Testosterone may increase rat anterior cruciate ligament strength.

BACKGROUND: Women are more likely than men to injure the anterior cruciate ligament (ACL). Human and animal trials have linked circulating estradiol to injury rate and ligament strength. Fewer studies have examined the role of testosterone. The purpose of this study was to determine if male rats with normal testosterone levels would have stronger ACLs than castrated rats. METHODS: Eight castrated (group C) and eight normal (group N) 12-week-old, male Sprague-Dawley rats were used for the study. Mean testosterone levels were 0.14ng/mL (95% CI: 0.10 to 0.17) in group C and 3.54ng/mL (95% CI: 1.32 to 5.76) in group N. After euthanasia, ACL cross-sectional area was calculated, and a servohydraulic material testing unit was used to measure ligament properties. RESULTS: Specimens from both groups had similar cross-sectional area, but N specimens showed greater mean load-to-failure (34.5N [95% CI: 31.6 to 37.4] vs 29.2N [95% CI: 27.9 to 30.6]) and ultimate stress (38.7MPa [95% CI: 34.1 to 43.3] vs 31.8MPa [95% CI: 29.8 to 33.8]). Mean energy was 27.7mJ (95% CI: 23.1 to 32.2) in the N group and 23.4mJ (95% CI: 18.2 to 28.6) in the C group. CONCLUSIONS: Rats with normal circulating testosterone had higher ACL load-to-failure and ultimate stress, indicating that testosterone may influence ACL strength and the injury rate of the ligament.

Identification of tibial stress fractures using therapeutic continuous ultrasound.

STUDY DESIGN: One-group discriminant analysis. OBJECTIVE: To determine whether 1 MHz of continuous ultrasound can identify tibial stress fractures in subjects. BACKGROUND: Stress fractures can lead to loss of function or to more serious nonunion fractures. Early diagnosis is important to reduce the risk of further injury and to assure a safe return to activity. Therapeutic ultrasound has been reported to be an accessible, less expensive alternative in diagnosing stress fractures compared with other diagnostic techniques. METHODS AND MEASURES: Twenty-six subjects (12 men, 20.33 +/- 1.37 years; 14 women, 20.78 +/- 3.8 years) with unilateral tibia pain for less than 2 weeks volunteered to participate in the study. Continuous, 1 MHz ultrasound was applied to the uninvolved and involved tibias at 7 increasing intensities for 30 seconds each. Subjects completed a visual analog scale after the application of each intensity to assess the pain response to ultrasound. Results from the visual analog scale were compared to magnetic resonance imaging (MRI) findings to determine if continuous ultrasound could predict whether subjects had a normal MRI, increased bone remodeling, or advanced bone remodeling consistent with a stress fracture. RESULTS: Discriminant analysis on the visual analog scale correctly classified subjects into 1 of 3 clinical classification groups in 42.31% of the cases. None of the subjects found to have a stress fracture by MRI were correctly identified by continuous ultrasound. This resulted in a predicted sensitivity of 0% and a predicted specificity of 100%. CONCLUSIONS: A protocol using visual analog scores after the application of 1 MHz continuous ultrasound is not sensitive for identifying subjects with tibial stress fractures.