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Sex Related Outcomes Following Anterior Cruciate Ligament Reconstruction (Aclr): A Systematic Review and Meta-Analysis

Anthony Charles Mok, BS
UNITED STATES

Sex Related Outcomes Following Anterior Cruciate Ligament Reconstruction (Aclr): A Systematic Review and Meta-Analysis

Anthony Charles Mok, BS, UNITED STATES Andrew J Fancher, BS, UNITED STATES Matthew L Vopat, MD, UNITED STATES Jordan Charles Baker, BS, UNITED STATES Armin Tarakemeh, BS, UNITED STATES Mary K. Mulcahey, MD, UNITED STATES Scott Mullen, MD, UNITED STATES Paul Schroeppel, MD, UNITED STATES Kimberly J. Templeton, MD, UNITED STATES Bryan Vopat, UNITED STATES

University of Kansas Medical Center, Kanas City, Kansas, UNITED STATES

2021 Congress Abstract Presentation 5 minutes Not yet rated

Anatomic Location

Knee

Anatomic Structure

Ligaments

Diagnosis / Condition

Tears

Treatment / Technique

Repair / Reconstruction

Ligaments

ACL

Patient Populations

Gender Specific

Sports Medicine

Outcome Studies

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Summary: This study looks to identify differences in outcomes following ACL reconstructions with regard to the patient's sex.

Introduction

There is a paucity of information on the influence of patient sex on outcomes following ACL reconstructions (ACLR). Previous studies have demonstrated that females have worse outcomes with regards to instrumented laxity, revision rate, Lysholm score, Tegner activity score, and are less likely to return to sport. However, other measures have been shown to be similar between male and female patients. The purpose of this study was to perform a systematic review and meta-analysis comparing outcomes after ACL reconstructions with regard to sex.

Methods

A systematic review and meta-analysis were conducted using PubMed, PubMed Central, Embase, Cochrane Library, and OVID (inception – April 2020) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Outcomes including functional tests, re-rupture rates, re-operative rates, post-operative range of motion, post-operative stability, return-to-sport rates, and International Knee Documentation Committee (IKDC) scores were recorded and analyzed.

Results

Studies that reported post-operative IKDC scores, re-rupture rates, and revisions rates were included in the meta-analysis. For IKDC scores, there were 7 studies included with 2022 males and 1402 females. We found that males had a statistically significant higher IKDC post-operative score (MD = 3.02; 95% CI = [1.19, 4.84]; I2 = 66%). Seven studies (14,543 males and 5,306 females) reported the rate of ACL revision. Our results show that there was no significant difference between males and females with regards to revisions (OR = 0.85; 95% CI = [0.45, 1.60]; I2=94%). For the re-rupture rate, there were 7 studies with 19,370 males and 14,747 females. We found that males were significantly more likely to suffer a graft re-rupture than their female counterparts (OR=1.35; 95% CI = [1.22, 1.50], I2 = 0%). Males also reported a 17% higher return-to-sport (RTS) rate than females (59.82% compared to 42.89%); however, no formal statistical analysis was able to be done due to the variability in reporting techniques between papers.

Conclusion

To our knowledge, this is the most recent and comprehensive study focused on the role of a patient’s sex on ACLR outcomes. Males and females showed similar outcomes with regards to rate of revision surgery. However, males were found to have higher post-operative IKDC scores and higher re-rupture rates. Males also showed almost a 17% higher incidence of returning to sport; however, the variability in reporting RTS rates following ACLR by sex prevents us from being able to perform a statistical analysis on these results. More studies are needed that focus directly on the effect of sex, combined with other co-variables such as age, graft used, or level of sport, to increase the breadth of knowledge on sex specific outcomes following ACL reconstructions.

