Abstract
Young female athletes experience a higher incidence of ligament injuries than their male counterparts, females experience a higher incidence of joint hypermobility syndrome (a risk factor for osteoarthritis development), and post-menopausal females experience a higher prevalence of osteoarthritis than age-matched males. These observations indicate that fluctuating sex hormone levels in young females and loss of ovarian sex hormone production due to menopause likely contribute to observed sex differences in knee joint function and risk for loss of function. In studies of osteoarthritis, however, there is a general lack of appreciation for the heterogeneity of hormonal control in both women and men. Progress in this field is limited by the relatively few preclinical osteoarthritis models, and that most of the work with established models uses only male animals. To elucidate sex differences in osteoarthritis, it is important to examine sex hormone mechanisms in cells from knee tissues and the sexual dimorphism in the role of inflammation at the cell, tissue, and organ levels. There is a need to determine if the risk for loss of knee function and integrity in females is restricted to only the knee or if sex-specific changes in other tissues play a role. This paper discusses these gaps in knowledge and suggests remedies.
Highlights
The knee comprises a number of tissues that function as an organ system during rapid growth, adult life, and aging
The purpose of this review is to summarize current knowledge on the role of sex hormones in modulating knee homeostasis and how changes in the sex hormone milieu during development and aging contribute to the incidence, severity, and progression of knee OA
The goal of this paper is to present a synopsis of the current state of knowledge of sex hormone regulation of knee tissues and to identify gaps in knowledge
Summary
The knee comprises a number of tissues (bones, muscle, cartilage, menisci, ligaments, tendons, synovium, and capsule) that function as an organ system during rapid growth, adult life, and aging. The observation that cartilage cells respond to these concentrations via membrane-associated signaling pathways suggests that sex differences in these cells are likely due to local production and signaling, it should be noted that sex differences have been observed using concentrations of sex hormones at levels comparable to those found in blood [1] How such differences could contribute to risk for loss of knee function remains to be determined. Not all postmenopausal women develop knee OA and it is not clear what distinguishes those who do from those who do not To address this gap in knowledge, some studies have begun to investigate systemic aspects of molecular changes in sex hormone metabolism after menopause [76], as well as direct and indirect effects of estrogens on cartilage in various populations [77]. The possibility that hormone-associated changes in systemic and tissuespecific inflammatory cytokines can influence the risk of knee OA should be addressed in future studies so that it is possible to identify those individuals at higher risk
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
