Maruyama S, Yamazaki T, Sato Y, Suzuki Y, Shimizu S, Ikezu M, Kaneko F, Matsuzawa K, Hirabayashi R, Edama M. Relationship Between Anterior Knee Laxity and General Joint Laxity During the Menstrual Cycle.
Orthop J Sports Med 2021;
9:2325967121993045. [PMID:
33855094 PMCID:
PMC8010836 DOI:
10.1177/2325967121993045]
[Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/13/2020] [Indexed: 11/17/2022] Open
Abstract
Background
Anterior cruciate ligament (ACL) injury has been reported to have a higher incidence in women than in men.
Purpose/Hypothesis
The purpose was to examine the relationship of anterior knee laxity (AKL), stiffness, and generalized joint laxity (GJL) with respect to the menstrual cycle. It was hypothesized that AKL and GJL would increase during the ovulation phase, when estrogen levels are high.
Study Design
Descriptive laboratory study.
Methods
A total of 15 female university students aged >20 years and with normal menstrual cycles were evaluated. AKL was measured as anterior tibial displacement of the femur after application of 44-, 89-, and 133-N loads to the tibia. Stiffness was calculated as Δ force/Δ displacement at loads between 44 and 89 N and between 89 and 133 N. The University of Tokyo joint laxity test was used for evaluation of GJL. The participants' menstrual cycle was divided into the early follicular, late follicular, ovulation, and luteal phases using the basal body temperature method and an ovulation kit; AKL and GJL were measured once during each phase. Participants were also stratified according to the presence or absence of genu recurvatum (GR).
Results
There was no significant difference in AKL, stiffness, or GJL among the menstrual phases. In the GR group, AKL values at 89 N and 133 N were significantly higher in the ovulation phase than in the early follicular phase (P = .025 and P =.018, respectively); there were no significant differences in AKL among the phases in the non-GR group. In addition, the GR group in the ovulation phase had significantly higher AKL values at 44 N, 89 N, and 133 N compared with the non-GR group (P = .013, P = .005, and P = .010, respectively). There were no significant differences in GJL among the phases in the GR or non-GR groups.
Conclusion
Women with GR may have increased AKL in the ovulation phase when compared with the early follicular phase, which may be a risk factor for ACL injury.
Clinical Relevance
The results of this study suggest that the ovulation phase may be related to the greater incidence of ACL injuries in women.
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