Male-Female Differences in Knee Laxity and Stiffness

Boguszewski, Daniel V.; Cheung, E.; Joshi, Nirav B.; Markolf, Keith L.; McAllister, David R.

doi:10.1177/0363546515608478

Cited by 42 publications

(37 citation statements)

References 32 publications

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“…In the second one, of 2009, they treat the laxity of the ligaments and stiffness of the knee joint related to the menstrual cycle of 26 women [9]. The article of 2015 deals with the same topic but in general terms, without considering the menstrual cycle and only comparing men and women [10].…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology of Primary Anterior Cruciate Ligament Ruptures in Men and Women

María¹,

Roberto²,

Pérez‐Bellmunt³

et al. 2019

Int J Sports Exerc Med

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In the practice of sports that require impact and pivot movements such as football or skiing, knee injuries are common and among these is important to underline the rupture of the Anterior Cruciate Ligament (ACL). Noncontact movements cause a 70% of ACL injuries and there is a high incidence of ruptures in women. Therefore, the objective of this study is to analyse what are the causes for the difference in incidence between men and women in terms of ACL ruptures. Through the search in the previous literature it has been observed that the fact that female athletes suffer ACL injuries with a higher frequency than male athletes is mainly due to anatomical, hormonal, biomechanical and neuromuscular control factors. Due to this occurrence, it is important to promote mainly treatments and prevention plans in order to reduce neuromuscular imbalances, that is predominant in women, to decrease the risk of ACL injuries in female athletes.

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Section: Discussionmentioning

confidence: 99%

“…Two of the studies used corpses to carry out the research, in one of them the average age is 41.55 [5] while in the other one is 31.5 [10]. For the study conducted in 2017, 85 athletes with an average age of 25 were selected [11].…”

Section: Characteristics Of the Samplesmentioning

confidence: 99%

Epidemiology of Primary Anterior Cruciate Ligament Ruptures in Men and Women

María¹,

Roberto²,

Pérez‐Bellmunt³

et al. 2019

Int J Sports Exerc Med

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“…Male subjects may have increased frontal plane knee stability with a greater quadriceps force. In addition, previous studies have shown that females have greater laxity, or less stiffness, during knee valgus rotation than males [ 32 – 34 ]. These neuromuscular and structural differences may be reasons for the observed differences in the impact of a subsequent jump on the knee abduction angle during the early landing phase between female and male subjects.…”

Section: Discussionmentioning

confidence: 99%

The effects of a subsequent jump on the knee abduction angle during the early landing phase

Ishida

Koshino

Yamanaka

et al. 2018

BMC Musculoskelet Disord

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BackgroundA double-leg landing with or without a subsequent jump is commonly used to evaluate the neuromuscular control of knee abduction. However, the differences in frontal plane knee biomechanics between landings with and without a subsequent jump are not well known. The purpose of the present study was to investigate the effects of a subsequent jump on knee abduction, including during the early landing phase, in female and male subjects.MethodsTwenty-one female subjects and 21 male subjects participated. All subjects performed drop landing task (a landing without a subsequent jump) and drop vertical jump task (a landing with a subsequent jump). The subjects landed from a 30-cm height. In drop vertical jump, the subjects also performed a maximum vertical jump immediately after landing. The knee abduction angle and moment were analyzed using a 3D motion analysis system. A two-way analysis of variance (task × time) was performed to examine the effects of a subsequent jump on the knee abduction angle during the early landing phase in female and male subjects. Another two-way analysis of variance (task × sex) was performed to compare peak knee abduction angles and moments.ResultsIn female subjects, the knee abduction angle was significantly greater during drop vertical jump than during drop landing, as measured 45 to 80 ms after initial contact (P < 0.05). Significant task-dependent effects in the peak knee abduction angle (P = 0.001) and the abduction moment (P = 0.029) were detected. The peak knee abduction angle and the abduction moment were greater during drop vertical jump than during drop landing.ConclusionsSubsequent jumps cause greater knee abduction during the early landing phase only in female subjects. This finding may relate to the sex discrepancy in non-contact anterior cruciate ligament injuries. Additionally, the presence of a subsequent jump significantly increases the peak knee abduction angle and the peak knee abduction moment during landings. Therefore, compared with a landing task without a subsequent jump (drop landing), a landing task with a subsequent jump (drop vertical jump) may be advantageous for screening for knee abduction control, especially in female athletes.

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“…This may be accounted for by the larger female to male ratio in Group 2 compared to Group 1. It is widely accepted that female knees demonstrate greater joint laxity compared to males [31], [32], [33]. Whether this larger degrees of rotation corresponds to symptomatic laxity is entire subjective.…”

Section: Discussionmentioning

confidence: 99%

Does additional reconstruction of the anterolateral ligament during a primary anterior cruciate ligament reconstruction affect tibial rotational laxity - A case series

Shah

Singh

Dugdale

et al. 2017

Annals of Medicine &Amp; Surgery

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BackgroundThe current evidence suggests that rotational stability in not restored in patients with anterior cruciate ligament (ACL) ruptures, despite reconstructive surgery. The graded pivot-shift is a useful clinical test to delineate extent of ligamentous laxity within the knee. Given its lateralised position, we hypothesized that reconstruction of the anterolateral ligament (ALL) would provide restraint to excessive internal rotation, restoring rotational stability.Methods10 patients with MRI confirmed diagnosis of an isolated ACL rupture were included. Patients assigned a grade-3 pivot-shift underwent dual-ligament reconstruction for the ACL and ALL (Group 2), whilst patients with an absent pivot-shift, grade-1 or grade-2 underwent single ligament reconstruction for just the ACL (Group 1). Total range of rotation (TRR) was measured using a 3D-kinematic system at 30°,60°and 90° of knee flexion. Data was collected on the pathology-free contralateral normal knee (CNK), ACL-deficient knee (ADK) and the ACL-reconstructed knee (ARK).ResultsA statistically significant pre-operative difference in TRR between the CNK and ADK was noted between Group 1 and 2 (4.04° vs. 1.53°; p < 0.05). Postoperatively, both groups achieved a TRR that was either equivalent, or surpassed values that were observed on the CNKs. The absolute and percentage reduction in TRR at 30° of knee flexion was significantly higher in Group-2 compared to Group-1 (−8.15° vs. −2.96°; p < 0.001) and (28.04% vs. 13.31%; p < 0.001) respectively.ConclusionOur findings are based primarily in anaesthetized patients, with kinematic values at time-zero postoperatively. Patients presenting with significant rotational instability following a primary ACL injury and assessed to have a grade-3 pivot-shift may benefit from dual-ligament reconstruction. Further research is required to assess long-term patient-centered clinical outcomes.

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Male-Female Differences in Knee Laxity and Stiffness

Abstract: Understanding the risk factors for noncontact ACL injury is important for injury prevention. In combination with other female-specific risk factors, increased knee laxity may be a contributing factor associated with the higher rate of female ACL injuries.

Cited by 42 publications

References 32 publications

Epidemiology of Primary Anterior Cruciate Ligament Ruptures in Men and Women

Epidemiology of Primary Anterior Cruciate Ligament Ruptures in Men and Women

The effects of a subsequent jump on the knee abduction angle during the early landing phase

Does additional reconstruction of the anterolateral ligament during a primary anterior cruciate ligament reconstruction affect tibial rotational laxity - A case series

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