Knee ligament behavior following a controlled loading protocol does not differ by menstrual cycle day

Abstract

Background: Females experience a disproportionate number of anterior cruciate ligament injuries compared to males. Increased estradiol concentration has been suggested to alter ligament properties and strength. Determining whether the knee responds differently to an external load at various hormonal levels may be helpful in further explaining the gender disparity.

Methods: Estradiol, progesterone and testosterone were quantified at menses, near ovulation and at the mid-luteal phase. With one knee serving as the control limb and the other as the experimental limb, displacement at 134N and stiffness between 90 and 134N were recorded with a knee ligament arthrometer on both knees before and after a loading protocol. The protocol consisted of three, 3-min, posterior to anterior normalized loads directed to the posterior calf with a ligament testing device.

Findings: The loading protocol produced a measurable increase in displacement but not stiffness. Neither displacement nor stiffness measures however were affected by day of the menstrual cycle. No consistent relationships between hormonal concentrations and displacement or stiffness were evident.

Interpretation: Following a controlled, static external load, displacement and stiffness were not affected differently by day of the menstrual cycle.