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Review
. 2022 Dec;15(6):645-650.
doi: 10.1007/s12178-022-09801-3. Epub 2022 Oct 15.

Sex-Based Differences in Adult ACL Reconstruction Outcomes

Katherine Branche  1 , Hannah L Bradsell  2 , Alex Lencioni  3 , Rachel M Frank  4
Affiliations
Review

Sex-Based Differences in Adult ACL Reconstruction Outcomes

Katherine Branche et al. Curr Rev Musculoskelet Med. 2022 Dec.

Abstract

Purpose of review: In the setting of ever improving outcomes following anterior cruciate ligament (ACL) reconstruction, both objectively and subjectively, there remains continued interest in better understanding the differences in outcomes between male and female patients. The current review investigates the recent literature surrounding the roles of biological sex in adult ACL reconstruction outcomes.

Recent findings: Within the past five years, the most prominent and recurrent difference between male and female patient cohorts is the subjective report of pain and function. Female patients have been consistently shown to have worse self-reported outcomes following ACL reconstruction. Specific and quantifiable subjective outcomes that are highlighted include the International Knee Documentation Committee (IKDC) subjective score, the Knee injury and Osteoarthritis Outcome Score (KOOS), and patient-acceptable symptom state (PASS). Current research on the topic of biological sex-based differences in ACL reconstruction outcomes can be divided into four main categories: patient-reported subjective outcomes; physical assessment and gait analysis; kinematics; and rates of reinjury, revision, and contralateral reconstruction. This chapter provides a summary of recent literature focused on these four main areas of interest related to ACL reconstruction outcomes in males and females.

Keywords: ACL reconstruction; Biological sex; Differential outcomes.

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Conflict of interest statement

Katherine Branche, Hannah Bradsell, Alex Lencioni, and Rachel Frank declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
ACL-RSI Scale [10]
See this image and copyright information in PMC

References

    1. Sanders TL, Maradit Kremers H, Bryan AJ, Larson DR, Dahm DL, Levy BA, Stuart MJ, Krych AJ. Incidence of anterior cruciate ligament tears and reconstruction: a 21-year population-based study. Am J Sports Med. 2016;44(6):1502–1507. doi: 10.1177/0363546516629944. - DOI - PubMed
    1. Webster KE, Feller JA. Younger patients and men achieve higher outcome scores than older patients and women after anterior cruciate ligament reconstruction. Clin Orthop Relat Res. 2017;475(10):2472–2480. doi: 10.1007/s11999-017-5418-2. - DOI - PMC - PubMed
    1. Nwachukwu BU, Patel BH, Lu Y, Allen AA, Williams RJ., 3rd Anterior cruciate ligament repair outcomes: an updated systematic review of recent literature. Arthroscopy. 2019;35(7):2233–2247. doi: 10.1016/j.arthro.2019.04.005. - DOI - PubMed
    1. Group MK, Spindler KP, Huston LJ, Chagin KM, Kattan MW, Reinke EK, et al. Ten-year outcomes and risk factors after anterior cruciate ligament reconstruction: a MOON longitudinal prospective cohort study. Am J Sports Med. 2018;46(4):815–825. doi: 10.1177/0363546517749850. - DOI - PMC - PubMed
    1. Nwachukwu BU, Voleti PB, Berkanish P, Chang B, Cohn MR, Williams RJ, 3rd, et al. Return to play and patient satisfaction after ACL reconstruction: study with minimum 2-year follow-up. J Bone Joint Surg Am. 2017;99(9):720–725. doi: 10.2106/JBJS.16.00958. - DOI - PubMed