TY - JOUR
T1 - Sex comparisons of in vivo anterior cruciate ligament morphometry
AU - Wang, Hsin-Min
AU - Shultz, Sandra J.
AU - Ross, Scott E.
AU - Henson, Robert A.
AU - Perrin, David H.
AU - Kraft, Robert A.
AU - Schmitz, Randy J.
N1 - Publisher Copyright:
© by the National Athletic Trainers’ Association, Inc.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Context: Females have consistently higher anterior cruciate ligament (ACL) injury rates than males. The reasons for this disparity are not fully understood. Whereas ACL morphometric characteristics are associated with injury risk and females have a smaller absolute ACL size, comprehensive sex comparisons that adequately account for sex differences in body mass index (BMI) have been limited. Objective: To investigate sex differences among in vivo ACL morphometric measures before and after controlling for femoral notch width and BMI. Design: Cross-sectional study. Setting: Laboratory. Patients or Other Participants: Twenty recreationally active men (age ¼ 23.2 6 2.9 years, height ¼ 180.4 6 6.7 cm, mass ¼ 84.0 6 10.9 kg) and 20 recreationally active women (age ¼ 21.3 6 2.3 years, height ¼ 166.9 6 7.7 cm, mass ¼ 61.9 6 7.2 kg) participated. Main Outcome Measure(s): Structural magnetic resonance imaging sequences were performed on the left knee. Anterior cruciate ligament volume, width, and cross-sectional area measures were obtained from T2-weighted images and normalized to femoral notch width and BMI. Femoral notch width was measured from T1-weighted images. We used independent-samples t tests to examine sex differences in absolute and normalized measures. Results: Men had greater absolute ACL volume (1712.2 6 356.3 versus 1200.1 6 337.8 mm3; t38 ¼ 4.67, P, .001) and ACL width (8.5 6 2.3 versus 7.0 6 1.2 mm; t38 ¼ 2.53, P ¼ .02) than women. The ACL volume remained greater in men than in women after controlling for femoral notch width (89.31 6 15.63 versus 72.42 6 16.82 mm3/mm; t38 ¼ 3.29, P ¼ .002) and BMI (67.13 6 15.40 versus 54.69 6 16.39 mm3/kg/m2; t38 ¼ 2.47, P ¼ .02). Conclusions: Whereas men had greater ACL volume and width than women, only ACL volume remained different when we accounted for femoral notch width and BMI. This suggests that ACL volume may be an appropriate measure of ACL anatomy in investigations of ACL morphometry and ACL injury risk that include sex comparisons.
AB - Context: Females have consistently higher anterior cruciate ligament (ACL) injury rates than males. The reasons for this disparity are not fully understood. Whereas ACL morphometric characteristics are associated with injury risk and females have a smaller absolute ACL size, comprehensive sex comparisons that adequately account for sex differences in body mass index (BMI) have been limited. Objective: To investigate sex differences among in vivo ACL morphometric measures before and after controlling for femoral notch width and BMI. Design: Cross-sectional study. Setting: Laboratory. Patients or Other Participants: Twenty recreationally active men (age ¼ 23.2 6 2.9 years, height ¼ 180.4 6 6.7 cm, mass ¼ 84.0 6 10.9 kg) and 20 recreationally active women (age ¼ 21.3 6 2.3 years, height ¼ 166.9 6 7.7 cm, mass ¼ 61.9 6 7.2 kg) participated. Main Outcome Measure(s): Structural magnetic resonance imaging sequences were performed on the left knee. Anterior cruciate ligament volume, width, and cross-sectional area measures were obtained from T2-weighted images and normalized to femoral notch width and BMI. Femoral notch width was measured from T1-weighted images. We used independent-samples t tests to examine sex differences in absolute and normalized measures. Results: Men had greater absolute ACL volume (1712.2 6 356.3 versus 1200.1 6 337.8 mm3; t38 ¼ 4.67, P, .001) and ACL width (8.5 6 2.3 versus 7.0 6 1.2 mm; t38 ¼ 2.53, P ¼ .02) than women. The ACL volume remained greater in men than in women after controlling for femoral notch width (89.31 6 15.63 versus 72.42 6 16.82 mm3/mm; t38 ¼ 3.29, P ¼ .002) and BMI (67.13 6 15.40 versus 54.69 6 16.39 mm3/kg/m2; t38 ¼ 2.47, P ¼ .02). Conclusions: Whereas men had greater ACL volume and width than women, only ACL volume remained different when we accounted for femoral notch width and BMI. This suggests that ACL volume may be an appropriate measure of ACL anatomy in investigations of ACL morphometry and ACL injury risk that include sex comparisons.
KW - Anterior cruciate ligament volume
KW - Femoral notch width
KW - Knee
KW - Magnetic resonance imaging
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U2 - 10.4085/1062-6050-371-17
DO - 10.4085/1062-6050-371-17
M3 - Article
C2 - 31058539
SN - 1062-6050
VL - 54
SP - 513
EP - 518
JO - Journal of Athletic Training
JF - Journal of Athletic Training
IS - 5
ER -