Sex-based differences in the tensile properties of the human anterior cruciate ligament

Chandrashekar, Naveen; Mansouri, Hossein; Slauterbeck, James R.; Hashemi, Javad

doi:10.1016/j.jbiomech.2005.10.031

Cited by 273 publications

(234 citation statements)

References 16 publications

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“…In the males, fibril area fraction showed the strongest correlation with stiffness, explaining 53% of the variability. Male ACLs are stiffer than female ACLs, 6 and the higher levels of fibrils per unit area in males reported here explains this difference. However, because of the low correlation between fibril density and stiffness in males, there may be another mechanism that improves the stiffness of the male ACL that is not completely measurable by ultrastructural properties (i.e., differences in the collagen matrix/fibril interactions).…”

Section: Discussionmentioning

confidence: 45%

“…Finally, correlation analysis was used to determine significant linear relationships between the ultrastructural parameters and the linear elastic properties, which had been previously determined. 6 RESULTS TEM images of the proximal, middle, and distal regions of the AMB of female and male ACLs ( Fig. 1) revealed sex differences in ultrastructural characteristics of the ACL.…”

Section: Methodsmentioning

confidence: 92%

“…6 The male donors averaged 36 years of age (range 26-50), lean body mass of 62 kg (range 53-75), and height of 179 cm (range 178-183). The female donors averaged 34 years of age (range 17-50), lean body mass of 46 kg (range 36-50), and height of 164 cm (range 158-175).…”

Section: Methodsmentioning

confidence: 99%

“…4,5 Recent studies showed that ACL mechanical, structural, and geometric characteristics are dependent on sex. 6,12 Female ACLs offer less resistance to deformation (are less stiff) and fail at lower loads compared to male ACLs. Furthermore, molecular studies identified sex differences in expression of collagen and matrix metalloproteinase genes that influence remodeling and turnover of structural elements in the ACL.…”

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confidence: 99%

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The human anterior cruciate ligament: Sex differences in ultrastructure and correlation with biomechanical properties

Hashemi

Chandrashekar

Mansouri

et al. 2008

Journal Orthopaedic Research

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The purpose of this study was to investigate the existence of sex-based differences in the ultrastructural characteristics of the human anterior cruciate ligament (ACL) as the underlying cause of differences in the structural and mechanical properties between sexes. The ACL of six male and six female cadaveric donors were randomly chosen from a pool of 10 male and 10 female ACLs that had previously been tested for their structural and mechanical properties. Eighteen tissue samples from the distal, proximal, and middle sections of the anteromedial and posterolateral bundles were analyzed by transmission electron microscopy. Female ACLs exhibited both lower fibril concentration and lower percent area occupied by collagen fibrils ( p < 0.05) compared to males. There was also a difference in the fibril diameters ( p < 0.05); donor age, height, body mass, and body mass index contributed significantly to this difference. In females, ACL stiffness and modulus of elasticity were highly correlated to fibril concentration (r ¼ 0.96 and 0.97, respectively); in males ACL failure load and strength were highly correlated to percent area occupied by collagen (r ¼ 0.96 and 0.96, respectively). These differences in ultrastructure may underlie differences in ACL properties between sexes. The anterior cruciate ligament (ACL) is a multifascicular structure made up of two bundles. Its two-bundle structure and complex attachment to the femur and the tibia allow for one or both bundles to be functional (taut) in all possible knee positions. 1 ACL bundles are composed of collagen fibrils oriented mostly in the direction of loading. 2 Strocchi et al. 3 and Baek et al. 4 previously described the ultrastructural characteristics of the human ACL, including size distribution of the collagen fibrils, number of fibrils per unit area, and percent area occupied by collagen, as determined by transmission electron microscopy (TEM). These investigators suggested that changes or variations in ultrastructural characteristics are strictly related to functional requirements. 4,5 Recent studies showed that ACL mechanical, structural, and geometric characteristics are dependent on sex. 6,12 Female ACLs offer less resistance to deformation (are less stiff) and fail at lower loads compared to male ACLs. Furthermore, molecular studies identified sex differences in expression of collagen and matrix metalloproteinase genes that influence remodeling and turnover of structural elements in the ACL. 7 If ACL properties indeed reflect ultrastructure, and sex-based differences in ACL properties exist, then the ultrastructure of the male and female ACL should also differ. To date, sex-based ultrastructural differences have not been reported. Furthermore, the mechanical properties of the ACL have not been directly linked to its ultrastructure.We hypothesized that collagen fibril measurements, including average fibril diameter, number of fibrils per unit area, and percent area occupied by collagen, are different between sexes. We further hypothesized that A...

