Anterior cruciate ligament tear during the menstrual cycle in female recreational skiers

Lefèvre, Nicolas; Bohu, Yoann; Klouche, Shahnaz; Lecocq, J.; Herman, S.

doi:10.1016/j.otsr.2013.02.005

Cited by 36 publications

(51 citation statements)

References 28 publications

(38 reference statements)

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“…There were 4 studies conducted in the United States (US), 20,22,23,26 1 in Austria, 44 1 in France, 33 and 1 in Denmark. 42 The studies ranged in size from 65 to 51,348 participants.…”

Section: Resultsmentioning

confidence: 99%

The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis

Herzberg

Motu’apuaka

Lambert

et al. 2017

Orthopaedic Journal of Sports Medicine

153

112

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Background:Women are at substantially greater risk for anterior cruciate ligament (ACL) injuries than are men.Purpose:To conduct a systematic review and meta-analysis of the literature to clarify the effect of the menstrual cycle and contraceptives on the laxity of and noncontact injuries to the ACL.Study Design:Systematic review; Level of evidence, 4.Methods:Searches were conducted using MEDLINE (1946–August 2016), the Cochrane Library Database, clinical trial registries, and related reference lists. Search terms included athletic injuries, knee injuries, ligaments, joint instability, menstrual cycle, ovulation, hormones, and contraceptives. Investigators independently dually abstracted and reviewed study details and quality using predefined criteria and evaluated overall strength of evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria.Results:Twenty-one studies totaling 68,758 participants were included: 5 on the menstrual cycle and ACL injury, 7 on hormonal contraceptives and ACL injury, as well as 13 on menstrual cycle and ligament laxity. Four of 5 studies of women not using hormonal contraception indicated that the luteal phase was the least associated with ACL injuries. The 2 largest and highest quality studies on hormonal contraceptives suggested that hormonal contraceptives may be protective against ACL injury. Six of 12 studies on ACL laxity provided quantitative data for meta-analysis, finding significantly increased laxity during the ovulatory phase compared with the follicular phase.Conclusion:The literature suggests an association between hormonal fluctuations and ACL injury. Recent studies have suggested that oral contraceptives may offer up to a 20% reduction in risk of injury. The literature on ACL injuries and the menstrual cycle has more than doubled over the past decade, permitting quantitative analysis for the first time. However, the overall strength of this evidence is low. Promising potential directions for future research include long-term observational studies with ongoing hormonal assays and large interventional trials of follicular suppression, including newer hormonal methods.

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“…There were 4 studies conducted in the United States (US), 20,22,23,26 1 in Austria, 44 1 in France, 33 and 1 in Denmark. 42 The studies ranged in size from 65 to 51,348 participants.…”

Section: Resultsmentioning

confidence: 99%

The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis

Herzberg

Motu’apuaka

Lambert

et al. 2017

Orthopaedic Journal of Sports Medicine

153

112

View full text Add to dashboard Cite

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“…Because of the high use of hormonal contraceptives [8,9] and the high rates of ACL injuries among female athletes, it is important for sci-entists to understand how hormonal contraceptives may affect the risk for ACL injury. There are conflicting data regarding ACL injury susceptibility and hormonal contraceptive use, with some studies concluding there are protective effects and others concluding there are not [1,[10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Early studies examining functional movement via clinical tests have concluded that knee valgus moment is the biomechanical risk factor with the highest specificity and sensitivity to predict ACL injury [17][18][19][20]. Depending on the clinical test, a knee valgus moment of [16][17][18][19][20][21][22][23][24][25] Nm indicates a high risk of injury [18]. Additionally, it has been found that a shift in the center of mass away from the stance leg, as evidenced by a high vertical ground reaction force (GRF) when landing, results in increased knee valgus moments.…”

Section: Introductionmentioning

confidence: 99%

Preliminary Evaluation of Knee Kinetics in Female Athletes on Hormonal Contraceptives

Gilmer

Oliver

2019

Int J Sports Med

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Recently, an emphasis has been placed on understanding how ovarian sex hormones and hormonal contraceptives affect risk for anterior cruciate ligament (ACL) injury. The literature presents large discrepancies in whether or not hormonal contraceptives affect ACL injury risk; therefore, the purpose of this study was to evaluate whether vertical ground reaction force (GRF) and knee valgus force are different between athletes who do and do not use hormonal contraceptives. Twenty-two female athletes volunteered to participate and were divided into two groups based on their answers to a health history questionnaire: those who use hormonal contraceptives and those who do not. Participants performed a drop vertical jump (DVJ) and single leg crossover dropdown (SCD) at two different time points in their menstrual cycle (pre-ovulatory phase and mid-luteal phase). Kinetic data were collected at 1000 Hz. Independent samples t-tests revealed no significant differences between groups in vertical GRF and knee valgus force at both time points. Findings from this study suggest that hormonal contraceptives do not elicit detectable changes in vertical GRF and knee valgus force. Ultimately, this calls for further studies on the relationship between hormones and ACL injury risk and physicians to consider hormonal screening in addition to neuromuscular and biomechanical screening.

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“…Serum estradiol concentrations peak in the ovulatory phase, which is prevented by using oral contraception, leading to constant level of serum estradiol concentrations . However, despite a more constant hormonal profile when using hormonal contraception fluctuations in ACL injury prevalence appear to persist, although the overall risk has been reported to decrease when using oral contraceptives …”

Section: Introductionmentioning

confidence: 99%

Constant performance in balance and proprioception tests across the menstrual cycle – a pilot study in well trained female ice hockey players on hormonal contraception

Legerlotz

Bey

Götz

et al. 2017

Health Science Reports

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Anterior cruciate ligament tear during the menstrual cycle in female recreational skiers

Abstract: Level IV. Retrospective cohort study.

Cited by 36 publications

References 28 publications

The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis

The Effect of Menstrual Cycle and Contraceptives on ACL Injuries and Laxity: A Systematic Review and Meta-analysis

Preliminary Evaluation of Knee Kinetics in Female Athletes on Hormonal Contraceptives

Constant performance in balance and proprioception tests across the menstrual cycle – a pilot study in well trained female ice hockey players on hormonal contraception

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