Download PDF
Sportverletz Sportschaden 2011; 25(4): 235-240
DOI: 10.1055/s-0031-1281708
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Gendermedizinische Aspekte einer Kreuzbandruptur

Cruciate Ligament Injuries under Gender AspectsD. E. Grabau1 , K. Vitzthum1 , 2 , S. Mache1 – 3 , D. A. Groneberg1 , 2 , D. Quarcoo1 , 2
  • 1Institut für Arbeitsmedizin, Charité – Universitätsmedizin Berlin, Freie Universität & Humboldt-Universität zu Berlin, Berlin
  • 2Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Abteilung Rehabilitationsmedizin, Goethe-Universität, Frankfurt am Main
  • 3Medizinische Klinik m. S. Psychosomatik, Charité – Universitätsmedizin Berlin, Freie Universität Berlin und Humboldt-Universität zu Berlin, Berlin
Further Information

Publication History

Publication Date:
12 December 2011 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Eine Verletzung des vorderen Kreuzbands ist eine der häufigsten Knieverletzungen, die zumeist ohne Fremdeinwirkung und gegen Ende des Trainings oder Wettkampfs entstehen. Frauen, insbesondere Athletinnen aus Ball- oder Rückschlagsportarten, sind dabei 2- bis 8-mal häufiger als Männer betroffen. Anatomische, biomechanische und hormonelle Unterschiede zwischen Frauen und Männern werden in der Literatur als Risikofaktoren diskutiert. Für die Prävention sind vor allem biomechanische Einflüsse, die durch Trainingsmethoden beeinflusst werden können, von Bedeutung. Erfolgreich waren bisher Trainingsprogramme, die folgende Elemente beinhalteten: Ausdauertraining, Kräftigung der knieumgebenden Muskulatur, Balance-Training und Plyometrie. Weitere Studien, die die Begleitumstände des Verletzungshergangs berücksichtigen, sollten in Zukunft mehr in den Fokus rücken.

Abstract

An injury of cruciate ligament is one the most common knee injuries. This accident happens mostly without external impact and towards the end of training and competition sessions. Women, especially athletes playing team sports ball games such as soccer or disciplines such as tennis, are affected 2 to 8 times more often than men. Anatomic, biomechanical and endocrinological differences are currently discussed as potential risk factors. In terms of prevention, biomechanical impact is of greatest importance given its influenceability through various training opportunities. Training programs including endurance aspects, strengthening knee musculature, balance as well as plyometric trainings were most effective. Further studies should focus more on concomitants of course of injuries.

