Sophie Bodek • Wed, August 6th, 2014
The anterior cruciate ligament (ACL) is one of the most frequently injured knee ligaments with an injury incidence of over 200,000 cases per year, according to the University of California, San Francisco Department of Orthopedic Surgery’s website. By the numbers, more ACL injuries happen to men because a greater amount of men participate in sports. Women, however, have a higher risk of ACL injury due to lower extremity alignment, looseness in the joints, hormonal differences, and ACL size. According to National Collegiate Athletic Association (NCAA) statistics, women are 2 to 8 times more likely to experience an ACL injury from sports participation. Although it is well documented that women are more likely to sustain an ACL injury, several doctors wondered if females are predisposed to poor outcomes following ACL reconstruction.
John Ryan, M.D.; Robert A. Magnussen, M.D.; Charles L. Cox, M.D., M.P.H.; Jason G. Hurbanek, M.D.; David C. Flanigan, M.D.; and Christopher C. Kaeding, M.D. conducted a systematic review of the medical literature concerning the outcomes of ACL reconstruction by sex. Published in the March issue of The Journal of Bone and Joint Surgery, the review is titled, “ACL Reconstruction: Do Outcomes Differ by Sex?” The doctors evaluated a total of 13 studies in order to determine whether sex played a role in the outcome of ACL reconstruction. After reviewing the studies, determining several outcome measures, and assessing the results for homogeneity, the doctors performed a meta-analysis. The four outcome measures analyzed were “graft failure risk, contralateral ACL injury risk, knee laxity, and patient-reported outcome scores following ACL reconstruction.” They determined homogeneity with a chi-square test and performed the meta-analysis using a Mantel-Haenszel analysis with a random-effects model.