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Studies in skeletally immature patients indicate differences in ACL size and joint laxity between males and females after the onset of adolescence. However, functional data regarding the ACL and its anteromedial and posterolateral bundles in the pediatric population remain rare. Therefore, this study uses a porcine model to investigate the sex\u2010specific morphology and biomechanics of the ACL and its bundles throughout skeletal growth. Hind limbs from male and female Yorkshire pigs aged early youth to late adolescence were imaged using magnetic resonance imaging to measure the size and orientation of the ACL and its bundles, then biomechanically tested under anterior\u2010posterior drawer using a robotic testing system. Joint laxity decreased (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) while joint stiffness increased (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) throughout skeletal growth in both sexes. The ACL was the primary stabilizer against anterior tibial loading, while the functional role of the anteromedial bundle increased with age (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), with an earlier increase in males. ACL and posterolateral bundle cross\u2010sectional area and ACL and anteromedial bundle length were larger in males than females during adolescence (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01 for all), while ACL and bundle sagittal angle remained similar between sexes. Additionally, in situ ACL stiffness versus cross\u2010sectional area regressions were significant across skeletal growth (\n                    <jats:italic>r<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090.75,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001 in males and\n                    <jats:italic>r<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090.64,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001 in females), but not within age groups. This study has implications for age and sex\u2010specific surgical intervention strategies and suggests the need for human studies.\n                  <\/jats:p>","DOI":"10.1002\/jor.25207","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T10:23:03Z","timestamp":1636453383000},"page":"1853-1864","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Sex\u2010specific biomechanics and morphology of the anterior cruciate ligament during skeletal growth in a porcine model"],"prefix":"10.1002","volume":"40","author":[{"given":"Danielle","family":"Howe","sequence":"first","affiliation":[{"name":"Joint Department of Biomedical Engineering North Carolina State University and the University of North Carolina\u2010Chapel Hill  Raleigh North Carolina USA"},{"name":"Comparative Medicine Institute North Carolina State University  Raleigh North Carolina 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Collins","sequence":"additional","affiliation":[{"name":"Comparative Medicine Institute North Carolina State University  Raleigh North Carolina USA"},{"name":"Department of Animal Science North Carolina State University  Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn A.","family":"Fordham","sequence":"additional","affiliation":[{"name":"Department of Radiology University of North Carolina\u2010Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily H.","family":"Griffith","sequence":"additional","affiliation":[{"name":"Department of Statistics North Carolina State University  Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"Spang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of North Carolina\u2010Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3212-0870","authenticated-orcid":false,"given":"Matthew B.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Joint Department of Biomedical Engineering North Carolina State University and the University of North Carolina\u2010Chapel Hill  Raleigh North Carolina USA"},{"name":"Comparative Medicine Institute North Carolina State University  Raleigh North Carolina USA"},{"name":"Department of Orthopaedics University of North Carolina\u2010Chapel Hill  Chapel Hill North Carolina 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