Influence of Early Ovariohysterectomy on the Mechanical Properties of Rabbit Medial Collateral Ligament

Author(s):  
Gail M. Thornton ◽  
Soraya J. Bailey ◽  
Xinxin Shao ◽  
Douglas Morck ◽  
David A. Hart ◽  
...  

Female athletes have significantly higher incidence of anterior cruciate ligament (ACL) injuries than males participating in similar sports [1]. To date, no clear explanation has emerged for this disparity. However, hormonal differences may provide an explanation because some ACL injuries have been linked to physiologic fluctuations in estrogen levels over the menstrual cycle [2]. Receptors for estrogen have been identified in rabbit and human ACLs and medial collateral ligaments (MCLs) [3]. Increased estrogen levels caused decreased fibroblast proliferation and collagen synthesis in cell cultures from human and rabbit ACLs [4]. Since fibroblasts maintain collagen production and degradation in ligaments and collagen is the major load-bearing component of ligaments, estrogen may affect knee ligament mechanical properties.

2006 ◽  
Vol 290 (5) ◽  
pp. E1034-E1040 ◽  
Author(s):  
Stuart J. Warden ◽  
Leanne K. Saxon ◽  
Alesha B. Castillo ◽  
Charles H. Turner

Women are at greater risk of tearing their knee anterior cruciate ligament (ACL) than men participating in similar athletic activities. There is currently no conclusive explanation for this disparity; however, as ACL injuries in women have been linked with estrogen fluctuations during the menstrual cycle, one hypothesis is that estrogen has a direct detrimental effect on knee ligament mechanical properties. This study investigated the influence of estrogen and its receptors (ERα and ERβ) on knee ligament mechanical properties. This was achieved by testing the viscoelastic and tensile mechanical properties of knee medial collateral ligaments (MCL) and ACLs from: 1) male Sprague-Dawley rats treated with either estrogen (17α-ethynylestradiol; 0.03 mg/kg) or an ERα-specific agonist (propyl pyrazole triol; 2 mg/kg), and 2) female mice with a null mutation of the gene encoding for ERβ. Estrogen treatment had no significant effects on the viscoelastic or tensile mechanical properties of the rat MCL or ACL. Similarly, pharmacological stimulation of ERα using a selective agonist in rats and genetic modulation of ERβ by null mutation of its gene in mice did not influence MCL or ACL properties. These data indicate that estrogen does not have a major direct effect on ligament mechanical properties. Energies for the prevention of the disproportionately high rate of knee ligament injuries in women may be better spent focusing on more established and modifiable risk factors, such as abnormalities in neuromuscular control about the knee.


2013 ◽  
Author(s):  
Irfan M Asif ◽  
Emily Edwards ◽  
Kimberly Harmon

Musculoskeletal injuries in the female athlete are, for the most part, similar to those in the male athlete. However, there are differences in the incidence of these injuries and in the sports in which they tend to occur. Stress fractures are more common in the female athlete because of the higher prevalence of disordered eating and subsequent energy imbalance that leads to detrimental effects on bone. In addition, female athletes have a higher rate of noncontact anterior cruciate ligament (ACL) injuries than male athletes. Other musculoskeletal problems are also more common in females, such as multidirectional instability of the shoulder, adhesive capsulitis, and patellofemoral pain. Finally, as a function of greater participation by females in certain sports, such as dance and gymnastics, injuries specific to those sports are more common in females. This chapter addresses injuries that are seen commonly in the female athlete and reviews unique issues related to exercise and the female reproductive system. Figures depict the management of stress fractures, a stress fracture of the inferior pubic ramus, the tension aspect of the femoral neck, stress fractures of the rib, multidirectional shoulder instability, adhesive capsulitis, spondylolysis, proper squat landing technique, and the female athlete triad. A table outlines the recommended intake of both calcium and vitamin D for bone health at various ages.This chapter contains 9 figures, 1 table, 59 references, and 5 Board-styled MCQs.


Author(s):  
Hsiu-Chen Lin ◽  
Weng-Hang Lai ◽  
Chia-Ming Chang ◽  
Horng-Chaung Hsu

Female athletes are more likely to sustain an anterior cruciate ligament (ACL) injury than male athletes. Previous study has showed that female individuals had larger anterior knee laxity than their male counterparts [1]. Researchers have also reported that knee laxity and hyperextension knee were a possible factor contributing to ACL injury [2]. Loudon showed that a person with hyperextension knee, either healthy or ACL-injured, had poorer proprioceptive control. Even more, ACL-injured subjects with hyperextension knee demonstrated a declined function of proprioception feedback loop and the ability to initiate protective reflexes [3].


