Gender differences following computer-navigated single- and double-bundle anterior cruciate ligament reconstruction

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomechanical research

Background:

• Female patients face higher risks and poorer outcomes after anterior cruciate ligament (ACL) rupture.
• Existing research lacks gender-specific comparisons for computer-navigated single-bundle (SB) versus double-bundle (DB) ACL reconstruction.

Purpose of the Study:

• To evaluate gender-based differences in outcomes following computer-navigated SB and DB ACL reconstruction.
• To establish reference values for gender and technique in ACL reconstruction outcomes.

Main Methods:

• Retrospective review of 55 patients (SB: 15 males, 12 females; DB: 18 males, 10 females) undergoing ACL reconstruction with autogenous hamstring grafts.
• Minimum 24-month follow-up including intraoperative laxity measurements and clinical assessments (pivot-shift, KT-1000, IKDC, Lysholm, Tegner scores).

Main Results:

• Pre-operatively, females exhibited higher internal rotation in both SB and DB groups.
• Post-operatively, females in the SB group showed greater internal rotation reduction; females in the DB group showed greater anterior-posterior translation reduction.
• Female patients undergoing DB ACL reconstruction had significantly worse IKDC, Lysholm, and Tegner scores compared to males, with all scores lower than the female SB group. Male patients showed better results with DB compared to SB.

Conclusions:

• Computer-navigated double-bundle ACL reconstruction resulted in significantly worse outcomes for female patients compared to males.
• The complex relationship between gender, joint function, and ACL reconstruction outcomes requires further investigation.