Kuenze Christopher, Bell David R, Grindstaff Terry L, Lisee Caroline M, Birchmeier Thomas, Triplett Ashley, Pietrosimone Brian
Michigan State University, East Lansing.
University of Wisconsin, Madison.
J Athl Train. 2021 Feb 1;56(2):164-169. doi: 10.4085/1062-6050-0034.20.
Postoperative functional and return-to-sport outcomes after anterior cruciate ligament reconstruction (ACLR) differ by sex. However, whether sex disparities are observed in patient-reported outcome measures (PROMs) before return to sport after ACLR is unclear.
To compare common PROMs between young men and women who had not yet returned to sport after ACLR.
Cross-sectional study.
University laboratory.
Forty-five young men (age = 18.7 ± 2.7 years, time since surgery = 6.8 ± 1.4 months) and 45 women matched for age (±1 year) and time since surgery (±1 month; age = 18.8 ± 2.8 years, time since surgery = 6.9 ± 1.4 months) with ACLR participated.
MAIN OUTCOME MEASURE(S): Participants completed the Tegner Activity Scale, ACL Return to Sport After Injury scale, Tampa Scale of Kinesiophobia, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Score, and Knee Injury and Osteoarthritis Outcome Score (KOOS). The PROMs were compared between men and women using Mann-Whitney U tests. Odds ratios were calculated to evaluate the odds of a male reporting a PROM value above the previously established normative value as compared with a female.
Sex differences were present for the IKDC score (P = .01) and KOOS Pain score (P = .04) but not for the Tegner Activity Scale (P = .22), ACL Return to Sport After Injury scale score (P = .78), Tampa Scale of Kinesiophobia score (P = .64), or other KOOS subscales (P values = .40 to .52). The odds of reporting values above normative levels differed only for the IKDC score (odds ratio = 2.72, 95% confidence interval = 1.16, 6.38).
After ACLR, young men and women reported similar levels of knee-related function, fear of movement, and readiness for return to sport and were equally likely to meet clinically meaningful normative values before return to sport. Overreliance on patient reports or objective functional outcomes in evaluating patient progress and readiness for return to sport after ACLR may limit clinicians in their ability to comprehensively evaluate and develop individualized interventional approaches that optimize patient outcomes.
前交叉韧带重建术（ACLR）后，术后功能及恢复运动的结果存在性别差异。然而，ACLR后恢复运动前患者报告的结局指标（PROMs）中是否存在性别差异尚不清楚。
比较ACLR后尚未恢复运动的年轻男性和女性之间常见的PROMs。
横断面研究。
大学实验室。
45名年轻男性（年龄 = 18.7 ± 2.7岁，术后时间 = 6.8 ± 1.4个月）和45名年龄（±1岁）及术后时间（±1个月；年龄 = 18.8 ± 2.8岁，术后时间 = 6.9 ± 1.4个月）匹配的女性参与ACLR。
参与者完成了特格纳活动量表、ACL损伤后恢复运动量表、坦帕运动恐惧量表、国际膝关节文献委员会（IKDC）主观膝关节评估评分以及膝关节损伤和骨关节炎结局评分（KOOS）。使用曼-惠特尼U检验比较男性和女性之间的PROMs。计算优势比以评估男性报告的PROM值高于先前确定的正常标准值的可能性与女性相比。
IKDC评分（P = 0.01）和KOOS疼痛评分（P = 0.04）存在性别差异，但特格纳活动量表（P = 0.22）、ACL损伤后恢复运动量表评分（P = 0.78）、坦帕运动恐惧量表评分（P = 0.64）或其他KOOS子量表（P值 = 0.40至0.52）不存在性别差异。仅IKDC评分报告值高于正常水平的可能性存在差异（优势比 = 2.72，95%置信区间 = 1.16，6.38）。
ACLR后，年轻男性和女性报告的膝关节相关功能、运动恐惧和恢复运动的准备程度相似，并且在恢复运动前达到临床有意义的正常标准值的可能性相同。在评估ACLR后患者的进展和恢复运动的准备程度时，过度依赖患者报告或客观功能结局可能会限制临床医生全面评估和制定优化患者结局的个性化干预方法的能力。