2020 ◽  
Vol 25 (5) ◽  
pp. 254-257
Author(s):  
Hayley M. Ericksen ◽  
Rachele E. Vogelpohl

Anterior cruciate ligament (ACL) injury in female athletes is common. Team sport athletes experience more ACL injuries than ballet and modern dancers. Examining biomechanical differences between these two groups may help to explain the discrepancy in ACL injury rates. The purpose of this study was to examine lower extremity kinematic differences between collegiate dancers and National Collegiate Athletic Association Division I soccer athletes during a rebound jump-landing task. Peak hip, knee, and ankle kinematics were collected during a jump-landing task. Results showed more knee flexion and less ankle eversion in the dancers compared to the soccer athletes. Differences in training and strategies used during landing may explain the kinematic differences between groups.


Author(s):  
A. Homyk ◽  
A. Orsi ◽  
S. Wibby ◽  
N. H. Yang ◽  
H. N. Hashemi ◽  
...  

A full or partial tear of the anterior cruciate ligament (ACL) is a common and painful injury that has been estimated to occur approximately 250,000 times annually in the U.S. [1]. Articular cartilage and meniscal injuries are also associated with ACL injuries [2]. ACL injuries can often lead to degenerative osteoarthritis of the articular cartilage [2]. An epidemiology study of athletic injuries by Majewski et al. [3] determined that out of 19,530 sports injuries, 20% were ACL injuries and 8% were medial collateral ligament (MCL) injuries.


2010 ◽  
Vol 3 (3) ◽  
pp. 15
Author(s):  
Larry W. McDaniel ◽  
Adrienna Rasche ◽  
Laura Gaudet ◽  
Allen Jackson

The Anterior Cruciate Ligament (ACL) is located behind the kneecap (patella) and connects the thigh bone (femur) to the shin bone (tibia). Stabilizing the knee joint is the primary responsibility of the ACL. Injuries that affect the ACL are three to five times more common in females than males. This is a result of anatomical, biomechanical, strength, and hormonal differences. The probability of potentially devastating tears to the ACL may be reduced in female athletes by an alternative warm-up program that focuses on muscle flexibility, strength, motor skill, and balance enhancement. Once the ACL has been torn, it becomes impossible to reattach or stitch the ligament back together.  The blood supply in this area of the body is diminished and the tissue becomes nonviable. Reconstruction of the ACL involves attaching the ligament to another tendon from the hamstring, just below the knee. Although reconstruction and treatment of ACL injuries are available, much unnecessary pain, money, and time may be wasted during these procedures. It is important to be aware of the prevention methods available to reduce the possibility of potentially devastating tears to the ACL. These prevention methods include proper warm-up and avoiding activities that cause pain. Other preventive measures include incorporating balance exercises along with stretching and strengthening muscles near the ACL. Appropriate rest and recovery time are other important factors that may prevent ACL injuries. Quality footwear, strapping, or taping may provide an additional level of support to the knee joint and ACL.  


2021 ◽  
Vol 9 (12) ◽  
pp. 232596712110253
Author(s):  
Tayt M. Ellison ◽  
Ilexa Flagstaff ◽  
Anthony E. Johnson

Background: Although most anterior cruciate ligament (ACL) injuries occur in male athletes, female athletes are consistently observed to be at a higher risk for sports-specific ACL injury. Purpose: To provide a thorough review of what is known about the sexual dimorphisms in ACL injury to guide treatment and prevention strategies and future research. Study Design: Narrative review. Methods: We conducted a comprehensive literature search for ACL-related studies published between January 1982 and September 2017 to identify pertinent studies regarding ACL injury epidemiology, prevention strategies, treatment outcomes, and dimorphisms. By performing a broad ACL injury search, we initially identified 11,453 articles. After applying additional qualifiers, we retained articles if they were published in English after 1980 and focused on sex-specific differences in any of 8 different topics: sex-specific reporting, difference in sports, selective training, hormonal effects, genetics, neuromuscular and kinematic control, anatomic differences, and outcomes. Results: A total of 122 articles met the inclusion criteria. In sum, the literature review indicated that female athletes are at significantly higher risk for ACL injuries than are their male counterparts, but the exact reasons for this were not clear. Initial studies focused on intrinsic differences between the sexes, whereas recent studies have shifted to focus on extrinsic factors to explain the increased risk. It is likely both intrinsic and extrinsic factors contribute to this increased risk, but further study is needed. In addition to female patients having an increased risk for ACL injuries, they are less likely than are male patients to undergo reconstructive surgery, and they experience worse postsurgical outcomes. Despite this, reconstructive surgery remains the gold standard when knee stability, return to sports, and high functional outcome scores are the goal, but further research is needed to determine why there is disparity in surgical rates and what surgical techniques optimize postsurgical outcomes for female patients. Conclusion: Male athletes often predominated the research concerning ACL injury and treatment, and although sex-specific reporting is progressing, it has historically been deficient. ACL injuries, prevention techniques, and ACL reconstruction require further research to maximize the health potential of at-risk female athletes.


