2018 Volume 64 Issue Suppl.1 Pages 144
Anterior cruciate ligament (ACL) injury is one of a common knee injury and is estimated the incidence of 2～30,000 tears annually in Japan. Subjects who are changing direction rapidly, stopping suddenly, landing from a jump incorrectly, direct contact or collision, may cause ACL tear and often is associated a meniscal tear or osteochondral injury. The surgical treatment includes ACL reconstruction with the aim of restoring the mechanical stability of the knee joint and re-establishing knee function. A recent study shows that the ACL reconstruction in female ends up with an inferior clinical outcome compared to male. Although several factors predicted to be involved in the differences, the detail remains unclear. The purpose of this study was to evaluate the difference between male and female at one year after ACL reconstruction.
110 subjects [58 males, mean age (SD)=24.9 (6.6); 52 females, mean age (SD)=25.8 (8.8); p>0.05] who were undergoing anatomic single-bundle ACL reconstruction using multiple-stranded semitendinosus graft had been enrolled in this study. Subjects completed the Visual Analog Scale for Activities of Daily Living (VAS-ADL/0-100 mm), the Visual Analog Scale for Sports (VAS-Sports/0-100 mm) and their implanted graft length, anterior-posterior instability had been evaluated.
No significant difference in graft length and anterior-posterior instability were observed between male and female. Females had an inferior outcome in both VAS-ADL (male vs. female, 95.2 vs. 89.0; p=0.03) and VAS-Sports (male vs. female, 83.4 vs. 75.8; p=0.02), respectively. In young subjects (below 25-year-old), there had no significant difference in graft length, anterior-posterior instability, VAS-ADL and VAS-Sports between male and female [32 males, mean age (SD)=20.1 (2.6); 25 females, mean age (SD)=18.8 (2.3); p>0.05]. However, female above 25-year-old [26 males, mean age (SD)=30.8 (5.0); 27 females, mean age (SD)=32.3 (7.6); p>0.05 ] had significant inferior outcome in both VAS-ADL (male vs female, 94.4 vs 83.6; p=0.008) and VAS-Sports (male vs female, 83.3 vs 72.4; p=0.028) . In addition, female above 25-year-old showed significantly worse outcome in VAS-ADL (p=0.002) compared to the younger group but no significant difference in VAS-Sports.
Our study showed that aging should be the one of infect to result inferior outcomes in females on subjective outcomes. In addition, regardless of age, subjective outcomes of the VAS-ADL and VAS-Sports, have been shown to be poorer in females. No statistically significant sex difference was identified in both graft length and anterior-posterior instability.
