{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:10:53Z","timestamp":1790925053243,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T00:00:00Z","timestamp":1590364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01\u2010AR065462"],"award-info":[{"award-number":["R01\u2010AR065462"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Despite a well\u2010established role of anterior cruciate ligament (ACL) anatomy on its biomechanics, little is known on how ACL anatomy develops and changes during skeletal growth. We hypothesized that ACL size and orientation will change by age during skeletal growth and maturation with different trends in males vs females. Magnetic resonance images of 269 unique knees (3\u201018 years old; 51% female) were used to measure ACL length, cross\u2010sectional area, length\u2010to\u2010cross\u2010sectional area ratio, and elevation angles. In both males and females, ACLs became longer, thicker, and more vertical in sagittal and coronal planes by increasing age (\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009&gt;\u20090.2;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.001 for all associations). ACL cross\u2010sectional area\u2010to\u2010length ratio increased by age only in males (\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090.06;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u2009.003). Despite similar ACL sizes between males and females at early age, adolescent males had significantly longer and thicker ACLs compared to the age\u2010matched females (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.05). There were no sex differences in ACL elevation angles (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&gt;\u2009.2) except for larger coronal elevation in 7 to 10 years old females compared to age\u2010matched males (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u2009.012). Observed changes in ACL cross\u2010sectional area\u2010to\u2010length ratio indicate that age\u2010 and sex\u2010dependent changes in ACL size are not homogenous. The trends seen in normalized ACL size measurements suggest that unlike ACL cross\u2010sectional area, ACL length is primarily controlled by body size. Smaller ACLs and lower cross\u2010sectional growth rates observed in females may be contributing factors to the higher risk of ACL injuries in females. Further investigations are required to identify the intrinsic and extrinsic factors responsible for these discrepancies.\n                  <\/jats:p>","DOI":"10.1002\/jor.24748","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T17:17:19Z","timestamp":1589908639000},"page":"841-849","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Age\u2010related changes in ACL morphology during skeletal growth and maturation are different between females and males"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5326-6852","authenticated-orcid":false,"given":"Shayan","family":"Hosseinzadeh","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Boston Children's Hospital Harvard Medical School  Boston 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