Greater body mass index and hip abduction muscle strength predict noncontact anterior cruciate ligament injury in female Japanese high school basketball players



This 3-year prospective study assessed risk factors for noncontact anterior cruciate ligament (ACL) injuries in female Japanese high school basketball players. Players suffering noncontact ACL injuries were assumed to demonstrate poorer hip abductor, knee flexor, and knee extensor muscle strength, as well as static balance, than those without injuries.


One hundred and ninety-five new female high school basketball players underwent baseline examinations for various parameters during their first year of high school. After the baseline data were collected, all ACL injuries occurring over the subsequent 3 years were recorded. The assessment parameters between the noncontact ACL injury group and the control group were compared.


Of the 195 players, 24 were excluded due to pre-existing injuries present during the initial examination, quitting the basketball club during the follow-up period, or missing data. The remaining 171 players were observed for 3 years; unilateral noncontact ACL injuries were occurred in 12 players. Significantly lower general joint laxity and greater hip abductor strength were observed in the ACL injury group than in the control group. Body mass index (BMI) and hip abductor strength were significantly greater in the ACL injury group than in the control group, based on logistic regression analysis.


Greater BMI and hip abductor muscle strength were independent risk factors for noncontact ACL injuries in female Japanese high school basketball players. Although performing complete screens may be difficult, attention should be given to ACL injuries, particularly in highly competitive players with strong muscles.

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Fig. 1



Anterior cruciate ligament


Body mass index


Confidence interval


General joint laxity




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Correspondence to Junsuke Nakase.

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The authors have no conflicts of interest.

Ethical approval

This study was approved by the Ethical Committee of the Graduate School of Medical Sciences, Kanazawa University (approval # 1050).

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All participants and their parents coaches were given a thorough explanation of the study design and voluntarily provided written informed consent.

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Shimozaki, K., Nakase, J., Takata, Y. et al. 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 26, 3004–3011 (2018).

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  • Noncontact
  • Anterior cruciate ligament injury
  • Female
  • Japanese high school basketball players
  • Body mass index
  • Hip abduction muscle