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Section: Discussionmentioning

confidence: 45%

Section: Methodsmentioning

confidence: 92%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

The human anterior cruciate ligament: Sex differences in ultrastructure and correlation with biomechanical properties

Hashemi

Chandrashekar

Mansouri

et al. 2008

Journal Orthopaedic Research

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“…Wojtys et al (2003) demonstrated a gender bias in passive torsional knee stiffness when comparing sized-matched males and females during in vivo testing. During in vitro mechanical testing, Chandrashekar et al (2006) found persistent sex differences in human ACL tensile properties even when anthropometric covariates were taken into account. Further, in a sheep model, ultimate stress, a material property, was found to be greater in ram ligaments than in ewe ligament (Strickland et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

The differential effects of gender, anthropometry, and prior hormonal state on frontal plane knee joint stiffness

Cammarata

Dhaher

2008

Clinical Biomechanics

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Background-Gender differences in passive frontal plane knee stiffness may contribute to the increased anterior cruciate ligament injury rate in females. Gender-based stiffness differences have been attributed to anthropometric variations, but little data exist describing this relationship. Furthermore, sex hormone levels appear to influence joint stiffness, but the differential effects of instantaneous and prior hormonal concentrations remain unknown. This study sought to explore the effect of gender, prior hormonal status, and anthropometry on passive frontal plane knee joint stiffness.

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Assembled Cell‐Decorated Collagen (AC‐DC) Fiber Bioprinted Implants with Musculoskeletal Tissue Properties Promote Functional Recovery in Volumetric Muscle Loss

Christensen¹,

Turner

Coughenour³

et al. 2021

Adv Healthcare Materials

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Musculoskeletal tissue injuries, including volumetric muscle loss (VML), are commonplace and often lead to permanent disability and deformation. Addressing this healthcare need, an advanced biomanufacturing platform, assembled cell-decorated collagen (AC-DC) bioprinting, is invented to rapidly and reproducibly create living biomaterial implants, using clinically relevant cells and strong, microfluidic wet-extruded collagen microfibers. Quantitative analysis shows that the directionality and distribution of cells throughout AC-DC implants mimic native musculoskeletal tissue. AC-DC bioprinted implants further approximate or exceed the strength and stiffness of human musculoskeletal tissue and exceed collagen hydrogel tensile properties by orders of magnitude. In vivo, AC-DC implants are assessed in a critically sized muscle injury in the hindlimb, with limb torque generation potential measured over 12 weeks. Both acellular and cellular implants promote functional recovery compared to the unrepaired group, with AC-DC implants containing therapeutic muscle progenitor cells promoting the highest degree of recovery. Histological analysis and automated image processing of explanted muscle cross-sections reveal increased total muscle fiber count, median muscle fiber size, and increased cellularization for injuries repaired with cellularized implants. These studies introduce an advanced bioprinting method for generating musculoskeletal tissue analogs with near-native biological and biomechanical properties with the potential to repair myriad challenging musculoskeletal injuries.

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Sex-based differences in the tensile properties of the human anterior cruciate ligament

Cited by 273 publications

References 16 publications

The human anterior cruciate ligament: Sex differences in ultrastructure and correlation with biomechanical properties

The human anterior cruciate ligament: Sex differences in ultrastructure and correlation with biomechanical properties

The differential effects of gender, anthropometry, and prior hormonal state on frontal plane knee joint stiffness

Assembled Cell‐Decorated Collagen (AC‐DC) Fiber Bioprinted Implants with Musculoskeletal Tissue Properties Promote Functional Recovery in Volumetric Muscle Loss

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