The Effect of Estrogen on Anterior Cruciate Ligament Structure and Function: A Systematic Review

Abstract

There is a widely acknowledged biological sex difference in anterior cruciate ligament (ACL) injuries, with females at a significantly higher risk compared to males. Due to the sex difference, the influence of the sex hormone estrogen has been investigated. Consequently, the aim of this study through reviewing current literature was to explore the association fluctuations in estrogen concentration during the menstrual cycle and altered ACL extracellular matrix (ECM) structure and subsequent function.