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General Orthopaedics

GENDER AND HAMSTRING ANTAGONIST MOMENTS: FURTHER INVESTIGATION OF THE ACL GENDER-BIAS

Australian Orthopaedic Association Limited (AOA)



Abstract

Given their role in reducing anterior tibial translation, the recruitment patterns and viscoelastic properties of the hamstring muscles have been implicated as neuromuscular factors contributing to the ACL gender bias. Nevertheless, it is uncertain whether patterns of aberration displayed by the female neuromuscular system significantly alters the antagonist moments generated by the hamstrings during maximal effort knee extension. The purpose of the current study was to examine the effect of gender on hamstring antagonist moments in order to explain the higher ACL injury rates in females.

Eleven females (age 30.6 ± 10.1 years, mass 62.1± 6.9 kg, height 165.9 ± 4.6) and 11 males (age 29.0 ± 8.2 years, mass 78.6± 14.4 kg, height 178.5± 6.2) were recruited as subjects. Surface electrodes were placed over the semitendinosus (ST) and biceps femoris (BF) muscles of the dominant and non-dominant limbs. Each subject performed two sets of five maximal extension and flexion repetitions at 180-1. EMG, isokinetic torque and knee displacement data were sampled at 1000Hz using an AMLAB data acquisition system.

Average hamstring antagonist torque data across the range of knee flexion for female subjects was significantly higher (%Diff=24%) than for the male control subject. Statistical analyses revealed a significant main effect of gender (F = 4.802; p = 0.036).

Given that females possess a more compliant ACL and hamstring musculature, compared with their male counterparts, an augmented hamstring antagonist may represent a compensatory neuromuscular strategy to increase knee stiffness to control tibial translation and ACL strain. The results of this project suggest that it is unlikely that gender-related differences in hamstring antagonist torque is one of the predisposing factors contributing to the higher ACL injury rates in females.