Aldrian S, Valentin P, Wondrasch B, Krusche-Mandl I, Ostermann R C, Platzer P, Hofbauer M
Department of Trauma Surgery, General Hospital, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria,
Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2145-52. doi: 10.1007/s00167-013-2649-y. Epub 2013 Sep 14.
Female patients not only demonstrate an increased risk for injury, but also a poorer response following anterior cruciate ligament (ACL) rupture. However, no study has investigated gender-related differences between computer-navigated single-bundle (SB) and double-bundle (DB) ACL reconstruction. The aim of this study was to evaluate the effects of gender on the outcome of computer-navigated SB and DB ACL reconstruction and to present reference values.
A retrospective review of 55 consecutive patients who underwent SB (15 males, 12 females) and DB (18 males, 10 females) ACL reconstruction with autogenous hamstring tendon grafts and showed a minimum follow-up of 24 months was conducted. Intraoperatively, the anteroposterior and rotational laxity were measured and the follow-up examination included pivot-shift testing, KT-1000 arthrometer testing, International Knee Documentation Committee (IKDC) form, the Lysholm score and Tegner score.
Pre-operatively, female patients showed a significant higher internal rotation in (p < 0.001) both the SB and DB group. Regarding the post-operative reduction in internal rotation, females in the SB group revealed a greater reduction compared to males (p < 0.001), whereas females in the DB group revealed a significantly greater post-operative reduction in anterior-posterior translation (p = 0.04). Female patients following DB ACL reconstruction presented a significant worse IKDC score, Lysholm score and Tegner score compared to male patients. All score values of the female DB group were worse than in the female SB group. In contrast, male patients showed better results of all examined clinical scores following DB procedure compared to SB technique.
Female patients who underwent computer-navigated DB ACL reconstruction exhibited significantly worse outcome scores than males who underwent DB ACL reconstruction. The gender-based relationship between joint function and outcome after ACL reconstruction remains unclear and requires further investigation.
Retrospective case-control series, Level III.
女性患者不仅受伤风险增加，而且在前交叉韧带（ACL）断裂后反应较差。然而，尚无研究调查计算机导航下单束（SB）和双束（DB）ACL重建之间的性别相关差异。本研究的目的是评估性别对计算机导航下SB和DB ACL重建结果的影响，并给出参考值。
对55例连续接受自体腘绳肌腱移植进行SB（15例男性，12例女性）和DB（18例男性，10例女性）ACL重建且随访至少24个月的患者进行回顾性研究。术中测量前后向和旋转松弛度，随访检查包括轴移试验、KT-1000关节测压计测试、国际膝关节文献委员会（IKDC）表格、Lysholm评分和Tegner评分。
术前，SB组和DB组女性患者的内旋均显著更高（p<0.001）。关于术后内旋减少情况，SB组女性与男性相比减少幅度更大（p<0.001），而DB组女性术后前后向平移减少幅度显著更大（p=0.04）。与男性患者相比，DB ACL重建后的女性患者IKDC评分、Lysholm评分和Tegner评分显著更差。女性DB组的所有评分值均比女性SB组差。相比之下，男性患者DB手术的所有检查临床评分结果均优于SB技术。
接受计算机导航DB ACL重建的女性患者的结果评分显著低于接受DB ACL重建的男性患者。ACL重建后关节功能与结果之间基于性别的关系仍不清楚，需要进一步研究。
回顾性病例对照系列，III级。
