Knee ligament mechanical properties are not influenced by estrogen or its receptors

2006 ◽  
Vol 290 (5) ◽  
pp. E1034-E1040 ◽  
Author(s):  
Stuart J. Warden ◽  
Leanne K. Saxon ◽  
Alesha B. Castillo ◽  
Charles H. Turner
Keyword(s):  
Mechanical Properties ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
High Rate ◽  
Null Mutation ◽  
Sprague Dawley ◽  
Gene Encoding ◽  
Acl Injuries ◽  
Knee Ligament ◽  
Anterior Cruciate

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.

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

2007 ◽  
Author(s):  
Gail M. Thornton ◽  
Soraya J. Bailey ◽  
Xinxin Shao ◽  
Douglas Morck ◽  
David A. Hart ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Fibroblast Proliferation ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Acl Injuries ◽  
Knee Ligament ◽  
Clear Explanation ◽  
Anterior Cruciate

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.

scholarly journals Anterior cruciate ligament injuries in Australian football: should women and girls be playing? You’re asking the wrong question

2020 ◽  
Vol 6 (1) ◽  
pp. e000778 ◽  
Author(s):  
Aaron Fox ◽  
Jason Bonacci ◽  
Samantha Hoffmann ◽  
Sophia Nimphius ◽  
Natalie Saunders
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Early Years ◽  
High Rate ◽  
Acl Injuries ◽  
Sports Science ◽  
Australian Football ◽  
Women And Girls ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injuries have been a rising concern in the early years of the women’s Australian Football League (AFLW), eliciting headlines of a ‘knee crisis’ surrounding the league. There has been a focus on female biology as the primary factor driving the high rate of ACL injuries in the AFLW. Emphasising Australian football (AF) as being dangerous predominantly due to female biology may be misrepresenting a root cause of the ACL injury problem, perpetuating gender stereotypes that can restrict physical development and participation of women and girls in the sport. We propose that an approach addressing environmental and sociocultural factors, along with biological determinants, is required to truly challenge the ACL injury problem in the AFLW. Sports science and medicine must therefore strive to understand the whole system of women in AF, and question how to address inequities for the benefit of the athletes.

Returning a Division I Hurdler to Sport After Multiple Knee Ligament Injuries

2020 ◽  
pp. 1-6
Author(s):  
Xavier D. Thompson ◽  
Brianna DiAntonio
Keyword(s):  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Neuromuscular Control ◽  
Biceps Femoris ◽  
Patient Reported Outcome ◽  
Return To Play ◽  
Knee Ligament ◽  
Patient Reported ◽  
Anterior Cruciate ◽  
Knee Ligament Injuries

An 18-year-old male hurdler reported to preparticipation physicals, with a history of anterior cruciate ligament, lateral collateral ligament, and posterior cruciate ligament sprain; medial meniscocapsular sprain; and biceps femoris tendon avulsion. The patient received full clearance from his surgeon, despite functional deficits. Rehabilitation and return-to-play decision making included analysis of patient-reported outcome scores and tests of symmetry and neuromuscular control. After graduated intervention and multiple batteries of assessments, the patient was allowed to return to full participation. The nature of this sport and the time between surgery and the intervention made thorough evaluation of function and graduated progression a necessity.

Design and characterization of three-dimensional twist-braid scaffolds for anterior cruciate ligament regeneration

TECHNOLOGY ◽  
2017 ◽  
Vol 05 (02) ◽  
pp. 98-106 ◽  
Author(s):  
Shreya Madhavarapu ◽  
Rohit Rao ◽  
Sarah Libring ◽  
Emma Fleisher ◽  
Yasonia Yankannah ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Three Dimensional ◽  
Fatigue Properties ◽  
Acl Injuries ◽  
Glycol Diacrylate ◽  
Synthetic Materials ◽  
Anterior Cruciate ◽  
Poly Ethylene

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.

scholarly journals Review Article: Validity of the KT-1000 Knee Ligament Arthrometer

2009 ◽  
Vol 17 (1) ◽  
pp. 77-79 ◽  
Author(s):  
S Arneja ◽  
J Leith
Keyword(s):  
Cruciate Ligament ◽  
Review Article ◽  
Acl Injuries ◽  
Knee Ligament ◽  
Predictive Values ◽  
Medline Search ◽  
Anterior Tibial ◽  
Kt 1000 ◽  
Anterior Cruciate ◽  
Injured Knee

