A Between Sex Comparison of Anterior-Posterior Knee Laxity after Anterior Cruciate Ligament Reconstruction with Patellar Tendon or Hamstrings Autograft
- 249 Downloads
Anterior-posterior (AP) knee laxity after anterior cruciate ligament (ACL) reconstruction may differ between sexes for different graft types. Females may experience an increase in AP knee laxity following an ACL reconstruction with a hamstrings graft, which is not seen in males with a hamstrings graft or in males or females with a bone-patellar tendon-bone (BTB) graft. The hypothesis of this review is sex differences in AP knee laxity and this will be identified in patients who undergo an ACL reconstruction with a hamstrings graft, while no sex differences will be observed in patients who have an ACL reconstruction with a BTB graft.
A systematic search was performed in PubMed, CINAHL® and SPORTDiscus™. Inclusion criteria were articles published in the English language that studied human subjects who underwent an ACL reconstruction with a BTB or hamstrings autograft, and the presence of a sex comparison on outcome measures including side-to-side difference in AP knee laxity. Methodological quality was assessed using a Modified Coleman Methodology Score. Eleven cohort studies met the inclusion criteria. Six investigated sex differences in both hamstrings and BTB grafts. Three only investigated BTB grafts and two only investigated hamstrings grafts. These studies consistently reported increases in AP knee laxity in females after an ACL reconstruction with a hamstrings graft that was not observed in the other cohorts. This systematic review indicates that female patients have greater AP knee laxity following an ACL reconstruction with a hamstrings autograft compared with males with a similar procedure, and both females and males following an ACL reconstruction with a BTB autograft. These results are derived from lower level evidence, as no randomized control trials have attempted to answer this question. Future studies need to rigorously address this clinical question to confirm the results currently in the literature.
KeywordsAnterior Cruciate Ligament Anterior Cruciate Ligament Reconstruction Patellar Tendon Knee Laxity Hamstring Graft
Unable to display preview. Download preview PDF.
- 24.Fu FH, Bennett CH, Ma CB, et al. Current trends in anterior cruciate ligament reconstruction. Part II: operative procedures and clinical correlations. Am J Sports Med 2000; 28 (1): 124–30Google Scholar
- 29.Coleman BD, Khan KM, Maffulli N, et al. Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports 2000; 10 (1): 2–11Google Scholar
- 46.Fitzgerald GK, Axe MJ, Snyder-Mackler L. The efficacy of perturbation training in nonoperative anterior cruciate ligament rehabilitation programs for physically active individuals including commentary by DeCarlo M, Irrgang J, Wilk K, and Rothstein J with author response (corrected) [published erratum appears in Phys Ther 2000; 80 (4): 416]. Phys Ther 2000; 80 (2): 128–51PubMedGoogle Scholar
- 48.Portney LG, Watkins MP. Foundations of clinical research: applications to practice. Upper Saddle River (NJ): Pearson Prentice Hall, 2009Google Scholar