The Menstrual Cycle May Affect Anterior Knee Laxity and the Rate of Anterior Cruciate Ligament Rupture

Somerson, Jeremy S.; Isby, Ian J.; Hagen, Mia S.; Kweon, Christopher; Gee, Albert O.

doi:10.2106/jbjs.rvw.18.00198

Cited by 38 publications

(40 citation statements)

References 56 publications

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“…The presence of sex hormones or relaxing receptors in ACL might explain their effect on this structure, but other extrinsic or intrinsic factors may contribute to this process [ 79 , 80 ]. Recent reviews [ 81 , 82 ] seem to show a decreased risk of ACL injury during L vs. F and PeO, with increased ACL laxity in PeO at high E2 levels vs. other MC phases. However, no association was found between increased risks of ACL tears and increased laxity [ 82 ].…”

Section: Possible Mechanisms: Performance and Health Risksmentioning

confidence: 99%

“…Recent reviews [ 81 , 82 ] seem to show a decreased risk of ACL injury during L vs. F and PeO, with increased ACL laxity in PeO at high E2 levels vs. other MC phases. However, no association was found between increased risks of ACL tears and increased laxity [ 82 ]. Moreover, other authors have reported no significantly different ACL laxity in high-level female athletes in F, PeO, and L, at rest or during exercise [ 83 , 84 ].…”

Section: Possible Mechanisms: Performance and Health Risksmentioning

confidence: 99%

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The Specificities of Elite Female Athletes: A Multidisciplinary Approach

Castanier

Bougault

Jaffré

et al. 2021

Life

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Female athletes have garnered considerable attention in the last few years as more and more women participate in sports events. However, despite the well-known repercussions of female sex hormones, few studies have investigated the specificities of elite female athletes. In this review, we present the current but still limited data on how normal menstrual phases, altered menstrual phases, and hormonal contraception affect both physical and cognitive performances in these elite athletes. To examine the implicated mechanisms, as well as the potential performances and health risks in this population, we then take a broader multidisciplinary approach and report on the causal/reciprocal relationships between hormonal status and mental and physical health in young (18–40 years) healthy females, both trained and untrained. We thus cover the research on both physiological and psychological variables, as well as on the Athlete Biological Passport used for anti-doping purposes. We consider the fairly frequent discrepancies and summarize the current knowledge in this new field of interest. Last, we conclude with some practical guidelines for eliciting improvements in physical and cognitive performance while minimizing the health risks for female athletes.

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Section: Possible Mechanisms: Performance and Health Risksmentioning

confidence: 99%

Section: Possible Mechanisms: Performance and Health Risksmentioning

confidence: 99%

The Specificities of Elite Female Athletes: A Multidisciplinary Approach

Castanier

Bougault

Jaffré

et al. 2021

Life

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“…A recent systematic review with meta-analysis concluded an increased risk of ACL tear does not appear to be associated with periods of increased laxity. The results showed anterior knee translation was the lowest during the follicular phase (days 1-9) compared to the ovulatory phase (days [10][11][12][13][14] or the luteal phase (days 15-28) [20]. During the ovulatory phase, the surge in estradiol has been shown to decrease fibroblast proliferation and collagen synthesis, thus increasing knee laxity.…”

Section: Discussionmentioning

confidence: 98%

“…There is also evidence that the menstrual cycle may affect anterior knee laxity and the risk of ACL rupture. It is estimated that women have a two to four-fold increased risk of ACL tear compared to men; however, how much of this risk is related to hormonal fluctuations remains unclear [20]. The direct associations between the menstrual cycle and ACL injury remain controversial.…”

Section: Discussionmentioning

confidence: 99%

Seeing Double: A Case of ACL Tears in Monozygotic Twin Female Athletes Within 48 Hours

Pelkowski

DeMatas

McCoy

et al. 2020

Cureus

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Anterior cruciate ligament (ACL) injuries are a serious issue for young athletes. These injuries are devastating and costly, leading to significant time away from sports, and substantial financial cost. A case is presented in which monozygotic twin sisters sustained ACL injuries within 48 hours of one another. Limited research is available studying twins with ACL tears and the risk factors associated with them. This is the first reported case of monozygotic sisters that are high-level athletes with ACL tears in such close proximity to one another. Enhanced knowledge of genetic contribution to ACL injuries is important to better understand predisposing factors and to develop preventative approaches. More research is needed to support a distinct association between ACL rupture and genetic variants.

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“…12 It has been postulated that the increased ligamentous laxity seen during the ovulatory phase of the menstrual cycle may be part of the reason why there are gender-specific differences seen in the prevalence of tendon injury and joint disease. [12][13][14] In particular, anterior cruciate ligament laxity has been shown to be significantly increased with peak levels of estrogen and progesterone during the menstrual cycle. 12 Relaxin is a hormone that circulates at low concentrations in the nonpregnant state, but during pregnancy, relaxin is secreted by the corpus luteum and from the placenta.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Charcot Neuroarthropathy in Pregnancy: A Case Report and Review of the Influence of Pregnancy Hormones on Ligament Laxity

Rogers

Dhatariya

2021

AACE Clinical Case Reports

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Objective To describe the case of a woman with long-standing poorly controlled type 1 diabetes mellitus who developed bilateral Charcot foot while pregnant. To the best of our knowledge, this is the first reported case of this condition in pregnancy. Methods We performed a retrospective review of physical paper medical records; electronically held laboratory results, including glycated hemoglobin; and imaging reports, including plain radiographs and magnetic resonance imaging. Results The Charcot feet were treated by standard offloading in total-contact casts or below-knee removable walking boots. As 1 side resolved, the patient was stepped down into normal footwear on one side and a below-knee walking boot on the other. A review of the literature suggests that the increase in ligamentous laxity associated with a rise in circulating hormones, such as relaxin, increases the risk of developing Charcot neuroarthropathy. Conclusion Bilateral concurrent Charcot neuroarthropathic foot is uncommon, and to our knowledge, this is the first reported case in pregnancy. We present a possible explanation for why there is an increased risk for the development of Charcot neuroarthropathy in pregnancy.

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The Menstrual Cycle May Affect Anterior Knee Laxity and the Rate of Anterior Cruciate Ligament Rupture

Cited by 38 publications

References 56 publications

The Specificities of Elite Female Athletes: A Multidisciplinary Approach

The Specificities of Elite Female Athletes: A Multidisciplinary Approach

Seeing Double: A Case of ACL Tears in Monozygotic Twin Female Athletes Within 48 Hours

Bilateral Charcot Neuroarthropathy in Pregnancy: A Case Report and Review of the Influence of Pregnancy Hormones on Ligament Laxity

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