Schlüsselwörter

vorderes Kreuzband - Gender - Prävention - Verletzungsrisiko

Key words

cruciate ligament - gender - prevention - risk of injury

Literatur

  • 1 Kaestner R, Xu X. Effects of Title IX and sports participation on girls’ physical activity and weight.  Adv Health Econ Health Serv Res. 2007;  17 79-111
    Google Scholar
  • 2 Labella C, Carl R. Preventing knee ligament injuries in young athletes.  Pediatr Ann. 2010;  39 714-720
    Google Scholar
  • 3 Griffin L Y, Albohm M J, Arendt E A et al. Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II meeting, January 2005.  Am J Sports Med. 2006;  34 1512-1532
    Google Scholar
  • 4 Park H S, Wilson N A, Zhang L Q. Gender differences in passive knee biomechanical properties in tibial rotation.  J Orthop Res. 2008;  26 937-944
    Google Scholar
  • 5 Kvist J, Cunningham D, Tigerstrand-Wejlemark H. Gender differences in post-exercise sagittal knee translation: a comparison between elite volleyball players and swimmers.  Knee. 2006;  13 132-136
    Google Scholar
  • 6 Nagano Y, Ida H, Akai M et al. Gender differences in knee kinematics and muscle activity during single limb drop landing.  Knee. 2007;  14 218-223
    Google Scholar
  • 7 Mountcastle S B, Posner M, Kragh J F et al. Gender differences in anterior cruciate ligament injury vary with activity: epidemiology of anterior cruciate ligament injuries in a young, athletic population.  Am J Sports Med. 2007;  35 1635-1642
    Google Scholar
  • 8 Waldén M, Hägglund M, Magnusson H et al. Anterior cruciate ligament injury in elite football: a prospective three-cohort study.  Knee Surg Sports Traumatol Arthrosc. 2011;  19 11-19
    Google Scholar
  • 9 Bjordal J M, Arnły F, Hannestad B et al. Epidemiology of anterior cruciate ligament injuries in soccer.  Am J Sports Med. 1997;  25 341-345
    Google Scholar
  • 10 Ireland M L. Anterior cruciate ligament injury in female athletes: epidemiology.  J Athl Train. 1999;  34 150-154
    Google Scholar
  • 11 McLean S G, Lipfert S W, Bogert A J. Effect of gender and defensive opponent on the biomechanics of sidestep cutting.  Med Sci Sports Exerc. 2004;  36 1008-1016
    Google Scholar
  • 12 Beaulieu M L, Lamontagne van den M, Xu L. Lower limb muscle activity and kinematics of an unanticipated cutting manoeuvre: a gender comparison.  Knee Surg Sports Traumatol Arthrosc. 2009;  17 968-976
    Google Scholar
  • 13 Chaudhari A M, Zelman E A, Flanigan D C et al. Anterior cruciate ligament-injured subjects have smaller anterior cruciate ligaments than matched controls: a magnetic resonance imaging study.  Am J Sports Med. 2009;  37 1282-1287
    Google Scholar
  • 14 Krosshaug T, Nakamae A, Boden B P et al. Mechanisms of anterior cruciate ligament injury in basketball: video analysis of 39 cases.  Am J Sports Med. 2007;  35 359-367
    Google Scholar
  • 15 Boden B P, Dean G S, Feagin J A et al. Mechanisms of anterior cruciate ligament injury.  Orthopedics. 2000;  23 573-578
    Google Scholar
  • 16 Quatman C E, Hewett T E. The anterior cruciate ligament injury controversy: is “valgus collapse” a sex-specific mechanism?.  British journal of sports medicine. 2009;  43 328-335
    Google Scholar
  • 17 Olsen O E, Myklebust G, Engebretsen L et al. Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis.  Am J Sports Med. 2004;  32 1002-1012
    Google Scholar
  • 18 Ramesh R, Von Arx O, Azzopardi T et al. The risk of anterior cruciate ligament rupture with generalised joint laxity.  J Bone Joint Surg Br. 2005;  87 800-803
    Google Scholar
  • 19 Gray J, Taunton J E, McKenzie D C et al. A survey of injuries to the anterior cruciate ligament of the knee in female basketball players.  Int J Sports Med. 1985;  6 314-316
    Google Scholar
  • 20 Hewett T E, Stroupe A L, Nance T A et al. Plyometric training in female athletes. Decreased impact forces and increased hamstring torques.  Am J Sports Med. 1996;  24 765-773
    Google Scholar
  • 21 White K K, Lee S S, Cutuk A et al. EMG power spectra of intercollegiate athletes and anterior cruciate ligament injury risk in females.  Med Sci Sports Exerc. 2003;  35 371-376
    Google Scholar
  • 22 Palmer I. On the injuries to the ligaments of the knee joint: a clinical study. 1938.  Clin Orthop Relat Res. 2007;  454 17-22 ; discussion 14
    Google Scholar
  • 23 Simon R A, Everhart J S, Nagaraja H N et al. A case-control study of anterior cruciate ligament volume, tibial plateau slopes and intercondylar notch dimensions in ACL-injured knees.  J Biomech. 2010;  43 1702-1707
    Google Scholar
  • 24 Shelbourne K D, Davis T J, Klootwyk T E. The relationship between intercondylar notch width of the femur and the incidence of anterior cruciate ligament tears. A prospective study.  Am J Sports Med. 1998;  26 402-408
    Google Scholar
  • 25 Anderson A F, Dome D C, Gautam S et al. Correlation of anthropometric measurements, strength, anterior cruciate ligament size, and intercondylar notch characteristics to sex differences in anterior cruciate ligament tear rates.  Am J Sports Med. 2001;  29 58-66
