Age and Sex-Specific Joint Biomechanics in Response to Partial and Complete ACL Injury in the Porcine Model

Abstract Context: Pediatric anterior cruciate ligament (ACL) injury rates are increasing and are highest in adolescent females. Complete ACL tears are typically surgically reconstructed, but there are few guidelines and very limited data regarding the need for surgical reconstruction or rehabilitation for partial ACL tears in skeletally immature patients. Objective: To evaluate the impact of partial (anteromedial bundle) and complete ACL transection on joint laxity and tissue forces under anterior and rotational loads in male and female stifle joints throughout skeletal growth in the porcine model. Design: Descriptive Laboratory Study. Setting: Laboratory. Patients or Other Participants: Sixty male and female Yorkshire cross-breed pigs aged 1.5, 3, 4.5, 6, and 18 months (n=6/age/sex). Main Outcome Measure(s): Joint laxity was measured in intact, anteromedial bundle-transected, and ACL-transected joints under applied anterior-posterior drawer and varus-valgus torque using a robotic testing system. The loading of the soft tissues in the stifle joint was measured under each condition. Results: Anterior-posterior joint laxity increased by 13–50% (p<0.05) after anteromedial bundle transection and 75–178% (p<0.05) after ACL transection. Destabilizations after anteromedial bundle transection increased with age (p<0.05) and were greater in late adolescent females than late adolescent males (p<0.05). In anteromedial bundle-transected joints, the posterolateral bundle resisted the anterior load. In ACL-transected joints, the medial collateral ligament (MCL) contribution was largest, followed by the medial meniscus. MCL contribution was larger while medial meniscus contribution was smaller in males versus females. Conclusions: Partial ACL transection resulted in moderate increases in joint laxity, while the remaining bundle performed the primary ACL function. Destabilizations due to partial ACL transection were largest in late adolescent joints, indicating that operative treatment should be considered in active, late adolescent patients. Increased forces in the MCL and medial meniscus after ACL transection suggest that rehabilitation protocols may need to focus on protecting these tissues.

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Sex Differences in Anatomic Features Linked to Anterior Cruciate Ligament Injuries During Skeletal Growth and Maturation

The American Journal of Sports Medicine ◽

10.1177/0363546520931831 ◽

2020 ◽

Vol 48 (9) ◽

pp. 2205-2212

Author(s):

Shayan Hosseinzadeh ◽

Ata M. Kiapour

Keyword(s):

Sex Differences ◽

Cruciate Ligament ◽

Acl Injury ◽

Tibial Slope ◽

Skeletal Growth ◽

Late Adolescent ◽

Male And Female ◽

Female Patients ◽

Notch Width ◽

Age Related

Background: Several anatomic features of the knee have been shown to affect joint and anterior cruciate ligament (ACL) loading and the risk of subsequent injuries. While several studies have highlighted sex differences between these anatomic features, little is known on how these differences develop during skeletal growth and maturation. Hypotheses: (A) Anatomic features linked to an ACL injury will significantly change during skeletal growth and maturation. (B) The age-related changes in anatomic features linked to an ACL injury are different between male and female patients. Study Design: Cross-sectional study; Level of evidence, 3 Methods: After institutional review board approval, magnetic resonance imaging data from 269 unique knees (patient age 3-18 years; 51% female), free from any injuries, were used to measure femoral notch width, posterior slope of the lateral tibial plateau (lateral tibial slope), medial tibial depth, tibial spine height, and posterior lateral meniscal bone angle. Linear regression was used to test the associations between age and quantified anatomic indices. Patients were then divided into 4 age groups: preschool (3-6 years), prepubertal (7-10 years), early adolescent (11-14 years), and late adolescent (15-18 years). Also, 2-way analysis of variance with the Holm-Sidak post hoc test was used to compare morphology between male and female patients in each age group. Results: The femoral notch width, medial tibial depth, and tibial spine height significantly increased with age ( P < .001). The lateral tibial slope decreased with age only in male patients ( P < .001). Except for the posterior lateral meniscal bone angle, the age-related changes in anatomy were different between male and female patients ( P < .05). On average, early and late adolescent female patients had smaller femoral notches, steeper lateral tibial slopes, flatter medial tibial plateaus, and shorter tibial spines compared with age-matched male patients ( P < .01). Conclusion: Overall, the findings supported our hypotheses, showing sex-specific changes in anatomic features linked to an ACL injury during skeletal growth and maturation. These observations help to better explain the reported age and sex differences in the prevalence of ACL injuries. The fact that most of these anatomic features undergo substantial changes during skeletal growth and maturation introduces the hypothesis that prophylactic interventions (ie, activity modification) would have the potential to reshape a maturing knee in a manner that lowers the risk of noncontact ACL injuries.

