SUN VALLEY, Idaho-Women seem to be the weak-kneed sex.
The reason may be the menstrual cycle, the width of the femoral intercondylar notch, estrogen’s effect on the anterior cruciate ligament, or maybe all three, researchers told the American Orthopaedic Society for Sports Medicine meeting here. But whatever the cause, women’s ACLs have an injury rate much higher than men’s in jumping and cutting sports, they say.
When Dr. Stephen Liu’s UCLA team cultured fragments of the ACL in various concentrations of estradiol, estrogen inhibited the synthesis of type 1 procollagen and proliferation of ACL fibroblast. The changes may lead to weaker ACLs during cyclical variations in menstruating athletes, he says.
In a study of 28 ACL injuries in female athletes, eight occurred during the estrogen surge in the four-day ovulatory phase of the cycle and four in the nine-day menstrual phase, says the University of Michigan’s Dr. Ed Wojtys.
Dr. Don Shelbourne, the Indianapolis Colts’ team physician, says women may be more prone to ACL injuries because the ligament is smaller. He infers this because the femoral intercondylar notch that accommodates the ligament is narrower in females than in males. Using calipers intraoperatively, he found that the notch’s mean width was 13.9 mm in 234 women and 15.9 mm in 480 men.
What’s more, reconstructed ACLs don’t stand up as well in females as in males, says Dr. Gene Barrett, a Jackson, Miss., orthopedic surgeon. Using autogenous semitendinous tendons, he arthroscopically repaired ACLs of 45 women and 38 men. Postop, the women had more pain and couldn’t resume their preinjury activity level.
SUN VALLEY, Idaho-Women seem to be the weak-kneed sex.