    Google Scholar
  • 26 Hsu W H, Fisk J A, Yamamoto Y et al. Differences in torsional joint stiffness of the knee between genders: a human cadaveric study.  Am J Sports Med. 2006;  34 765-770
    Google Scholar
  • 27 Hashemi J, Chandrashekar N, Mansouri H et al. The human anterior cruciate ligament: sex differences in ultrastructure and correlation with biomechanical properties.  J Orthop Res. 2008;  26 945-950
    Google Scholar
  • 28 Klein P, Sommerfeld P. Biomechanik der Gelenke: Grundlagen, Becken, untere Extremität. Urban & Fischer; 2004
    Google Scholar
  • 29 Hüter-Becker A, Dölken M. Biomechanik, Bewegungslehre, Leistungsphysiologie, Trainingslehre. Stuttgart: Thieme; 2004
    Google Scholar
  • 30 Gehring D, Melnyk M, Gollhofer A. Gender and fatigue have influence on knee joint control strategies during landing.  Clin Biomech (Bristol, Avon). 2009;  24 82-87
    Google Scholar
  • 31 Lloyd D G, Buchanan T S, Besier T F. Neuromuscular biomechanical modeling to understand knee ligament loading.  Med Sci Sports Exerc. 2005;  37 1939-1947
    Google Scholar
  • 32 Wojtys E M, Wylie B B, Huston L J. The effects of muscle fatigue on neuromuscular function and anterior tibial translation in healthy knees.  Am J Sports Med. 1996;  24 615-621
    Google Scholar
  • 33 Myer G D, Ford K R, Hewett T E. The effects of gender on quadriceps muscle activation strategies during a maneuver that mimics a high ACL injury risk position.  J Electromyogr Kinesiol. 2005;  15 181-189
    Google Scholar
  • 34 Hewett T E, Myer G D, Ford K R et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study.  Am J Sports Med. 2005;  33 492-501
    Google Scholar
  • 35 Liu S H, al-Shaikh R, Panossian V et al. Primary immunolocalization of estrogen and progesterone target cells in the human anterior cruciate ligament.  J Orthop Res. 1996;  14 526-533
    Google Scholar
  • 36 Moller Nielsen J, Hammar M. Sports injuries and oral contraceptive use. Is there a relationship?.  Sports medicine. 1991;  12 152-160
    Google Scholar
  • 37 Iwamoto J, Takeda T, Sato Y et al. Retrospective case evaluation of gender differences in sports injuries in a Japanese sports medicine clinic.  Gend Med. 2008;  5 405-414
    Google Scholar
  • 38 Ireland M L. The female ACL: why is it more prone to injury?.  The Orthopedic clinics of North America. 2002;  33 637-651
    Google Scholar
  • 39 Pollard C D, Braun B, Hamill J. Influence of gender, estrogen and exercise on anterior knee laxity.  Clin Biomech (Bristol, Avon). 2006;  21 1060-1066
    Google Scholar
  • 40 Chaudhari A M, Lindenfeld T N, Andriacchi T P et al. Knee and hip loading patterns at different phases in the menstrual cycle: implications for the gender difference in anterior cruciate ligament injury rates.  Am J Sports Med. 2007;  35 793-800
    Google Scholar
  • 41 Cammarata M L, Dhaher Y Y. The differential effects of gender, anthropometry, and prior hormonal state on frontal plane knee joint stiffness.  Clin Biomech (Bristol, Avon). 2008;  23 937-945
    Google Scholar
  • 42 Shakhlina L JG. Medizinisch-biologische Grundlage des sportlichen Trainings von Frauen. 1 ed. Bonn: Bundesinstitut für Sportwissenschaft; 2010
    Google Scholar
  • 43 Yoo J H, Lim B O, Ha M et al. A meta-analysis of the effect of neuromuscular training on the prevention of the anterior cruciate ligament injury in female athletes.  Knee Surg Sports Traumatol Arthrosc. 2010;  18 824-830
    Google Scholar
  • 44 Elliot D L, Goldberg L, Kuehl K S. Young women’s anterior cruciate ligament injuries: an expanded model and prevention paradigm.  Sports Med. 2010;  40 367-376
    Google Scholar
  • 45 Sáez-Sáez de Villarreal E, Requena B, Newton R U. Does plyometric training improve strength performance? A meta-analysis.  J Sci Med Sport. 2010;  13 513-522
    Google Scholar
  • 46 Mandelbaum B R, Silvers H J, Watanabe D S et al. Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up.  Am J Sports Med. 2005;  33 1003-1010
    Google Scholar
  • 47 Hewett T E, Lindenfeld T N, Riccobene J V et al. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study.  Am J Sports Med. 1999;  27 699-706
    Google Scholar
  • 48 Hewett T E, Ford K R, Myer G D. Anterior cruciate ligament injuries in female athletes: Part 2, a meta-analysis of neuromuscular interventions aimed at injury prevention.  Am J Sports Med. 2006;  34 490-498
    Google Scholar
  • 49 Silvers H J, Mandelbaum B R. Prevention of anterior cruciate ligament injury in the female athlete.  Br J Sports Med. 2007;  41 Suppl 1 i52-i59
    Google Scholar

Mag. phil. Karin Vitzthum

Institut für Arbeitsmedizin, Charité – Universitätsmedizin Berlin, Zentrum für Human- und Gesundheitswissenschaften, Freie Universität & Humboldt-Universität zu Berlin

Thielallee 69 – 73

14195 Berlin

Email: karin.vitzthum@charite.de