Fältström Anne, Hägglund Martin, Kvist Joanna
Region Jönköping County, Rehabilitation Centre, Ryhov County Hospital, 551 85, Jönköping, Sweden.
Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.
BMC Sports Sci Med Rehabil. 2024 Sep 25;16(1):199. doi: 10.1186/s13102-024-00996-1.
Sex differences in patient-reported outcomes (PROs) are not well investigated after anterior cruciate ligament (ACL) reconstruction in football players. The aim was to study sex differences in player-related factors, ACL injury characteristics and PROs after primary ACL reconstruction in football players.
In this cross-sectional cohort study a survey was sent to 390 male and 403 female football players who were injured when playing football and had undergone a primary ACL reconstruction in the previous 1-3 years. Player-related factors, ACL injury characteristics, and PROs covering knee function, satisfaction with activity level and knee function, and readiness to return to sport were compared between male and females. The questionnaires International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC-SKF), Knee injury and Osteoarthritis Outcome Score (KOOS), ACL-Quality of Life (ACL-QoL) and ACL-Return to Sport after Injury (ACL-RSI) were used.
Ninety males (23%) and 283 (70%) females answered the survey, 65 males and 198 females fulfilled the inclusion criteria. Males had returned to football to a higher degree (77% vs 59%, p = 0.008) at any time after ACL reconstruction, but at the time of the survey, an equal number of males and females played football (55% vs 47%, p = 0.239) and had similar activity level according to the Tegner Activity Score (median, 9; interquartile range [IQR], 7, vs median, 8; IQR, 7; p = 0.740). Males were more satisfied with their knee function and activity level and rated higher scores in the IKDC-SKF (mean ± standard deviation, 83 ± 16 vs 76 ± 16, p = 0.006), KOOS Sport/Recreation (79 ± 19 vs 72 ± 22, p = 0.034), KOOS Quality of Life (73 ± 22 vs 64 ± 20, p = 0.008), ACL-QoL (7.6 ± 2 vs 6.8 ± 1.8, p = 0.008), and ACL-RSI (6.7 ± 2.1 vs 5.5 ± 2.3, p < 0.001) than females (all with small - medium effect sizes).
Male football players reported more favourable results than females in patient-reported knee function, satisfaction with activity level and knee function, knee-related quality of life and psychological readiness to return to sport 1-3 years after ACL reconstruction. The results contribute to a better understanding of the eventual effect of patient sex on outcomes after ACL reconstruction in football players. However, the clinical importance of these differences is unclear.
在足球运动员前交叉韧带（ACL）重建术后，患者报告结局（PROs）中的性别差异尚未得到充分研究。本研究旨在探讨足球运动员初次ACL重建术后，与运动员相关的因素、ACL损伤特征以及PROs方面的性别差异。
在这项横断面队列研究中，对390名男性和403名女性足球运动员进行了调查，这些运动员在踢足球时受伤，并在过去1至3年内接受了初次ACL重建。比较了男性和女性在与运动员相关的因素、ACL损伤特征以及涵盖膝关节功能、对活动水平和膝关节功能的满意度以及恢复运动准备情况等方面的PROs。使用了国际膝关节文献委员会主观膝关节评估表（IKDC-SKF）、膝关节损伤和骨关节炎结局评分（KOOS）、ACL生活质量（ACL-QoL）以及ACL损伤后恢复运动（ACL-RSI）等问卷。
90名男性（23%）和283名女性（70%）回复了调查，其中65名男性和198名女性符合纳入标准。男性在ACL重建术后的任何时间重返足球运动的比例更高（77%对59%，p = 0.008），但在调查时，踢足球的男性和女性数量相等（55%对47%，p = 0.239），并且根据Tegner活动评分，他们的活动水平相似（中位数为9；四分位间距[IQR]为7，对中位数为8；IQR为7；p = 0.740）。男性对其膝关节功能和活动水平更满意，并且在IKDC-SKF（平均值±标准差，83±16对76±16，p = 0.006）、KOOS运动/娱乐（79±19对72±22，p = 0.034）、KOOS生活质量（73±22对64±20，p = 0.008）、ACL-QoL（7.6±2对6.8±1.8，p = 0.008）和ACL-RSI（6.7±2.1对5.5±2.3，p < 0.001）方面的评分高于女性（所有效应大小均为小至中等）。
男性足球运动员在ACL重建术后1至3年的患者报告膝关节功能、对活动水平和膝关节功能的满意度、膝关节相关生活质量以及恢复运动的心理准备方面，报告的结果比女性更有利。这些结果有助于更好地理解患者性别对足球运动员ACL重建术后结局的最终影响。然而，这些差异的临床重要性尚不清楚。