Women in sport – an almost inexhaustible topic that has been neglected for a long time. Female Athletes conquer discipline after discipline – including the associated injuries. Common sports injuries in female athletes include stress fractures, anterior cruciate ligament (ACL) injuries and sport related concussions (SRC). Less commonly recognized are the specific sex differences that lead to these injuries. An understanding of these factors can improve their clinical management including surgical treatment, the rehabilitation phase and return to play.


2012 ◽  
Vol 41 (1) ◽  
pp. 203-215 ◽  
Author(s):  
Gregory D. Myer ◽  
Dai Sugimoto ◽  
Staci Thomas ◽  
Timothy E. Hewett

Background: In female athletes, sports-related injuries to the anterior cruciate ligament (ACL) increase during adolescence and peak in incidence during the mid- to late teens. Although biomechanical investigations indicate that a potential window of opportunity exists for optimal timing for the initiation of integrative neuromuscular training (NMT) in young female athletes, the influence of the timing of initiation of these programs on the efficacy of ACL injury reduction has yet to be evaluated. Hypothesis/Purpose: The purpose of the current report was to systematically review and synthesize the scientific literature regarding the influence of age of NMT implementation on the effectiveness for reduction of ACL injury incidence. The hypothesis tested was that NMT would show a greater effect in younger populations. Study Design: Meta-analysis; Level of evidence 1a. Methods: Data were pooled from 14 clinical trials that met the inclusion criteria of (1) number of ACL injuries reported; (2) NMT program used; (3) female participants were included; (4) investigations used prospective, controlled trials; and (5) age of participants was documented or was obtainable upon contact with the authors. A meta-analysis with odds ratio (OR) was used to compare the ratios of ACL injuries between intervention and control groups among differing age categorizations. Results: A meta-analysis of the 14 included studies demonstrated significantly greater knee injury reduction in female athletes who were categorized in the preventive NMT group compared with those who were in the control group (OR: 0.54; 95% confidence interval [CI]: 0.35, 0.83). Lower ACL injuries in mid-teens (OR 0.28; CI: 0.18, 0.42) compared with late teens (OR 0.48; CI: 0.21, 1.07) and early adults (OR 1.01; CI: 0.62, 1.64) were found in participants undergoing NMT. Conclusion: The findings of this meta-analysis revealed an age-related association between NMT implementation and reduction of ACL incidence. Both biomechanical and the current epidemiological data indicate that the potential window of opportunity for optimized ACL injury risk reduction may be before the onset of neuromuscular deficits and peak knee injury incidence in female athletes. Specifically, it may be optimal to initiate integrative NMT programs during early adolescence, before the period of altered mechanics that increase injury risk.


TECHNOLOGY ◽  
2017 ◽  
Vol 05 (02) ◽  
pp. 98-106 ◽  
Author(s):  
Shreya Madhavarapu ◽  
Rohit Rao ◽  
Sarah Libring ◽  
Emma Fleisher ◽  
Yasonia Yankannah ◽  
...  

The anterior cruciate ligament (ACL) is the most commonly injured ligament in the knee, with more than 350,000 ACL injuries reported annually in the US. Current treatments include the use of autografts and allografts, which have a number of disadvantages. Previous attempts to use synthetic materials in ligament replacement have been unsuccessful due to their inability to replicate the long-term mechanical properties of the native ligament. The focus of this study was to develop twist-braid poly(L-lactic acid) (PLLA) scaffolds for ACL regeneration. Poly(ethylene glycol) diacrylate (PEGDA) was incorporated into the twist-braid scaffolds to evaluate its impact on their mechanical behavior. The twist-braid scaffolds were also compared with braided scaffolds. Scaffold mechanical properties were evaluated based on stress-relaxation, tensile and fatigue properties of the braided-only, twist-braid, and the twist-braid scaffolds with PEGDA. All the scaffolds exhibited properties comparable to the native human ACL with the twist-braid scaffolds displaying resistance to fatigue. Scaffolds were seeded with rat patellar tendon fibroblasts. Cell viability and the amount of protein released were studied over a course of 8 weeks. The scaffolds were stained with Picrosirius red after 8 weeks to show the deposition of extracellular matrix by the cells. The results from this study showed that the twist-braid scaffolds have properties most suitable for ligament regeneration.


Sign in / Sign up

Export Citation Format

Share Document