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Gender-based differences in outcome after anatomic double-bundle anterior cruciate ligament reconstruction with hamstring tendon autografts.
Am J Sports Med. 2011 Sep; 39(9):1849-57.AJ

Abstract

BACKGROUND

Although previous studies suggested that female patients are predisposed to increase graft laxity compared with male patients after single-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons, there have been no studies specifically examining gender-based differences in outcome after anatomic double-bundle anterior cruciate ligament reconstruction with hamstring tendon autografts.

HYPOTHESES

(1) Female patients have significantly smaller hamstring graft diameters than do men for anatomic double-bundle anterior cruciate ligament reconstruction surgery; (2) female patients will have increased graft laxity compared with male patients after anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

The consecutive 174 patients who underwent anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons were enrolled. Of these patients, 49 women and 73 men were prospectively evaluated 2 years after surgery.

RESULTS

The diameters for anteromedial and posterolateral grafts in the female group were significantly smaller than those in the male group. On Lachman testing, 98% of the female group and 97% of the male group were rated as negative. Regarding the pivot-shift test, 80% of the female group and 85% of the male group were rated as negative. No significant differences were found between the female and male groups in these tests. The average side-to-side differences in the KT-2000 knee ligament arthrometer values were 1.3 mm in the female group and 1.4 mm in the male group; this difference between females and males was not statistically significant. The average Lysholm scores were 96.7 points in the female group and 97.2 points in the male group. Thirty-five cases (73%) in the female group and 54 cases (74%) in the male group were graded as normal on the International Knee Documentation Committee (IKDC) evaluation. There were no significant differences in Lysholm score or IKDC evaluation between the female and male groups.

CONCLUSION

The results of assessment for ligament laxity at the 2-year postoperative evaluation in the female group were approximately identical to those of the male group after anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons. Therefore, the present study suggests that anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons provides satisfactory knee stability to female patients as well as male patients.

Authors+Show Affiliations

Harukazu Tohyama, Department of Sports Medicine and Joint Surgery, Hokkaido University School of Medicine, Sapporo, Hokkaido, 060-8638, Japan. tohyama@med.hokudai.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21700783

Citation

Tohyama, Harukazu, et al. "Gender-based Differences in Outcome After Anatomic Double-bundle Anterior Cruciate Ligament Reconstruction With Hamstring Tendon Autografts." The American Journal of Sports Medicine, vol. 39, no. 9, 2011, pp. 1849-57.
Tohyama H, Kondo E, Hayashi R, et al. Gender-based differences in outcome after anatomic double-bundle anterior cruciate ligament reconstruction with hamstring tendon autografts. Am J Sports Med. 2011;39(9):1849-57.
Tohyama, H., Kondo, E., Hayashi, R., Kitamura, N., & Yasuda, K. (2011). Gender-based differences in outcome after anatomic double-bundle anterior cruciate ligament reconstruction with hamstring tendon autografts. The American Journal of Sports Medicine, 39(9), 1849-57. https://doi.org/10.1177/0363546511408864
Tohyama H, et al. Gender-based Differences in Outcome After Anatomic Double-bundle Anterior Cruciate Ligament Reconstruction With Hamstring Tendon Autografts. Am J Sports Med. 2011;39(9):1849-57. PubMed PMID: 21700783.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gender-based differences in outcome after anatomic double-bundle anterior cruciate ligament reconstruction with hamstring tendon autografts. AU - Tohyama,Harukazu, AU - Kondo,Eiji, AU - Hayashi,Riku, AU - Kitamura,Nobuto, AU - Yasuda,Kazunori, Y1 - 2011/06/23/ PY - 2011/6/25/entrez PY - 2011/6/28/pubmed PY - 2012/1/18/medline SP - 1849 EP - 57 JF - The American journal of sports medicine JO - Am J Sports Med VL - 39 IS - 9 N2 - BACKGROUND: Although previous studies suggested that female patients are predisposed to increase graft laxity compared with male patients after single-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons, there have been no studies specifically examining gender-based differences in outcome after anatomic double-bundle anterior cruciate ligament reconstruction with hamstring tendon autografts. HYPOTHESES: (1) Female patients have significantly smaller hamstring graft diameters than do men for anatomic double-bundle anterior cruciate ligament reconstruction surgery; (2) female patients will have increased graft laxity compared with male patients after anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: The consecutive 174 patients who underwent anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons were enrolled. Of these patients, 49 women and 73 men were prospectively evaluated 2 years after surgery. RESULTS: The diameters for anteromedial and posterolateral grafts in the female group were significantly smaller than those in the male group. On Lachman testing, 98% of the female group and 97% of the male group were rated as negative. Regarding the pivot-shift test, 80% of the female group and 85% of the male group were rated as negative. No significant differences were found between the female and male groups in these tests. The average side-to-side differences in the KT-2000 knee ligament arthrometer values were 1.3 mm in the female group and 1.4 mm in the male group; this difference between females and males was not statistically significant. The average Lysholm scores were 96.7 points in the female group and 97.2 points in the male group. Thirty-five cases (73%) in the female group and 54 cases (74%) in the male group were graded as normal on the International Knee Documentation Committee (IKDC) evaluation. There were no significant differences in Lysholm score or IKDC evaluation between the female and male groups. CONCLUSION: The results of assessment for ligament laxity at the 2-year postoperative evaluation in the female group were approximately identical to those of the male group after anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons. Therefore, the present study suggests that anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons provides satisfactory knee stability to female patients as well as male patients. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/21700783/Gender_based_differences_in_outcome_after_anatomic_double_bundle_anterior_cruciate_ligament_reconstruction_with_hamstring_tendon_autografts_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546511408864?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -