月经周期中膝关节前侧松弛与全身关节松弛之间的关系。
Relationship Between Anterior Knee Laxity and General Joint Laxity During the Menstrual Cycle.
作者信息
Maruyama Sae, Yamazaki Tomomi, Sato Yuuki, Suzuki Yukako, Shimizu Sohei, Ikezu Masahiro, Kaneko Fumiya, Matsuzawa Kanta, Hirabayashi Ryo, Edama Mutsuaki
机构信息
Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.
出版信息
Orthop J Sports Med. 2021 Mar 29;9(3):2325967121993045. doi: 10.1177/2325967121993045. eCollection 2021 Mar.
BACKGROUND
Anterior cruciate ligament (ACL) injury has been reported to have a higher incidence in women than in men.
PURPOSE/HYPOTHESIS: The purpose was to examine the relationship of anterior knee laxity (AKL), stiffness, and generalized joint laxity (GJL) with respect to the menstrual cycle. It was hypothesized that AKL and GJL would increase during the ovulation phase, when estrogen levels are high.
STUDY DESIGN
Descriptive laboratory study.
METHODS
A total of 15 female university students aged >20 years and with normal menstrual cycles were evaluated. AKL was measured as anterior tibial displacement of the femur after application of 44-, 89-, and 133-N loads to the tibia. Stiffness was calculated as Δ force/Δ displacement at loads between 44 and 89 N and between 89 and 133 N. The University of Tokyo joint laxity test was used for evaluation of GJL. The participants' menstrual cycle was divided into the early follicular, late follicular, ovulation, and luteal phases using the basal body temperature method and an ovulation kit; AKL and GJL were measured once during each phase. Participants were also stratified according to the presence or absence of genu recurvatum (GR).
RESULTS
There was no significant difference in AKL, stiffness, or GJL among the menstrual phases. In the GR group, AKL values at 89 N and 133 N were significantly higher in the ovulation phase than in the early follicular phase ( = .025 and =.018, respectively); there were no significant differences in AKL among the phases in the non-GR group. In addition, the GR group in the ovulation phase had significantly higher AKL values at 44 N, 89 N, and 133 N compared with the non-GR group ( = .013, = .005, and = .010, respectively). There were no significant differences in GJL among the phases in the GR or non-GR groups.
CONCLUSION
Women with GR may have increased AKL in the ovulation phase when compared with the early follicular phase, which may be a risk factor for ACL injury.
CLINICAL RELEVANCE
The results of this study suggest that the ovulation phase may be related to the greater incidence of ACL injuries in women.
背景
据报道，前交叉韧带（ACL）损伤在女性中的发生率高于男性。
目的/假设：目的是研究前膝松弛度（AKL）、刚度和全身关节松弛度（GJL）与月经周期的关系。假设在雌激素水平较高的排卵期，AKL和GJL会增加。
研究设计
描述性实验室研究。
方法
对15名年龄大于20岁且月经周期正常的女大学生进行评估。AKL通过在胫骨上施加44 N、89 N和133 N负荷后测量股骨的胫骨前移来测定。刚度通过44至89 N以及89至133 N负荷之间的力变化/位移变化来计算。使用东京大学关节松弛度测试来评估GJL。采用基础体温法和排卵试纸将参与者的月经周期分为卵泡早期、卵泡晚期、排卵期和黄体期；在每个阶段测量一次AKL和GJL。参与者还根据是否存在膝反屈（GR）进行分层。
结果
月经各阶段之间的AKL、刚度或GJL无显著差异。在GR组中，89 N和133 N时的AKL值在排卵期显著高于卵泡早期（分别为P = 0.025和P = 0.018）；非GR组各阶段之间的AKL无显著差异。此外，与非GR组相比，GR组在排卵期44 N、89 N和133 N时的AKL值显著更高（分别为P = 0.013、P = 0.005和P = 0.010）。GR组和非GR组各阶段之间的GJL无显著差异。
结论
与卵泡早期相比，有GR的女性在排卵期可能AKL增加，这可能是ACL损伤的一个危险因素。
临床意义
本研究结果表明，排卵期可能与女性ACL损伤发生率较高有关。
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