Salmon Lucy J, Refshauge Kathryn M, Russell Vivianne J, Roe Justin P, Linklater James, Pinczewski Leo A
Australian Institute of Musculoskeletal Research, Sydney, NSW, Australia.
Am J Sports Med. 2006 Apr;34(4):621-9. doi: 10.1177/0363546505281806. Epub 2005 Dec 28.
It is now well documented that women are more likely to suffer anterior cruciate ligament injuries than are men. A few studies have examined gender differences in the outcome of anterior cruciate ligament reconstruction with patellar tendon graft and hamstring tendon with EndoButton fixation, but no well-controlled studies have specifically compared men and women after anterior cruciate ligament reconstruction with hamstring tendon graft and interference screw fixation.
There is no difference in outcome between men and women after anterior cruciate ligament reconstruction with hamstring tendon autograft and interference screw fixation.
Cohort study; Level of evidence, 3.
There were 100 men and 100 women who underwent isolated anterior cruciate ligament reconstruction by a single surgeon. Patients were assessed preoperatively and at 1, 2, and 7 years after surgery. Variables were compared between female and male patients.
Laxity on physical evaluation was greater in women than in men on Lachman (P = .04), pivot-shift (P = .05), and mean manual maximum testing (P = .05) at 7 years. However, the magnitude of this difference was small. No patient had a greater than grade 1 Lachman or pivot-shift test result, and the mean difference between men and women was 0.6 mm on instrumented testing. Anterior cruciate ligament graft rupture occurred in 11 men and 10 women. There was no difference between male and female patients for self-reported knee function or symptoms of instability or radiologic examination.
Anterior cruciate ligament reconstruction using hamstring tendon autograft affords excellent self-reported and objective results in both men and women after 7 years. Although significantly greater laxity on physical examination was present in female patients than in male patients, the magnitude of this difference was small and had no effect on activity level, graft failure, or subjective or functional assessment.
现在有充分的文献记载，女性比男性更容易遭受前交叉韧带损伤。一些研究已经探讨了使用髌腱移植物和带EndoButton固定的腘绳肌腱进行前交叉韧带重建的结果中的性别差异，但没有严格对照的研究专门比较使用腘绳肌腱移植物和干涉螺钉固定进行前交叉韧带重建后的男性和女性。
使用自体腘绳肌腱和干涉螺钉固定进行前交叉韧带重建后，男性和女性的结果没有差异。
队列研究；证据等级，3级。
100名男性和100名女性由同一位外科医生进行单纯前交叉韧带重建。术前以及术后1年、2年和7年对患者进行评估。比较女性和男性患者的各项变量。
在术后7年的拉赫曼试验（P = 0.04）、轴移试验（P = 0.05）和平均手动最大试验（P = 0.05）中，女性体格检查时的松弛度大于男性。然而，这种差异的程度较小。没有患者的拉赫曼试验或轴移试验结果大于1级，仪器测试中男性和女性之间的平均差异为0.6毫米。11名男性和10名女性发生了前交叉韧带移植物断裂。在自我报告的膝关节功能、不稳定症状或影像学检查方面，男性和女性患者之间没有差异。
使用自体腘绳肌腱进行前交叉韧带重建在7年后为男性和女性都提供了出色的自我报告和客观结果。尽管女性患者体格检查时的松弛度明显大于男性患者，但这种差异的程度较小，对活动水平、移植物失败或主观或功能评估没有影响。
