Morphologic Characteristics Help Explain the Gender Difference in Peak Anterior Cruciate Ligament Strain During a Simulated Pivot Landing
Morphologic Characteristics Help Explain the Gender Difference in Peak Anterior Cruciate Ligament Strain During a Simulated Pivot Landing
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DOI：
10.1177/0363546511422325
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发表时间：
2012-01-01
影响因子：
4.8
通讯作者：
Wojtys, Edward M.
中科院分区：
文献类型：
--
作者：
Lipps, David B.;Oh, Youkeun K.;Wojtys, Edward M.
背景：前交叉韧带（ACL）横截面积和胫骨外侧倾斜度存在性别差异。生物力学原理表明，这些性别差异的方向应诱导更大的峰值ACL应变在女性动态loading.Hypothesis：峰值ACL相对应变在模拟支点着陆过程中是显着更大的女性比男性patients.Study设计：对照实验室研究。对20例身高体重匹配的男性和女性尸体的膝关节进行了2倍体重的压缩脉冲三维测试载荷，屈曲，胫骨内部扭矩从屈曲15度开始。测力传感器测量施加于膝关节的三维力和力矩，以及预张紧的股四头肌、腘绳肌和腓肠肌等效肌肉中的力。一种新型的、性别特异性的、非线性弹簧模拟了短距离和长距离股四头肌的拉伸刚度。使用微分可变磁阻传感器测量ACL前内侧束（AM-ACL）的峰值相对应变，同时使用磁共振成像测量ACL横截面积和胫骨外侧斜率。结果：女性膝关节AM-ACL峰值相对应变比男性膝关节高95%（6.37% [2.53%] vs 3.26% [1.89%]; P = 0.004）。前交叉韧带横截面积和胫骨外侧倾斜度是AM-ACL峰值相对应变的显著预测因素（R（2）= .59; P = .001）。结论：相同身高和体重供体的女性AM-ACL峰值相对应变显著大于男性。这种性别差异是由于一个较小的女性ACL横截面积和更大的胫骨外侧slope.Clinical相关性：由于女性ACL系统暴露于更大的压力比男性同行，培训和损伤预防计划应考虑到这一事实。
Background: Gender differences exist in anterior cruciate ligament (ACL) cross-sectional area and lateral tibial slope. Biomechanical principles suggest that the direction of these gender differences should induce larger peak ACL strains in females under dynamic loading.Hypothesis: Peak ACL relative strain during a simulated pivot landing is significantly greater in female ACLs than male ACLs.Study Design: Controlled laboratory study.Methods: Twenty cadaveric knees from height-and weight-matched male and female cadavers were subjected to impulsive 3-dimensional test loads of 2 times body weight in compression, flexion, and internal tibial torque starting at 15 degrees of flexion. Load cells measured the 3-dimensional forces and moments applied to the knee, and forces in the pretensioned quadriceps, hamstring, and gastrocnemius muscle equivalents. A novel, gender-specific, nonlinear spring simulated short-range and longer range quadriceps muscle tensile stiffness. Peak relative strain in the anteromedial bundle of the ACL (AM-ACL) was measured using a differential variable reluctance transducer, while ACL cross-sectional area and lateral tibial slope were measured using magnetic resonance imaging. A repeated-measures Mann-Whitney signed-rank test was used to test the hypothesis.Results: Female knees exhibited 95% greater peak AM-ACL relative strain than male knees (6.37% [2.53%] vs 3.26% [1.89%]; P = .004). Anterior cruciate ligament cross-sectional area and lateral tibial slope were significant predictors of peak AM-ACL relative strain (R(2) = .59; P = .001).Conclusion: Peak AM-ACL relative strain was significantly greater in female than male knees from donors of the same height and weight. This gender difference is attributed to a smaller female ACL cross-sectional area and a greater lateral tibial slope.Clinical Relevance: Since female ACLs are systematically exposed to greater strain than their male counterparts, training and injury prevention programs should take this fact into consideration.