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Am J Sports Med. 2012 Jan;40(1):32-40. doi: 10.1177/0363546511422325. Epub 2011 Sep 14.

Morphologic characteristics help explain the gender difference in peak anterior cruciate ligament strain during a simulated pivot landing.

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  • 1Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA. dlipps@umich.edu

Abstract

BACKGROUND:

Gender differences exist in anterior cruciate ligament (ACL) cross-sectional area and lateral tibial slope. Biomechanical principles suggest that the direction of these gender differences should induce larger peak ACL strains in females under dynamic loading.

HYPOTHESIS:

Peak ACL relative strain during a simulated pivot landing is significantly greater in female ACLs than male ACLs.

STUDY DESIGN:

Controlled laboratory study.

METHODS:

Twenty cadaveric knees from height- and weight-matched male and female cadavers were subjected to impulsive 3-dimensional test loads of 2 times body weight in compression, flexion, and internal tibial torque starting at 15° of flexion. Load cells measured the 3-dimensional forces and moments applied to the knee, and forces in the pretensioned quadriceps, hamstring, and gastrocnemius muscle equivalents. A novel, gender-specific, nonlinear spring simulated short-range and longer range quadriceps muscle tensile stiffness. Peak relative strain in the anteromedial bundle of the ACL (AM-ACL) was measured using a differential variable reluctance transducer, while ACL cross-sectional area and lateral tibial slope were measured using magnetic resonance imaging. A repeated-measures Mann-Whitney signed-rank test was used to test the hypothesis.

RESULTS:

Female knees exhibited 95% greater peak AM-ACL relative strain than male knees (6.37% [2.53%] vs 3.26% [1.89%]; P = .004). Anterior cruciate ligament cross-sectional area and lateral tibial slope were significant predictors of peak AM-ACL relative strain (R(2) = .59; P = .001).

CONCLUSION:

Peak AM-ACL relative strain was significantly greater in female than male knees from donors of the same height and weight. This gender difference is attributed to a smaller female ACL cross-sectional area and a greater lateral tibial slope.

CLINICAL RELEVANCE:

Since female ACLs are systematically exposed to greater strain than their male counterparts, training and injury prevention programs should take this fact into consideration.

PMID:
21917612
[PubMed - indexed for MEDLINE]
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