Anterior Cruciate Ligament Biology and Its Relationship to Injury Forces
Section snippets
Relationships among anterior cruciate ligament injury factors
Proposed causes of sex differences in the incidence rate of ACL injuries range from extrinsic factors, such as footwear and training, to intrinsic factors, such as anatomy [8], [9], [10], [11], [12], [13], neuromuscular control of the leg [14], ligament biomechanics [15], [16], ligament laxity [13], and hormonal effects [17], [18], [19]. These seemingly distinct, competing factors are interdependent. For example, anatomy influences choice of footwear, and coaching can influence neuromuscular
Effects of tissue remodeling
Tissue remodeling is an ongoing process whereby old or damaged structures are degraded and replaced with newly synthesized molecules [24], [25], [26], [27], [28]. This process has the potential to have an effect on several aspects of ACL injury susceptibility (Fig. 2). First, tissue remodeling determines the size, shape, and internal composition of the ACL. Any difference or change in ACL structure or geometric quality would alter the ligament's intrinsic susceptibility to failure. Second,
Sex, hormones, and anterior cruciate ligament injury
Sex and sex hormones influence several aspects of human ACL function and injury, including effects on the load on the ligament and its intrinsic load at failure (Fig. 2). No sex difference in the incidence rate of ACL injury before puberty has been reported. After puberty, however, the incidence rates of ACL injuries are greater for women compared with men who take part in similar activities or common sports [3], [41]. Concomitantly, neuromuscular strategies that control jumping and landing
Summary
The model presented in Fig. 2 illustrates that ACL injury is determined by two variables: the ultimate failure load of the ligament and the mechanical load applied to the ligament. All factors that contribute to ACL injury must do so by affecting one or both of these two basic variables. Some factors, such as sex hormones and tissue remodeling, have a multifaceted effect on the failure load of the ACL and the magnitude of the load applied to this ligament. The relationships defined by this
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Understanding the effects of sustained supraphysiologic concentrations of luteinizing hormone in gonadectomized dogs: What we know and what we still need to learn
2023, TheriogenologyCitation Excerpt :In addition to inducing laxity, increased nitric oxide within ligaments may alter collagen expression [64,65]. Altered collagen expression within the cruciate would decrease stress tolerance with increased load to the joint [66]. Decreases in fibroblast cell populations, increase in chondroid metaplastic cell populations, and extracellular matrix disruption have been described in morphological evaluation of ruptured cruciate ligaments [67].
A proposal to evaluate the fibers’ break probability in ligaments and tendons
2017, Journal of BiomechanicsCitation Excerpt :There is a wide literature concerning the function of normal ligaments and tendons (Blankevoort et al., 1991; Wilson et al., 1998) and about joint instabilities due to ligament deficiency (Mommersteeg et al., 1996; Zavatsky and O’Connor, 1992). On the contrary, there are few articles about the partially injured structures and about the mechanism of injury (Lee and Hyman, 2002; Slauterbeck et al., 2006). According to Zavatsky and Wright (2001) these mechanisms are difficult to identify and the correct diagnosis needs of invasive methods with respect to the normal clinical tests.
Bones, Joints, Tendons, and Ligaments
2017, Pathologic Basis of Veterinary Disease Expert ConsultFailure of Anterior Cruciate Ligament Reconstruction
2013, Clinics in Sports MedicineThe effects of levofloxacin on rabbit anterior cruciate ligament cells in vitro
2011, Toxicology and Applied PharmacologyCitation Excerpt :Tissue inhibitors of metalloproteinases function as antiangiogenic molecules by opposing the activity of MMPs in the extracellular matrix (Henriet et al., 1999). MMPs or TIMPs produced by ACL cells participate in tissue remodeling events that affect the ACL biomechanical stability (Foos et al., 2001; Raza and Cornelius, 2000a,b; Slauterbeck et al., 2006). Our results showed a dose-dependent participation of these MMPs (MMP-3, MMP-13) and TIMPs (TIMP-1) in the increased destruction of matrix in rabbit ACL cells after levofloxacin treatment.
Extracellular matrix content of ruptured anterior cruciate ligament tissue
2011, KneeCitation Excerpt :On a cellular level, repeated mechanical forces imposed on ligaments determine the level of specific proteoglycans present within the extracellular matrix of the tissue [8]. Both normal and injured ligaments are constantly remodelling in response to loading [9]. The composition of ligaments is affected by this remodelling, which in turn determines the ligaments susceptibility to failure.
Funding support for this article was provided by Orthopaedic Research and Education Foundation and NIH grant AR-049767.