Paris V Sports Medicine Private Hospital, 75005 Paris, France.
Orthop Traumatol Surg Res. 2013 Sep;99(5):571-5. doi: 10.1016/j.otsr.2013.02.005. Epub 2013 Jun 10.
Women run a 4-8-fold greater risk of anterior cruciate ligament (ACL) tear than men, and especially during the pre-ovulation stage of their cycle. The main study objective was to describe the distribution of ACL lesions according to menstrual cycle in a large population of female recreational skiers.
A prospective study was conducted during the 2010-11 ski season on women sustaining ACL tear during skiing. Patients filled out a questionnaire during consultation with the mountain physician, including date of last menstrual period (LMP) and contraceptive method. Fifty-seven of the 229 patients with diagnosed ACL tear were excluded from analysis, 41 being post-menopausal (mean age, 47 ± 9 years), and 16 having irregular cycles or LMP>30 days. One hundred and seventy-two patients (mean age, 34 ± 8.7 years) were thus included.
Fifty-eight women (33.72%) were in follicular phase, 63 (36.63%) in ovulatory phase and 51 (29.65%) in luteal phase; difference with respect to the theoretic distribution regardless of menstrual phase was highly significant: χ(2)=48.32; P=0.00001. Fifty-three of the 172 women (30.8%) were taking oral contraceptives. ACL tear was 2.4-fold more frequent in pre-ovulatory than post-ovulatory phase, whether in women using oral or other contraceptives: 85/119 (71.4%) vs. 36/53 (67.9%); P=0.64.
ACL tear risk in skiing in women is not constant over the menstrual cycle, being 2.4-fold more frequent in pre-ovulatory (follicular and ovulatory) than post-ovulatory phase (luteal). Oral contraception seems not to exert any protective effect.
Level IV. Retrospective cohort study.
女性前交叉韧带（ACL）撕裂的风险比男性高 4-8 倍，尤其是在她们周期的排卵前期。主要研究目的是描述在一个大型女性休闲滑雪者人群中，根据月经周期 ACL 损伤的分布情况。
在 2010-11 滑雪季，对在滑雪时 ACL 撕裂的女性进行了前瞻性研究。患者在与山地医生咨询时填写了一份问卷，包括末次月经（LMP）日期和避孕方法。229 例确诊 ACL 撕裂患者中有 57 例被排除在分析之外，41 例为绝经后（平均年龄 47 ± 9 岁），16 例月经不规律或 LMP>30 天。因此，172 例患者（平均年龄 34 ± 8.7 岁）被纳入研究。
58 例女性（33.72%）处于卵泡期，63 例（36.63%）处于排卵前期，51 例（29.65%）处于黄体期；无论月经周期如何，与理论分布的差异具有高度显著性：χ(2)=48.32；P=0.00001。172 例女性中 53 例（30.8%）服用口服避孕药。无论是否使用口服避孕药，排卵前期（卵泡期和排卵前期）的 ACL 撕裂发生频率比排卵后期高 2.4 倍：85/119（71.4%）比 36/53（67.9%）；P=0.64。
女性在滑雪时 ACL 撕裂的风险并非在整个月经周期内保持不变，排卵前期（卵泡期和排卵前期）比排卵后期（黄体期）高 2.4 倍。口服避孕药似乎没有任何保护作用。
IV 级。回顾性队列研究。
