Alterations in knee joint laxity during the menstrual cycle in healthy women leads to increases in joint loads during selected athletic movements

American Journal of Sports Medicine

Volumn 37, Issue 6, 2009, Pages 1169-1177

  Park, Sang Kyoon ^a   Stefanyshyn, Darren J ^a   Ramage, Barbara ^a,b   Hart, David A ^b   Ronsky, Janet L ^a,b  

^a UNIVERSITY OF CALGARY   (Canada)

^b UNIVERSITY OF CALGARY   (Canada)

Author keywords

ACL injury; Knee joint laxity (KJL); Knee joint loads; Menstrual cycle

Indexed keywords

ADDUCTION; ADULT; ANTERIOR CRUCIATE LIGAMENT INJURY; ARTICLE; ATHLETIC PERFORMANCE; CLINICAL ARTICLE; FEMALE; FOLLICULAR PHASE; HUMAN; JOINT LAXITY; KNEE; LUTEAL PHASE; MENSTRUAL CYCLE; MOVEMENT (PHYSIOLOGY); OVULATION; PRIORITY JOURNAL; ROTATION; TASK PERFORMANCE;

ADULT; ANTERIOR CRUCIATE LIGAMENT; ATHLETIC INJURIES; ATHLETIC PERFORMANCE; BIOMECHANICS; ESTROGENS; FEMALE; HUMANS; JOINT INSTABILITY; KNEE JOINT; MENSTRUAL CYCLE; WEIGHT-BEARING; YOUNG ADULT;

EID: 67649559385     PISSN: 03635465     EISSN: 15523365     Source Type: Journal    
DOI: 10.1177/0363546508330146     Document Type: Article

References (50)

