ACL reconstruction: do outcomes differ by sex? A systematic review

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomechanical research

Background:

• Anterior cruciate ligament (ACL) reconstruction is a common surgical procedure for knee instability after ACL injury.
• Female sex is a known risk factor for ACL tears, but its impact on post-reconstruction outcomes is not well-established.
• Previous research has not definitively determined if sex influences ACL reconstruction success rates.

Purpose of the Study:

• To investigate potential sex-based differences in outcomes following ACL reconstruction.
• To compare graft failure rates, contralateral ACL injury incidence, knee laxity, and patient-reported outcomes between male and female patients undergoing ACL reconstruction.

Main Methods:

• A systematic literature review was conducted to identify relevant studies.
• Studies reporting ACL reconstruction outcomes stratified by sex at a minimum two-year follow-up were included.
• Meta-analysis was performed on homogenous data to synthesize findings.

Main Results:

• Thirteen studies met the inclusion criteria for the review.
• Meta-analysis showed no significant differences in graft failure risk between sexes.
• No significant differences were found in contralateral ACL rupture risk, postoperative knee laxity, or patient-reported outcomes based on sex.

Conclusions:

• Outcomes of ACL reconstruction appear to be comparable between male and female patients.
• The findings suggest that sex does not significantly impact the success of ACL reconstruction.
• Further high-quality research is recommended to validate these results and explore potential nuances.