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Sex-Specific Function and Morphology of the Anterior Cruciate Ligament During Skeletal Growth in a Porcine Model

10.1101/2021.05.10.442986 ◽

2021 ◽

Author(s):

Danielle Howe ◽

Stephanie G. Cone ◽

Jorge A. Piedrahita ◽

Bruce Collins ◽

Lynn A. Fordham ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Porcine Model ◽

Cruciate Ligament ◽

Joint Laxity ◽

Cross Sectional Area ◽

Skeletal Growth ◽

Sectional Area ◽

Anteromedial Bundle ◽

Cross Sectional ◽

Anterior Cruciate

Pediatric anterior cruciate ligament (ACL) injuries are on the rise, and females experience higher ACL injury risk than males during adolescence. Studies in skeletally immature patients indicate differences in ACL size and joint laxity between males and females after the onset of adolescence. However, functional data regarding the ACL and its anteromedial and posterolateral bundles in the pediatric population remain rare. Therefore, this study uses a porcine model to investigate the sex-specific morphology and function of the ACL and its bundles throughout skeletal growth. Hind limbs from male and female Yorkshire pigs aged early youth to late adolescence were imaged using magnetic resonance imaging to measure the size and orientation of the ACL and its bundles, then biomechanically tested under anterior-posterior drawer using a robotic testing system. Joint laxity decreased (p<0.001) while joint stiffness increased (p<0.001) throughout skeletal growth in both sexes. The ACL was the primary stabilizer against anterior tibial loading in all specimens, while the functional role of the anteromedial bundle increased with age (p<0.001), with an earlier shift in males. ACL and posterolateral bundle cross-sectional area and ACL and anteromedial bundle length were larger in males than females during adolescence (p<0.01 for all), while ACL and bundle sagittal angle remained similar between sexes. Additionally, in situ ACL stiffness correlated with cross-sectional area across skeletal growth (r2=0.75, p<0.001 in males and r2=0.64, p<0.001 in females), but not within age groups. This study has implications for age and sex-specific surgical intervention strategies and suggests the need for human studies.

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A GYNANDROMORPH OF RACHISPODA SUBPILIGERA (MALLOCH) (DIPTERA: SPHAEROCERIDAE), WITH NOTES ON ASYMMETRY, CIRCUMVERSION, AND THE STRUCTURE OF THE MALE POSTABDOMEN

The Canadian Entomologist ◽

10.4039/ent124729-4 ◽

1992 ◽

Vol 124 (4) ◽

pp. 729-735 ◽

Cited By ~ 1

Author(s):

Terry A. Wheeler

Keyword(s):

Abdominal Segment ◽

Developmental Process ◽

Direct Consequence ◽

Male And Female ◽

Posterior Division ◽

Anterior Posterior

AbstractA gynandromorph of Rachispoda subpiligera (Malloch) is described. The specimen exhibits both bilateral and anterior/posterior division of male and female genitalic components. Abdominal segment 5 is male, segments 6 and 7 are bilaterally divided into male (right) and female (left) halves, and segments 8–11 are female. Comparison of male and female components supports the view that the large, asymmetrical sclerite posterior to sternite 5 in male Sphaeroceridae is synsternite 6 + 7. Circumversion of the genitalia, normally seen in male segments 8–11, is absent, although male components of segments 6 and 7 exhibit asymmetry normally associated with circumversion. This suggests that asymmetry of sternites 6 and 7 is a developmental process independent of circumversion, not a direct consequence of circumversion.

