age, sex, body anthropometry, and ACL size predict the structural properties of the human anterior cruciate ligament. J Orthop Res. 2011;29(7):993-1001.

Iriuchishima T, Ryu K, Fu FH. Evaluation of age-related differences in anterior cruciate ligament size. Knee Surg Sports Traumatol Arthrosc. 2019;27(1):223-9.

Wang HM, Shultz SJ, Ross SE, Henson RA, Perrin DH, Schmitz RJ. ACL Size and Notch Width Between ACLR and Healthy Individuals: A Pilot Study. Sports Heal. 2020;12(1):61-5.

DiSilvestro KJ, Jauregui JJ, Glazier E, Cherkalin D, Bennett CH, Packer JD et al. Outcomes of Anterior Cruciate Ligament Reconstruction in Obese and Overweight Patients: A Systematic Review. Clin J Sport Med. 2019;29(4):257-61.

Park YB, Ha CW, Kim HJ, Park YG. Preoperative prediction of anterior cruciate ligament tibial footprint size by anthropometric variables. Knee Surg Sports Traumatol Arthrosc. 2017;25(5):1638-45.

Ayerza MA, Múscolo DL, Costa-Paz M, Makino A, Rondón L. Comparison of sagittal obliquity of the reconstructed anterior cruciate ligament with native anterior cruciate ligament using magnetic resonance imaging. Arthroscopy. 2003;19(3):257-61.

Saita Y, Schoenhuber H, Thiébat G, Ravasio G, Pozzoni R, Panzeri A et al. Knee hyperextension and a small lateral condyle are associated with greater quantified antero-lateral rotatory instability in the patients with a complete anterior cruciate ligament (ACL) rupture. Knee Surg Sports Traumatol Arthrosc. 2019;27(3):868-74.

Samora W, Beran MC, Parikh SN. Intercondylar Roof Inclination Angle: Is It a Risk Factor for ACL Tears or Tibial Spine Fractures? J Pediatr Orthop. 2016;36(6):e71-4.

Shimozaki K, Nakase J, Takata Y, Shima Y, Kitaoka K, Tsuchiya H. Greater body mass index and hip abduction muscle strength predict noncontact anterior cruciate ligament injury in female Japanese high school basketball players. Knee Surg Sports Traumatol Arthrosc. 2018;26(10):3004-11.

Wang H-M, Sandra JS, Scott ER, Robert AH, David HP, Robert AK et al. Sex Comparisons of In Vivo Anterior Cruciate Ligament Morphometry. J Athl Train. 2019;54(5):513-8.

Zetel P. The association between body-built and injury occurrence in pre-professional ballet dancers-saperated analysis for the injured body locations. Int J Occup Med Envir Heal. 2017;30(1):151-9.

Diana M. Somatotype in high performance female netball players may influence player position and the incidence of lower limb and back injuries. Hopper Br J Sports Med. 1997;31:197-9.

Carter JEL. The Health Carter Anthropometric Somatotype Instruction Manual. 2002;1-26.

Kim JH, Jung ES, Kim CH, Youn H, Kim HR. Genetic associations of body composition, flexibility and injury risk with ACE, ACTN3 and COL5A1 polymorphisms in Korean ballerinas. J Exerc Nutrition Biochem. 2014;18(2):205-14.

Bowerman E, Whatman C, Harris N, Bradshaw E, Karin J. Are maturation, growth and lower extremity alignment associated with overuse injury in elite adolescent ballet dancers? Phys Ther Sport. 2014;15(4):234-41.






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