AAOS: Anterior Cruciate Ligament Injury Risk Greatest During Ovulatory Phase

DALLAS, TX — Researchers report that female athletes may be at greater risk of anterior cruciate ligament (ACL) injuries during the ovulatory phase of their menstrual cycles.

However, this increased risk of ACL injuries appears to be reduced in women who use oral contraception, the lead researcher Edward J. Wojtys, MD reported here yesterday during the 69th Annual Meeting of the American Academy of Orthopaedic Surgeons.

Previous research had demonstrated that when males and females play the same sport, ACL injuries occur more often in females than males. Although various explanations for this have been proposed, previous studies have been unable to conclusively establish a hormonal basis for this discrepancy.

Dr. Wojtys, a professor of surgery at the University of Michigan in Ann Arbor, said yesterday that earlier studies attempting to link menstrual cycle to injuries relied on questionnaire data to determine cycle phase.

For the current study, his team measured estrogen, progesterone, and lutenizing hormone metabolite levels in the urine within 24 hours of ACL injury and again at the start of the next menstrual cycle in 65 female athletes who sustained an acute ACL injury.

Dr.Wojtys said 43 percent of the women experienced ACL injuries during the midcycle ovulatory phase, which was more than twice the expected injury rate of 18 percent. The reverse was true during the luteal phase, when the observed rate of injury was 34 percent compared to an expected rate of 50 percent.

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