Comparison of anterior cruciate ligament reconstruction in male and female athletes using the patellar tendon and hamstring autografts

Abstract

Despite the higher incidence of anterior cruciate ligament (ACL) injuries in female than in male athletes few authors have studied the effects of gender on the outcome of ACL reconstruction. This prospective study compared the results of ACL reconstruction using the patellar tendon and hamstring techniques in men and women. We prospectively followed 80 comparable athletes (46 males, 32 females) from a population of 287 patients operated on at our institution for ACL reconstruction using either patellar tendon or hamstring graft. There were 26 males and 14 females in the patellar tendon group, and 22 males and 18 females in the hamstring group. All patients were operated on by the same surgeon within 6 months from injury and underwent the same rehabilitation program at the same center. After an average of 36 months the patients were assessed by clinical evaluation, computerized knee laxity analysis, and isokinetic and functional strength tests; standard knee scores were also used. Among patellar tendon patients there were no significant differences between males and females regarding knee evaluation form, laxity, or isokinetic and functional tests. Females in the hamstring group had significantly greater laxity, and isokinetic tests at 1 year revealed a significantly higher deficit of peak torque at 60 degrees /s in flexion and extension. We suggest further studies on the clinical significance of these findings particularly on their possible ramifications in the areas of return to sports and rehabilitation of female athletes.

Reconstruction of the ACL with a semitendinosus tendon graft: a prospective randomized single blinded comparison of double-bundle versus single-bundle technique in male athletes

“…Barret et al have suggested that generalized ligamentous laxity, which is more frequent in females, contributes to increased graft laxity [4]. This is in line with the findings of Corry and Gobbi [6,12]. They found a significant increased laxity in females operated with a autologous hamstring graft.…”

A prospective comparison of bone-patellar tendon-bone and hamstring tendon grafts for anterior cruciate ligament reconstruction in male patients

“…However, contrary to some previous studies, especially those relating to female patients [8,17], an increase in post-operative knee laxity using ST/ G autografts was not found [6,13,36]. In our opinion, this is an interesting and important finding and indicates that ST/G grafts may be safely used even in young, highly active male athletes.…”

Single- versus Double-bundle ACL Reconstruction: Is There Any Difference in Stability and Function at 3-year Followup?

“…We must always plan our surgery according to the type of patient we are presented with; for instance, a double-bundle ACLR may be more appropriate for an athlete of high-contact or impact sport but certainly not for a skeletally immature patient or a patient with important lateral femoral condyle bone bruise [8,38,46,47,49,51]. Furthermore, we must also consider the anthropometric anatomy; thus, a thin light female would not be a good candidate for DB ACLR [13]. There is a considerable learning curve associated with DB ACLR.…”