The KT-1000 knee arthrometer (KT-1000) is an objective instrument to measure anterior tibial motion relative to the femur for anterior cruciate ligament (ACL) reconstruction. Four studies between 1950 and 2007 regarding validity of the KT-1000 were identified using a Medline search. One had interpretable information on sensitivities, specificities, and predictive values to validate the instrument as a diagnostic tool in patients with acute or chronic ACL injuries. Three had limitations in methodology. We suggest that the KT-1000 should be used with caution as an objective instrument. Rather, using a KT-1000 score derived by subtracting the anterior tibial motion relative to the femur of the injured knee to that of the uninjured knee may be more appropriate as a dichotomous diagnostic test with a threshold of 2 or 3 mm.

ACL Injury Mechanism is Related to Articular Pressure Distribution: A Cadaveric and Finite Element Investigation

2012 ◽  
Author(s):  
Ata M. Kiapour ◽  
Constantine K. Demetropoulos ◽  
Ali Kiapour ◽  
Carmen E. Quatman ◽  
Jason W. Levine ◽  
...  
Keyword(s):  
Finite Element ◽  
Pressure Distribution ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
High Rate ◽  
Bone Bruise ◽  
Acl Injuries ◽  
Injury Mechanisms ◽  
Anterior Cruciate

Acute anterior cruciate ligament (ACL) injury can be devastating, and often results in clinical sequelae that include meniscal tears, chondral lesions and osteoarthritis. Various bone bruise patterns of the femur or tibia, and bone contusions of the lateral tibial plateau have been associated in more than 80% of partial or complete ACL ruptures [1]. As quantification of articular cartilage pressure distribution under high-rate loading conditions remains challenging, validated finite element (FE) models of the knee can be used to characterize the effects of different loading parameters on tibiofemoral (TF) joint pressure distribution. This study combines high-rate cadaveric experiments with FE analysis to simulate ACL injuries and associated bone bruise patterns following landing from a jump. We hypothesized that a potential relationship exists between ACL injury mechanisms and resultant tibial plateau bone bruise patterns. This relationship may enhance our understanding of ACL injury mechanisms, which may provide insight to improve current prevention strategies that aim to decrease the risk of ACL injury and damage to secondary anatomical structures. All of this may in turn minimize associated posttraumatic knee osteoarthritis.

scholarly journals Ball heading and subclinical concussion in soccer as a risk factor for anterior cruciate ligament injury

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
George Kakavas ◽  
Nikolaos Malliaropoulos ◽  
Wieslaw Blach ◽  
Georgios Bikos ◽  
Filippo Migliorini ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Acl Injury ◽  
Soccer Players ◽  
Ligament Injury ◽  
Neurocognitive Performance ◽  
Acl Injuries ◽  
Anterior Cruciate ◽  
The Impact

AbstractSoccer players have a high risk of anterior cruciate ligament (ACL) injury, a potentially career-ending event. ACL rupture has been linked with abnormal neuromuscular control in the lower limb. Additionally, heading the ball with the unprotected head during game play is increasingly recognized as a major source of exposure to concussive and sub-concussive repetitive head impacts. This article provides a hypothesis of potential connection of ACL injury with ball heading in soccer players. The study reviews literature sources regarding the impact of neurocognitive alterations after ball headings in ACL injuries. Poor baseline neurocognitive performance or impairments in neurocognitive performance via sleep deprivation, psychological stress, or concussion can increase the risk for subsequent musculoskeletal injury.

scholarly journals Komparativna analiza polozaja kalema u butnoj kosti posle rekonstrukcije prednjeg ukrstenog ligamenta kolena tehnikom kroz prednje-unutrasnji portal i tehnikom kroz golenjacu

2013 ◽  
Vol 60 (2) ◽  
pp. 81-85
Author(s):  
Vladimir Harhaji ◽  
Srdjan Ninkovic ◽  
Zoran Milojevic ◽  
Viktor Till ◽  
Vladimir Ristic ◽  
...  
Keyword(s):  
Control Method ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Anteromedial Portal ◽  
Transtibial Technique ◽  
Acl Injuries ◽  
Knee Ligament ◽  
X Ray ◽  
The Difference ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) is the most common surgically treated knee ligament. If we take into account the fact that incidence of ACL injuries is growing, it is clearly that the interest of orthopedic surgeons for this pathology is also growing. Increasing number of this operations leads to increasing of complications, which requires its analysis. One of the most common failure of ACL reconstruction is a bad position of the graft in the femoral condyle. This study aimed to analyze the positioning of the graft in to the femur by two generally accepted techniques - transtibial technique and technique through the antero-medial portal. The analysis included postoperative radiographs in 60 patients, of whom 30 were operated by transtibial technique and 30 by technique through anteromedial portal. Radiographic analysis involved the measurement of the AP digital imaging, the tunnel projection X ray measurements and measurements of the computed tomography (CT), which was here a control method. The accuracy of measurement was set at 0.5? or 1 min. All radiographs were made in the same way according to the literature. The results showed that the neoligaments were placed lower in the femoral condyle by technique through anteromedial portal than by transtibial technique, and the difference was statistically significant (on tunnel X ray by anteromedial portal screws were average placed at 50.0? and 10:20 am, and by transtibial technique at 37.5? or 10:45 am). Based on the results, it was concluded that the neoligaments were positioned closer to its anatomical position by technique through anteromedial portal.

scholarly journals Application and Surgical Technique of ACL Reconstruction Using Worldwide Registry Datasets: What Can We Extract?

2021 ◽  
Vol 7 (1) ◽  
pp. 2
Author(s):  
Ulrike Wittig ◽  
Georg Hauer ◽  
Ines Vielgut ◽  
Patrick Reinbacher ◽  
Andreas Leithner ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Knee Injuries ◽  
Epidemiological Data ◽  
Surgical Reconstruction ◽  
Acl Injuries ◽  
Knee Ligament ◽  
Graft Choice ◽  
Anterior Cruciate ◽  
The Uk ◽  
Country Specific

Anterior cruciate ligament (ACL) injuries are among the most common knee injuries. The purpose of this study was to compare surgical reconstruction of the ACL between different countries and regions in order to describe differences regarding epidemiological data, reconstruction frequency, and graft choice. A systematic literature search was performed using the ACL study group website in order to identify the relevant knee ligament registers. Four national registries were included, comprising those from Sweden, the UK, New Zealand, and Norway. A large variation was found concerning the total number of primary ACL reconstructions with a reported range from 4.1 to 51.3 per 100,000 inhabitants. The country-specific delay between injury and reconstruction varied between an average of 6.0 months and 17.6 months. The leading sports activities resulting in ACL injury included soccer, alpine skiing, handball, rugby, and netball. Moreover, a strong variability in graft choice for primary reconstruction was found. The comparison of ACL registers revealed large differences, indicating different clinical implications regarding conservative or surgical therapy and choice of the preferable graft. ACL registers offer a real-world clinical perspective with the aim to improve quality and patient safety by investigating factors associated with subsequent surgical outcomes.

Quadriceps Control: A Key Factor in Coping With Anterior Cruciate Ligament Deficiency

2003 ◽  
Author(s):  
Glenn N. Williams ◽  
Peter J. Barrance ◽  
Lynn Snyder-Mackler ◽  
Thomas S. Buchanan
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Activity Patterns ◽  
Neuromuscular Control ◽  
Acl Injury ◽  
The United States ◽  
Circular Statistics ◽  
Return To Sports ◽  
Acl Injuries ◽  
Anterior Cruciate

Approximately 250,000 anterior cruciate ligament (ACL) injuries occur in the United States each year. Most people cannot return to sports after an ACL injury without surgical intervention (Non-copers), but some can (Copers). Recent research suggests that the ability to cope with ACL injury is most likely related to neuromuscular function. The purpose of this study was to evaluate the neuromuscular control strategies of ACL deficient (ACL-D) Non-copers, ACL-D Copers, and people with uninjured knees using an established target-matching protocol, electromyography (EMG) of 10 muscles acting at the knee, and circular statistics methods. Thirty-two people (12 Non-Copers, 8 Copers, and 12 people without a history of knee injury) volunteered to participate in the study. The ACL-D subjects demonstrated diminished neuromuscular control when their muscle activity patterns were compared to those of the uninjured subjects. The key difference between the Copers and Non-copers was that Copers demonstrated better quadriceps control than the Non-copers. This study may have important implications for the treatment of people who sustain ACL injuries.

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