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Outcome of ACL Reconstruction for Chronic ACL Injury in Knees without the Posterior Horn of the Medial Meniscus: Comparison with ACL Reconstructed Knees with An Intact Medial Meniscus

Knee Surgery and Related Research ◽

10.5792/ksrr.16.072 ◽

2017 ◽

Vol 29 (1) ◽

pp. 39-44 ◽

Cited By ~ 3

Author(s):

Kevin Syam ◽

Devendra K. Chouhan ◽

Mandeep Singh Dhillon

Keyword(s):

Acl Reconstruction ◽

Medial Meniscus ◽

Acl Injury ◽

Posterior Horn

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Is ski boot sole abrasion a potential ACL injury risk factor for male and female recreational skiers?

Scandinavian Journal of Medicine and Science in Sports ◽

10.1111/sms.13391 ◽

2019 ◽

Vol 29 (5) ◽

pp. 736-741 ◽

Cited By ~ 1

Author(s):

Markus Posch ◽

Gerhard Ruedl ◽

Alois Schranz ◽

Katja Tecklenburg ◽

Martin Burtscher

Keyword(s):

Risk Factor ◽

Injury Risk ◽

Acl Injury ◽

Male And Female ◽

Injury Risk Factor ◽

Acl Injury Risk

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Affective Drinking Motives, Delinquency and Binge Drinking: A Comparison of Male and Female High School Seniors

Alcohol and Alcoholism ◽

10.1093/alcalc/agaa070 ◽

2020 ◽

Vol 55 (5) ◽

pp. 571-577

Author(s):

Glenn D Walters

Keyword(s):

High School ◽

Binge Drinking ◽

High School Seniors ◽

Drinking Motives ◽

Late Adolescent ◽

Male And Female ◽

Main Effect ◽

Components Analysis ◽

Monitoring The Future ◽

The Relationship

Abstract Aim The purpose of this study was to determine whether the association between affective drinking motives, delinquency and binge drinking varied as a function of sex and if so, whether delinquency moderated the relationship between affective drinking motives and binge drinking in late adolescent males and females. Methods Participants were 623 (257 males, 366 females) high school seniors from the 2018 Monitoring the Future study. A principal components analysis was initially performed to create component scores for the first factor of a 15-item drinking motives scale subsequently labeled affective drinking motives. These scores, along with sex and a measure of delinquency, were then entered into a three-way interaction. The interaction was found to correlate significantly with binge drinking. Because of the significant three-way interaction, analyses were performed on male and female participants separately. Results Analyses conducted on male participants revealed a moderate correlation between affective drinking motives and binge drinking but no evidence of an interaction between affective drinking motives and delinquency. Analyses performed on female participants, on the other hand, identified a significant main effect for affective drinking motives and a negative interaction between affective drinking motives and delinquency, indicating that the relationship between affective drinking motives and binge drinking was strongest when delinquency was low. Conclusions These results suggest that while delinquency had no apparent impact on the affective drinking motive–binge drinking correlation in boys, low delinquency clearly amplified the counter-binge drinking effects of low affective drinking motives in girls.

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Understanding Physical Activity through the Experiences of Adolescent Girls

Women in Sport and Physical Activity Journal ◽

10.1123/wspaj.21.1.3 ◽

2012 ◽

Vol 21 (1) ◽

pp. 3-14 ◽

Cited By ~ 3

Author(s):

Hope E. Yungblut ◽

Robert J. Schinke ◽

Kerry R. McGannon ◽

Mark A. Eys

Keyword(s):

Physical Activity ◽

Adolescent Girls ◽

Adolescent Females ◽

Qualitative Approach ◽

Female Adolescents ◽

Early Adolescent ◽

Late Adolescent ◽

Structured Interviews ◽

Physical Activity Programming ◽

Gender Specific

Researchers have found that female youths are particularly vulnerable to withdrawing from sport and physical activity programs in early adolescence (see Active Healthy Kids Canada, 2010). However, there is an absence of a comprehensive, emic description of how female adolescents experience physical activity. Open-ended, semi-structured interviews were conducted individually with 15 early adolescent females (12–14 years old) and 20 middle and late adolescent females (15–18years old). Co-participants in the mid to late adolescent cohort provided retrospective accounts of their early adolescent experiences along with insight on how their experiences shaped their current participation. The girls’ voices were brought to the forefront through composite vignettes that highlight their physical activity experiences, integrating the words used by the co-participants. Results are discussed in relation to physical activity programming for adolescent females and why a qualitative approach is useful in contributing to gender-specific physical activity programming.

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