Impacts of estrogens on ACL injuries

Abstract

Background: Anterior cruciate ligament (ACL) injuries occur more frequently in women than in men when compared in the same sport or in the same practice of physical effort. The ACL detaches from the tibial plateau, just at the medial bulge of the tibial spine, and then travels to the upper area where the lateral condyle of the femur is located. Together with the posterior cruciate ligament (LCP), its main function is to stabilize the knee joint, preventing displacement of the femur on the tibia and providing stability to the knee when there is rotation in it. Biochemical studies of the ACL tissue have shown the presence of estrogen receptors, where the synthesis of type I and III collagen is affected, which makes us think that this may be closely related to the variation in ligament laxity in the different phases of the menstrual cycle. Material and methods: Systematic review that included 10 scientific papers found in PubMed, Epistemonikos, and Google Scholar, which includes observational laboratory work, animal experimentation, and clinical trials. Results: The few scientific papers available in the academic field selected for carrying out this systemic review revealed that estrogen levels in the organism's plasma morphologically alter the composition of the ACL in women. Even at the present time, the relationship between the ACL lesion and changes in hormonal levels could not be verified due to the lack of studies directed to this purpose. Conclusion: There are strong indications that changes in estrogen levels directly influence women to be more prone to ACL injuries. Studies and clinical trials with larger and better controlled populations are lacking to confirm the clinical hypothesis that estrogens have a negative impact on women causing more ACL damage than men