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Preliminary Evaluation of Dynamic Knee Valgus and Serum Relaxin Concentrations After ACL Reconstruction

BACKGROUND: Athletes who have sustained a tear of the anterior cruciate ligament (ACL) are at a greater risk of re-tear and of developing other adverse outcomes, such as knee osteoarthritis, compared with uninjured athletes. Relaxin, a peptide hormone similar in structure to insulin, has been shown...

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Autores principales: Gilmer, Gabrielle G., Washington, Jessica K., Roberts, Michael D., Oliver, Gretchen D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147639/
https://www.ncbi.nlm.nih.gov/pubmed/32309763
http://dx.doi.org/10.2106/JBJS.OA.19.00060
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author Gilmer, Gabrielle G.
Washington, Jessica K.
Roberts, Michael D.
Oliver, Gretchen D.
author_facet Gilmer, Gabrielle G.
Washington, Jessica K.
Roberts, Michael D.
Oliver, Gretchen D.
author_sort Gilmer, Gabrielle G.
collection PubMed
description BACKGROUND: Athletes who have sustained a tear of the anterior cruciate ligament (ACL) are at a greater risk of re-tear and of developing other adverse outcomes, such as knee osteoarthritis, compared with uninjured athletes. Relaxin, a peptide hormone similar in structure to insulin, has been shown to interfere with the structural integrity of the ACL in female individuals. The purpose of the present study was to evaluate dynamic knee valgus and the serum relaxin concentration (SRC) in athletes who had previously sustained a torn ACL and in those who had not. METHODS: The study included 22 female athletes, divided into 2 groups: those who had previously sustained a torn ACL (4 participants; torn ACL in the dominant leg in all cases) and those who had not (18 participants). Kinematic data were collected at 100 Hz. To assess dynamic knee valgus, participants performed a single-leg squat, a single-leg crossover dropdown, and a drop vertical jump at 2 time points in the menstrual cycle of the patient, pre-ovulatory and mid-luteal. SRC was determined with use of the Human Relaxin-2 Immunoassay using a blood sample obtained during the mid-luteal phase of the menstrual cycle. RESULTS: Independent samples t tests were utilized to compare the differences in dynamic knee valgus and SRC between groups. For the single-leg squat, participants with a prior torn ACL were found to have significantly higher dynamic knee valgus at the mid-luteal phase but not at the pre-ovulatory phase. For the drop vertical jump and single-leg crossover dropdown, participants with a prior torn ACL were found to have significantly higher dynamic knee valgus at both the pre-ovulatory and mid-luteal phases. SRC was also significantly higher among participants with a prior torn ACL. CONCLUSIONS: Participants who had previously sustained a torn ACL had higher SRC and more dynamic knee valgus compared with those who had not. Further investigation of the effects of hormones as a risk factor for reinjury in participants with a prior ACL tear may be worthwhile. In addition, it may be worth monitoring hormonal and biomechanical properties in athletes during the long-term recovery from ACL reconstruction. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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spelling pubmed-71476392020-04-17 Preliminary Evaluation of Dynamic Knee Valgus and Serum Relaxin Concentrations After ACL Reconstruction Gilmer, Gabrielle G. Washington, Jessica K. Roberts, Michael D. Oliver, Gretchen D. JB JS Open Access Scientific Articles BACKGROUND: Athletes who have sustained a tear of the anterior cruciate ligament (ACL) are at a greater risk of re-tear and of developing other adverse outcomes, such as knee osteoarthritis, compared with uninjured athletes. Relaxin, a peptide hormone similar in structure to insulin, has been shown to interfere with the structural integrity of the ACL in female individuals. The purpose of the present study was to evaluate dynamic knee valgus and the serum relaxin concentration (SRC) in athletes who had previously sustained a torn ACL and in those who had not. METHODS: The study included 22 female athletes, divided into 2 groups: those who had previously sustained a torn ACL (4 participants; torn ACL in the dominant leg in all cases) and those who had not (18 participants). Kinematic data were collected at 100 Hz. To assess dynamic knee valgus, participants performed a single-leg squat, a single-leg crossover dropdown, and a drop vertical jump at 2 time points in the menstrual cycle of the patient, pre-ovulatory and mid-luteal. SRC was determined with use of the Human Relaxin-2 Immunoassay using a blood sample obtained during the mid-luteal phase of the menstrual cycle. RESULTS: Independent samples t tests were utilized to compare the differences in dynamic knee valgus and SRC between groups. For the single-leg squat, participants with a prior torn ACL were found to have significantly higher dynamic knee valgus at the mid-luteal phase but not at the pre-ovulatory phase. For the drop vertical jump and single-leg crossover dropdown, participants with a prior torn ACL were found to have significantly higher dynamic knee valgus at both the pre-ovulatory and mid-luteal phases. SRC was also significantly higher among participants with a prior torn ACL. CONCLUSIONS: Participants who had previously sustained a torn ACL had higher SRC and more dynamic knee valgus compared with those who had not. Further investigation of the effects of hormones as a risk factor for reinjury in participants with a prior ACL tear may be worthwhile. In addition, it may be worth monitoring hormonal and biomechanical properties in athletes during the long-term recovery from ACL reconstruction. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. Wolters Kluwer 2020-02-21 /pmc/articles/PMC7147639/ /pubmed/32309763 http://dx.doi.org/10.2106/JBJS.OA.19.00060 Text en Copyright © 2020 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Scientific Articles
Gilmer, Gabrielle G.
Washington, Jessica K.
Roberts, Michael D.
Oliver, Gretchen D.
Preliminary Evaluation of Dynamic Knee Valgus and Serum Relaxin Concentrations After ACL Reconstruction
title Preliminary Evaluation of Dynamic Knee Valgus and Serum Relaxin Concentrations After ACL Reconstruction
title_full Preliminary Evaluation of Dynamic Knee Valgus and Serum Relaxin Concentrations After ACL Reconstruction
title_fullStr Preliminary Evaluation of Dynamic Knee Valgus and Serum Relaxin Concentrations After ACL Reconstruction
title_full_unstemmed Preliminary Evaluation of Dynamic Knee Valgus and Serum Relaxin Concentrations After ACL Reconstruction
title_short Preliminary Evaluation of Dynamic Knee Valgus and Serum Relaxin Concentrations After ACL Reconstruction
title_sort preliminary evaluation of dynamic knee valgus and serum relaxin concentrations after acl reconstruction
topic Scientific Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147639/
https://www.ncbi.nlm.nih.gov/pubmed/32309763
http://dx.doi.org/10.2106/JBJS.OA.19.00060
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