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Contralateral versus ipsilateral quadriceps graft, for anterior cruciate ligament reconstruction. Abstract Presentation 6 minutes Franco Della Vedova, MD, ARGENTINA Hernan Galan, MD, ARGENTINA Daniel A. Slullitel, MD, Prof., ARGENTINA
Return To Elite Sport After ACL Reconstruction In 376 'Professional' Athletes Abstract Presentation 5 minutes Kyle Borque, MD, UNITED STATES Mary Jones, Msc Grad Dip Phys, UNITED KINGDOM Ganesh Balendra, MBBS, AUSTRALIA Lukas Willinger, MD, GERMANY Vitor Hugo Pinheiro, MD, UNITED KINGDOM Andy Williams, MBBS, FRCS(Orth), FFSEM(UK), UNITED KINGDOM
Local Anaesthetic Infiltration (Lia) Is Equally Effective As Adductor Nerve Blocks For Pain Relief In Anterior Cruciate Ligament (Acl) Reconstructions. Abstract Presentation 8 minutes Mohammad Abou Salhab, MBChB, MSc, UNITED KINGDOM Sonal Sonwalkar , FRCA, UNITED KINGDOM Sanjeev Anand, MD, UNITED KINGDOM Martin Stone, MD, UNITED KINGDOM
Does In Vivo Kinematics Following Acl Reconstruction With Or Without Lateral Extraarticular Tenodesis Correlate With Preoperative Quantitative Pivot Shift? Abstract Presentation 5 minutes Christopher M. Gibbs, MD, UNITED STATES Philipp Wilhelm Winkler, MD, AUSTRIA Jonathan D Hughes, MD, UNITED STATES Adam Popchak, DPT, PhD, UNITED STATES Daisuke Chiba, MD, PhD, JAPAN Bryson P. Lesniak, MD, UNITED STATES William Anderst, PhD, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES
Acl - Pcl Fixation Sequence During Multi-Ligament Knee Reconstruction Does Not Affect Knee Laxity Abstract Presentation 6 minutes Carola F. van Eck, MD, PhD, FAAOS, UNITED STATES Aly Maher Fayed, MD, EGYPT Ryo Kanto, MD, JAPAN Taylor M. Price, MS, UNITED STATES Michael Dinenna, BS, UNITED STATES Monica A. Linde, MSIE, RN, UNITED STATES Patrick J. Smolinski, PhD, UNITED STATES
Clinical Outcomes Of Primary Acl Reconstruction With Tibial Attachment Preserving Quadrupled Hamstring Graft: Does Graft Size Matter? - A Prospective Study With Review Of Literature Abstract Presentation 5 minutes Shaival Dalal, M.S.MRCS(Edinburgh), UNITED KINGDOM Ghislain N. Aminake , MBBS, MMed(Ortho),MRCPS(Glasg), QATAR Randy Guro, BSc, UNITED KINGDOM Amit Pramod Chandratreya, FRCS(Tr&Orth), MS(Orth), MCh(Orth), UNITED KINGDOM Rahul Kotwal, FRCS(Ortho), UNITED KINGDOM
THE OUTCOME OF BALANCE EXERCISES AND AGILITY TRAINING FOR POST ANTERIOR CRUCIATE LIGAMENT (ACL) RECONSTRUCTION: CLINICAL ASSESSMENT Abstract Presentation 7 minutes SITI MAIZATUL AKMAL ISMAIL, Medical Science (Orthopaedic Surgery Sports), MALAYSIA
Changes In Muscle Strength And Hop Performance After ACL Reconstruction. A Randomized Controlled Trial Comparing Patellar Tendon And Hamstring Tendon Autografts With Standard Or Accelerated Rehabilitation Abstract Presentation 6 minutes Riccardo Cristiani, MD, PhD, SWEDEN Christina Mikkelsen, PT, SWEDEN Peter Olov Wange, MD, SWEDEN Daniel Olsson, PhD, SWEDEN Anders Stalman, MD, PhD, associate professor, SWEDEN Bjorn Engstrom, MD, PhD, Assoc. Prof., SWEDEN
Inter- and Intra-Rater Reliability of Measurenebt of ACL TUnnels with Radiographs, CT, and MRI Abstract Presentation 4 minutes Robert A Magnussen, MD, MPH, UNITED STATES Alexander Sparks, BS, UNITED STATES Jacy Leon, BS, UNITED STATES Matthew Colatruglio, BS, UNITED STATES Joshua Bowler, MD James Oosten, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Joshua Scott Everhart, MD, MPH, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES David C. Flanigan, MD, UNITED STATES
Risk Factors for Grade 3 Pivot Shift in Acute ACL-Injured Knees Abstract Presentation 5 minutes Adnan Saithna, MD, FRCS, UNITED STATES Edoardo Monaco, MD, ITALY Edoardo Gaj, MD, ITALY Valerio Andreozzi, ITALY Alessandro Annibaldi, MD, ITALY Alessandro Carrozzo, MD, ITALY Thais Dutra Vieira, MD, FRANCE Bertrand Sonnery-Cottet, MD, PhD, FRANCE Andrea Ferretti, Prof., ITALY
Early ROM exercise after ACLR with hamstring autograft does not cause joint laxity : A Prospective Randomized Controlled Trial, 2 years follow up ePoster Presentation Jeong-Ku Ha, MD, phD, Prof, KOREA, REPUBLIC OF Kyu Sung Chung, MD, PhD, Prof., KOREA, REPUBLIC OF

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Sex Related Outcomes Following Anterior Cruciate Ligament Reconstruction (Aclr): A Systematic Review and Meta-Analysis

Sex Related Outcomes Following Anterior Cruciate Ligament Reconstruction (Aclr): A Systematic Review and Meta-Analysis

Introduction

Methods

Results

Conclusion

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Sex Related Outcomes Following Anterior Cruciate Ligament Reconstruction (Aclr): A Systematic Review and Meta-Analysis

Sex Related Outcomes Following Anterior Cruciate Ligament Reconstruction (Aclr): A Systematic Review and Meta-Analysis

Introduction

Methods

Results

Conclusion

More ISAKOS 2021: Global Content