1. Abt JP, Sell TC, Laudner KG, et al. Neuromuscular and biomechanical characteristics do not vary across the menstrual cycle. Knee Surg Sports Traumatol Arthrosc. 2007;15(7):901-907.
2. Adachi N, Nawata K, Maeta M, Kurozawa Y. Relationship of the menstrual cycle phase to anterior cruciate ligament injuries in teenaged female athletes. Arch Orthop Trauma Surg. 2008;128(5):473-478.
3. Arendt E, Dick R. Knee injury patterns among men and women in collegiate basketball and soccer: NCAA data and review of literature. Am J Sports Med. 1995;23(6):694-701.
4. Arnold C, Van Bell C, Rogers V, Cooney T. The relationship between serum relaxin and knee joint laxity in female athletes. Orthopedics. 2002;25(6):669-673.
5. Bell AL, Pedersen DR, Brand RA. A comparison of the accuracy of several hip center location prediction methods. J Biomech. 1990;23(6):617-621.
6. Beynnon BD, Johnson RJ, Braun S, et al. The relationship between menstrual cycle phase and anterior cruciate ligament injury: a case- control study of recreational alpine skiers. Am J Sports Med. 2006;34(5):757-764.
7. Chappell JD, Yu B, Kirkendall DT, Garrett WE. A comparison of knee kinetics between male and female recreational athletes in stop-jump tasks. Am J Sports Med. 2002;30(2):261-267.
8. Chaudhari AM, Lindenfeld TN, Andriacchi TP, et al. Knee and hip loading patterns at different phases in the menstrual cycle: implications for the gender difference in anterior cruciate ligament injury rates. Am J Sports Med. 2007;35(5):793-800.
9. Cole GK, Nigg BM, Ronsky JL, Yeadon MR. Application of the joint coordinate system to three-dimensional joint attitude and movement representation: a standardization proposal. J Biomech Eng. 1993;115(4A):344-349.
10. Dedrick GS, Sizer PS, Merkle JN, et al. Effect of sex hormones on neuromuscular control patterns during landing. J Electromyogr Kinesiol. 2008;18(1):68-78.
11. Deie M, Sakamaki Y, Sumen Y, Urabe Y, Ikuta Y. Anterior knee laxity in young women varies with their menstrual cycle. Int Orthop. 2002;26(3):154-156.
12. Eiling E, Bryant AL, Petersen W, Murphy A, Hohmann E. Effects of menstrual-cycle hormone fluctuations on musculotendinous stiffness and knee joint laxity. Knee Surg Sports Traumatol Arthrosc. 2007;15(2):126-132.
13. Fukuda Y, Woo SL, Loh JC, et al. A quantitative analysis of valgus torque on the ACL: a human cadaveric study. J Orthop Res. 2003;21(6):1107-1112.
14. Gottlob CA, Baker CL Jr, Pellissier JM, Colvin L. Cost effectiveness of anterior cruciate ligament reconstruction in young adults. Clin Orthop RelatRes. 1999;367:272-282.
15. Heitz NA, Eisenman PA, Beck CL, Walker JA. Hormonal changes throughout the menstrual cycle and increased anterior cruciate ligament laxity in females. J Athl Train. 1999;34(2):144-149.
16. Hertel J, Williams Nl, Olmsted-Kramer LC, Leidy HJ, Putukian M. Neuromuscular performance and knee laxity do not change across the menstrual cycle in female athletes. Knee Surg Sports Traumatol Arthrosc. 2006;14(9):817-822.
17. Hewett TE, Lindenfeld TN, Riccobene JV, Noyes FR. The effect of neuromuscular training on the incidence of knee injury in female athletes: a prospective study. Am J Sports Med. 1999;27(6):699-706.
18. Hewett TE, Myer GD, Ford KR, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med. 2005;33(4):492-501.
19. Hewett TE, Stroupe AL, Nance TA, Noyes FR. Plyometric training in female athletes: decreased impact forces and increased hamstring torques. Am J Sports Med. 1996;24(6):765-773.
20. Huston LJ, Greenfield ML, Wojtys EM. Anterior cruciate ligament injuries in the female athlete: potential risk factors. Clin Orthop Relat Res. 2000;372:50-63.
21. Kanamori A, Woo SL, Ma CB, et al. The forces in the anterior cruciate ligament and knee kinematics during a simulated pivot shift test: a human cadaveric study using robotic technology. Arthroscopy. 2000;16(6):633-639.
22. Liu SH, Al-Shaikh RA, Panossian V, Finerman GAM, Lane JM. Estrogen affects the cellular metabolism of the anterior cruciate ligament: a potential explanation for female athletic injury. Am J Sports Med. 1997;25(5):704-709.
23. Loudon JK. Measurement of knee-joint-position sense in women with genu recurvatum [Mesure du sens de la position de la rotule chez des femmes presentant un genu recurvatum]. J Sport Rehabil. 2000;9(1):15-25.
24. Markolf KL, Burchfield DM, Shapiro MM, Shepard MF, Finerman GA, Slauterbeck JL. Combined knee loading states that generate high anterior cruciate ligament forces. J Orthop Res. 1995;13(6):930-935.
