MRI comparison of injury mechanism and anatomical factors between sexes in non-contact anterior cruciate ligament injuries

Non-contact anterior cruciate ligament (ACL) rupture is mostly caused by a pivot shift mechanism including valgus collapse and internal tibial rotation. In female athletes, the incidence of ACL rupture has been reported to be significantly higher than in their male counterparts. However, to date, th...

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Bibliographic Details
Published in:PloS one 2019-08, Vol.14 (8), p.e0219586-e0219586
Main Authors: Choi, Won Rak, Yang, Jae-Hyuk, Jeong, Soo-Young, Lee, Jin Kyu
Format: Article
Language:English
Subjects:
Adult
Anterior cruciate ligament
Anterior Cruciate Ligament Injuries - etiology
Anterior Cruciate Ligament Injuries - pathology
Athletes
Biology and Life Sciences
Collapse
Collateral Ligaments - pathology
Contusions
Female
Females
Femur
Femur - pathology
Gender aspects
Gender differences
Health aspects
Human subjects
Humans
Incidence
Injuries
Injury prevention
Joint and ligament injuries
Kinematics
Knee
Knee Joint - pathology
Lesions
Ligaments
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Males
Measurement techniques
Medicine and Health Sciences
Meniscus
NMR
Nuclear magnetic resonance
Prognosis
Research and Analysis Methods
Rotation
Rupture
Rupturing
Sex
Sex differences
Sex Factors
Sexes
Slopes
Social Sciences
Sports injuries
Studies
Surgery
Tibia - pathology
Women athletes
Young Adult
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Summary:Non-contact anterior cruciate ligament (ACL) rupture is mostly caused by a pivot shift mechanism including valgus collapse and internal tibial rotation. In female athletes, the incidence of ACL rupture has been reported to be significantly higher than in their male counterparts. However, to date, there have been limited reports and controversy regarding sex differences underlying injury mechanisms of ACL and severity of injury. In this study, we hypothesized that 1) in patients with non-contact ACL rupture, the incidence and severity of pivot shift injury, which are determined by injury pattern on MRI, would be significantly higher in females, and 2) anatomical factors associated with pivot shift injury would be significantly associated with female sex. A total of 148 primary ACL ruptures (145 patients) caused by non-contact injury mechanisms were included in this study. Among them, 41 knees (41 patients) were female and 107 knees (104 patients) were male. The status of the osseous lesions, lateral and medial tibial slope, depth of the medial tibial plateau, collateral ligaments, and menisci were assessed by MRI and compared between sexes. The severity of osseous lesions at the lateral tibial plateau, lateral femoral condyle, medial tibial plateau, and medial femoral condyle were comparable between sexes. There were no significant differences between sexes in the location of tibial contusions (p = 0.21), femoral contusions (p = 0.23), or meniscus tears (p = 0.189). Lateral tibial slope was found to be significantly larger in females (8.95° vs. 6.82°; p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0219586