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

Knee Surgery, Sports Traumatology, Arthroscopy volume 12, pages 534–539 (2004)Cite this article

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°/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

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References

  1. Aglietti P, Buzzi R, D’Andria S, Zaccherotti G (1993) Patellofemoral problems after intra-articular anterior cruciate ligament reconstruction. Clin Orthop 288:195–204

    PubMed  Google Scholar 

  2. Asano H, Muneta T, Shinomiya K (2002) Evaluation of clinical factors affecting knee pain after anterior cruciate ligament reconstruction. J Knee Surg 15:23–28

    PubMed  Google Scholar 

  3. Barber-Westin SD, Noyes FR, Andrews M (1997) A rigorous comparison between the sexes of results and complications after anterior cruciate ligament reconstruction. Am J Sports Med 25:514–526

    CAS  PubMed  Google Scholar 

  4. Barrett GR, Noojin FK, Hartzog CW, Nash CR (2002) Reconstruction of the anterior cruciate ligament in females: a comparison of hamstring versus patellar tendon autograft. Arthroscopy 18:46–54

    Google Scholar 

  5. Bjordal JM, Arnly F, Hannestad B, Strand T (1997) Epidemiology of anterior cruciate ligament injuries in soccer. Am J Sports Med 25:341–345

    CAS  PubMed  Google Scholar 

  6. Corry IS, Webb JM, Clingeleffer AJ, Pinczewski LA (1999) Arthroscopic reconstruction of anterior cruciate ligament: a comparison of patellar tendon autograft and four-strand hamstring tendon autograft. Am J Sports Med 27:444–454

    CAS  PubMed  Google Scholar 

  7. Ferrari JD, Bach BR Jr, Bush-Joseph CA, Wang T, Bojchuk J (2001) Anterior cruciate ligament reconstruction in men and women: an outcome analysis comparing gender. Arthroscopy 17:588–596

    Google Scholar 

  8. Ferretti A, Papandrea P, Conteduca F, Mariani PP (1992) Knee ligament injuries in volleyball players. Am J Sports Med 20:203–207

    CAS  PubMed  Google Scholar 

  9. Freedman KB, D’Amato MJ, Nedeff DD, Kaz A, Bach BR Jr (2003) Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med 31:2–11

    PubMed  Google Scholar 

  10. Gobbi A, Diara A, Mahajan S, Zanazzo M, Tuy B (2002) Patellar tendon anterior cruciate ligament reconstruction with conical press-fit femoral fixation: 5-year results in athletes population. Knee Surg Sports Traumatol Arthrosc 10:73–79

    Google Scholar 

  11. Gobbi A, Tuy B, Panuncialman, et al (2003) Quadrupled bone-semitendinosus ACL reconstruction: a clinical investigation in a group of athletes. Arthroscopy 19:691–699

    Google Scholar 

  12. Gobbi A, Zanazzo M, Tuy B, et al (2003) Patellar tendon versus quadrupled bone semitendinosus ACL reconstruction: a prospective clinical investigation in athletes. Arthroscopy 19:592–601

    Google Scholar 

  13. Hoher J, Bach T, Munster A, Bouillon B, Tilling T (1997) Does the mode of data collection change results in a subjective knee score? Self-administration versus interview. Am J Sports Med 25:642–647

    CAS  PubMed  Google Scholar 

  14. Kirkley A, Jackowski D, Litchfield R, Amendola A, Gauthier S, Fowler (2001) A gender comparison of hamstring tendon graft diameter during ACL reconstruction. Presented at the ISAKOS Congress, Montreux, Switzerland, 14–18 May

  15. Nagasaki S, Ohkoshi Y, Yamamoto K, Yamane S (2001) The effect of gender on knee laxity after ACL reconstruction. Presented at the ISAKOS Congress, Montreaux, Switzerland, 14–18 May

  16. Noojin FK, Barrett GR, Hartzog CW, Nash CR (2000) Clinical comparison of intra-articular anterior cruciate ligament reconstruction using autogenous semitendinosus and gracilis tendons in men versus women. Am J Sports Med 28:783–789

    CAS  PubMed  Google Scholar 

  17. Pinczewski LA, Deehan DJ, Salmon LJ, Russell J, Clingeleffer A (2002) A five-year comparison of patellar tendon versus four-strand hamstring tendon autograft for arthroscopic reconstruction of the anterior cruciate ligament. Am J Sports Med 30:523–536

    PubMed  Google Scholar 

  18. Shelbourne KD, Patel D, Martini DJ (1996) Classification and management of arthrofibrosis of the knee after anterior cruciate ligament reconstruction. Am J Sports Med 24:857–862

    CAS  PubMed  Google Scholar 

  19. Snyder-Mackler L, Fritzgerald GK, Bartolozzi AR, Cicotti MG (1997) The relationship between passive joint laxity and functional outcome after anterior cruciate ligament injury. Am J Sports Med 25:191–19517

    CAS  PubMed  Google Scholar 

  20. Weiler A, Unterhauser FN, Bail HJ et al (2002) Alpha-smooth muscle actin is expressed by fibroblastic cells of the oine anterior cruciate ligament and its free tendon graft during remodeling. J Orthop Res 20:310–317

    Article  CAS  PubMed  Google Scholar 

  21. Williams G, Gangel T, Arciero R, et al (1999) Comparison of the Single Assessment Numeric Evaluation method and two shoulder rating scales. Outcomes measures after shoulder surgery. Am J Sports Med 27:214–221

    CAS  PubMed  Google Scholar 

  22. Wojtys EM, Huston LJ (2000) Longitudinal effects of anterior cruciate ligament injury and patellar tendon autograft reconstruction on neuromuscular performance. Am J Sports Med 28:336–344

    CAS  PubMed  Google Scholar 

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Affiliations

  1. Orthopaedic Arthroscopic Surgery International, Via Amadeo 24, 20133 , Milan, Italy

    Alberto Gobbi, Marcin Domzalski & Jose Pascual

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  1. Alberto Gobbi
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  2. Marcin Domzalski
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  3. Jose Pascual
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Correspondence to Alberto Gobbi.

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Gobbi, A., Domzalski, M. & Pascual, J. Comparison of anterior cruciate ligament reconstruction in male and female athletes using the patellar tendon and hamstring autografts. Knee Surg Sports Traumatol Arthrosc 12, 534–539 (2004). https://doi.org/10.1007/s00167-003-0486-0

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  • DOI: https://doi.org/10.1007/s00167-003-0486-0

Keywords

  • Knee
  • Anterior cruciate ligament reconstruction
  • Gender differences
  • Patellar tendon
  • Hamstring