25. McLean SG, Huang X, Su A, Van Den Bogert AJ. Sagittal plane biomechanics cannot injure the ACL during sidestep cutting. Clin Biomech (Bristol, Avon). 2004;19(8):828-838.
26. McLean SG, Huang X, van den Bogert AJ. Association between lower extremity posture at contact and peak knee valgus moment during sidestepping: implications for ACL injury. Clin Biomech (Bristol, Avon). 2005;20(8):863-870.
27. McLean SG, Lipfert SW, van den Bogert AJ. Effect of gender and defensive opponent on the biomechanics of sidestep cutting. Med Sci Sports Exerc. 2004;36(6):1008-1016.
28. McLean SG, Su A, van den Bogert AJ. Development and validation of a 3-D model to predict knee joint loading during dynamic movement. J Biomech Eng. 2003;125(6):864-874.
29. Moller-Nielsen J, Hammar M. Women's soccer injuries in relation to the menstrual cycle and oral contraceptive use. Med Sci Sports Exerc. 1989;21(2):126-129.
30. Moller Nielsen J, Hammar M. Sports injuries and oral contraceptive use: is there a relationship? Sports Med. 1991;12(3):152-160.
31. Myer GD, Ford KR, Paterno MV, Nick TG, Hewett TE. The effects of generalized joint laxity on risk of anterior cruciate ligament injury in young female athletes. Am J Sports Med. 2008;36(6):1073-1080.
32. Myklebust G, Maehlum S, Holm I, Bahr R. A prospective cohort study of anterior cruciate ligament injuries in elite Norwegian team handball. Scand J Med Sci Sports. 1998;8(3):149-153.
33. Park SK, Stefanyshyn DJ, Ramage B, Hart DA, Ronsky JL Changing hormone levels during the menstrual cycle affect knee laxity and stiffness in healthy female subjects. Am J Sports Med. 2009;37:588-598.
34. Piziali RL, Rastegar J, Nagel DA, Schurman DJ. The contribution of the cruciate ligaments to the load-displacement characteristics of the human knee joint. J Biomech Eng. 1980;102(4):277-283.
35. Pollard CD, Braun B, Hamill J. Influence of gender, estrogen and exercise on anterior knee laxity. Clin Biomech (Bristol, Avon). 2006;21(10):1060-1066.
36. Renstrom P, Ljungqvist A, Arendt E, et al. Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br J Sports Med. 2008;42(6):394-412.
37. Romani W, Patrie J, Curl LA, Flaws JA. The correlations between estradiol, estrone, estriol, progesterone, and sex hormone-binding globulin and anterior cruciate ligament stiffness in healthy, active females. J Womens Health (Larchmt). 2003;12(3):287-298.
38. Rozzi SL, Lephart SM, Gear WS, Fu FH. Knee joint laxity and neuromuscular characteristics of male and female soccer and basketball players. Am J Sports Med. 1999;27(3):312-319.
39. Seering WP, Piziali RL, Nagel DA, Schurman DJ. The function of the primary ligaments of the knee in varus-valgus and axial rotation. JBiomech. 1980;13(9):785-794.
40. Shultz SJ, Carcia CR, Perrin DH. Knee joint laxity affects muscle activation patterns in the healthy knee. J Electromyogr Kinesiol. 2004;14(4):475-483.
41. Shultz SJ, Gansneder BM, Sander TC, Kirk SE, Perrin DH. Absolute serum hormone levels predict the magnitude of change in anterior knee laxity across the menstrual cycle. J Orthop Res. 2006;24(2): 124-131.
42. Shultz SJ, Kirk SE, Johnson ML, Sander TC, Perrin DH. Relationship between sex hormones and anterior knee laxity across the menstrual cycle. Med Sci Sports Exerc. 2004;36(7):1165-1174.
43. Slauterbeck J, Clevenger C, Lundberg W, Burchfield DM. Estrogen level alters the failure load of the rabbit anterior cruciate ligament. J Orthop Res. 1999;17(3):405-408.
44. Slauterbeck JR, Fuzie SF, Smith MP, et al. The menstrual cycle, sex hormones, and anterior cruciate ligament injury. J Athl Train. 20O2;37(3):275-278.
45. Soderkvist I, Wedin PA. Determining the movements of the skeleton using well-configured markers. J Biomech. 1993;26(12):1473-1477.
46. Stefanyshyn DJ, Stergiou P, Lun VM, Meeuwisse WH, Worobets JT. Knee angular impulse as a predictor of patellofemoral pain in runners. Am J Sports Med. 2006;34(11 ):1844-1851.
47. Wojtys EM, Huston LJ, Boynton MD, Spindler KP, Lindenfeld TN. The effect of the menstrual cycle on anterior cruciate ligament injuries in women as determined by hormone levels. Am J Sports Med. 2002;30(2):182-188.
48. Wojtys EM, Huston LJ, Lindenfeld TN, Hewett TE, Greenfield ML. Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes. Am J Sports Med. 1998;26(5):614-619.
49. Yu B, Kirkendall DT, Taft TN, Garrett WE Jr. Lower extremity motor control-related and other risk factors for noncontact anterior cruciate ligament injuries. Instr Course Lect. 2002;51:315-324.
50. Yu WD, Liu SH, Hatch JD, Panossian V, Finerman GA. Effect of estrogen on cellular metabolism of the human anterior cruciate ligament. Clin Orthop RelatRes. 1999;366:229-238.