Females have Lower Knee Strength and Vertical Ground Reaction Forces During Landing than Males Following Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport.

dc.contributor.author

Sullivan, Zachary B

dc.contributor.author

Sugarman, Barrie S

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Faherty, Mallory S

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Killelea, Carrie

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Taylor, Dean C

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Le, Daniel

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Toth, Alison P

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Riboh, Jonathan C

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Diehl, Lee H

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Wittstein, Jocelyn R

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Amendola, Annunziato

dc.contributor.author

Sell, Timothy C

dc.date.accessioned

2023-02-01T21:58:54Z

dc.date.available

2023-02-01T21:58:54Z

dc.date.issued

2022-01

dc.date.updated

2023-02-01T21:58:54Z

dc.description.abstract

Purpose

There is a high rate of second anterior cruciate ligament (ACL) injury (ipsilateral graft or contralateral ACL) upon return-to-sport (RTS) following ACL reconstruction (ACLR). While a significant amount of epidemiological data exists demonstrating sex differences as risk factors for primary ACL injury, less is known about sex differences as potential risk factors for second ACL injury. The purpose of this study is to determine if there are sex-specific differences in potential risk factors for second ACL injury at the time of clearance for RTS.

Methods

Ten male and eight female athletes (age: 20.8 years ±6.3, height: 173.2 cm ±10.1, mass: 76.6 kg ±18.3) participated in the study following ACLR at time of RTS (mean 10.2 months). Performance in lower extremity isokinetic and isometric strength testing, static and dynamic postural stability testing, and a single leg stop-jump task was compared between the sexes.

Results

Normalized for body weight, males had significantly greater isokinetic knee flexion (141±14.1 Nm/kg vs. 78±27.4 Nm/kg, p=0.001) and extension strength (216±45.5 Nm/kg vs. 159±53.9 Nm/kg, p=0.013) as well as isometric flexion (21.1±6.87% body weight vs. 12.5±5.57% body weight, p=0.013) and extension (41.1±7.34% body weight vs. 27.3±11.0% body weight, p=0.016) strength compared to females. In the single-leg stop jump task, males had a greater maximum vertical ground reaction force during landing (332±85.5% vs. 259±27.4% body weight, p=0.027) compared to females.

Conclusions

Based on these results, there are significant differences between sexes following ACLR at the time of RTS. Lower knee flexion and extension strength may be a potential risk factor for second ACL injury among females. Alternatively, the increased maximum vertical force observed in males may be a potential risk factor of second ACL injury in males. Although these results should be interpreted with some caution, they support that rehabilitation programs in the post-ACLR population should be individualized based on the sex of the individual.

Level of evidence

Level 3.
dc.identifier

35575

dc.identifier.issn

2159-2896

dc.identifier.issn

2159-2896

dc.identifier.uri

https://hdl.handle.net/10161/26549

dc.language

eng

dc.relation.ispartof

International journal of sports physical therapy

dc.relation.isversionof

10.26603/001c.35575

dc.subject

ACL reconstruction

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risk factors

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second ACL injury

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sex differences

dc.title

Females have Lower Knee Strength and Vertical Ground Reaction Forces During Landing than Males Following Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport.

dc.type

Journal article

duke.contributor.orcid

Taylor, Dean C|0000-0001-7748-0469

duke.contributor.orcid

Toth, Alison P|0000-0002-4556-645X

duke.contributor.orcid

Amendola, Annunziato|0000-0002-1239-644X

pubs.begin-page

556

pubs.end-page

565

pubs.issue

4

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Orthopaedic Surgery

pubs.publication-status

Published

pubs.volume

17

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