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2025, Vol: 50, Issue: 4
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Original Research 


Clinical signs and symptoms of Anterior cruciate ligament rupture in female patients: findings from a prospective cohort study in Kurdish population

Rebar Fatah, Dyar Muatasam Ahmed.


Abstract
Objectives: To identify the specific clinical presentations of Anterior cruciate ligament (ACL) ruptures in females by concentrating on clinical signs and symptoms.
Methods: This prospective cohort study enrolled 72 female patients with MRI-confirmed ACL ruptures at Mercy Private Hospital, Iraq, from 2023 to 2025. Data included injury mechanisms, physical examination findings (Lachman, anterior drawer, pivot shift tests), MRI results, and 12-month follow-ups using the International Knee Documentation Committee (IKDC) score.
Results: Common clinical features included lameness (75% partial, 25% permanent), knee instability during daily activities (75%), marked pain after walking <2 km (55.6%), and swelling (80.6% constant/ordinary exertion). Functional limitations included impaired squatting (68.1% impossible) and stair climbing (77.8% requiring single-step ascent). Lachman (48.6% grade II, 40.3% grade III/IV) and anterior drawer tests (68.1% positive) showed high diagnostic utility, while 43.1% of pivot shift tests were falsely negative.
Conclusion: Female ACL rupture patients exhibit distinct clinical patterns, including severe functional limitations and pain exacerbated by daily activities. Clinicians should prioritize comprehensive evaluations integrating Lachman and anterior drawer tests, as pivot shift may underestimate injury severity. These findings underscore the need for sex-stratified diagnostic protocols and targeted rehabilitation strategies to address female-specific biomechanical vulnerabilities.

Key words: Biomechanics, knee joint, sex characteristics, clinical examination, ACL rupture.


 
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How to Cite this Article
Pubmed Style

Fatah R, Ahmed DM. Clinical signs and symptoms of Anterior cruciate ligament rupture in female patients: findings from a prospective cohort study in Kurdish population. RMJ. 2025; 50(4): 931-935. doi:10.5455/rmj.20250709082600

Web Style

Fatah R, Ahmed DM. Clinical signs and symptoms of Anterior cruciate ligament rupture in female patients: findings from a prospective cohort study in Kurdish population. https://www.rmj.org.pk/?mno=269932 [Access: October 29, 2025]. doi:10.5455/rmj.20250709082600

AMA (American Medical Association) Style

Fatah R, Ahmed DM. Clinical signs and symptoms of Anterior cruciate ligament rupture in female patients: findings from a prospective cohort study in Kurdish population. RMJ. 2025; 50(4): 931-935. doi:10.5455/rmj.20250709082600


Vancouver/ICMJE Style

Fatah R, Ahmed DM. Clinical signs and symptoms of Anterior cruciate ligament rupture in female patients: findings from a prospective cohort study in Kurdish population. RMJ. (2025), [cited October 29, 2025]; 50(4): 931-935. doi:10.5455/rmj.20250709082600


Harvard Style

Fatah, R. & Ahmed, . D. M. (2025) Clinical signs and symptoms of Anterior cruciate ligament rupture in female patients: findings from a prospective cohort study in Kurdish population. RMJ, 50 (4), 931-935. doi:10.5455/rmj.20250709082600


Turabian Style

Fatah, Rebar, and Dyar Muatasam Ahmed. 2025. Clinical signs and symptoms of Anterior cruciate ligament rupture in female patients: findings from a prospective cohort study in Kurdish population. Rawal Medical Journal, 50 (4), 931-935. doi:10.5455/rmj.20250709082600


Chicago Style

Fatah, Rebar, and Dyar Muatasam Ahmed. "Clinical signs and symptoms of Anterior cruciate ligament rupture in female patients: findings from a prospective cohort study in Kurdish population." Rawal Medical Journal 50 (2025), 931-935. doi:10.5455/rmj.20250709082600


MLA (The Modern Language Association) Style

Fatah, Rebar, and Dyar Muatasam Ahmed. "Clinical signs and symptoms of Anterior cruciate ligament rupture in female patients: findings from a prospective cohort study in Kurdish population." Rawal Medical Journal 50.4 (2025), 931-935. Print. doi:10.5455/rmj.20250709082600


APA (American Psychological Association) Style

Fatah, R. & Ahmed, . D. M. (2025) Clinical signs and symptoms of Anterior cruciate ligament rupture in female patients: findings from a prospective cohort study in Kurdish population. Rawal Medical Journal, 50 (4), 931-935. doi:10.5455/rmj.20250709082600


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