Gender-Based Differences in Outcome After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction With Hamstring Tendon Autografts
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概要
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Background: Although previous studies suggested that female patients are predisposed to increase graft laxity compared with male patients after single-bundle anterior cruciate ligament (ACL) reconstruction using autogenous hamstring tendons, there have been no studies specifically examining gender-based differences in outcome after anatomic double-bundle ACL reconstruction with hamstring tendon autografts. Hypotheses: 1) Female patients would have significantly smaller hamstring graft diameters than did men for anatomical double-bundle ACL reconstruction surgery; 2) Female patients would have increased graft laxity compared with male patients after anatomical double-bundle ACL reconstruction using autogenous hamstring tendons. Study Design: Cohort study. Methods: The consecutive 174 patients who underwent anatomic double-bundle ACL reconstruction using autogenous hamstring tendons were enrolled. Of these subjects, 49 women and 73 men were prospectively evaluated 2 years after surgery. Results: The diameters for anteromedial and posterolateral grafts in the female group were significantly smaller than those in the male group. On Lachman testing, 98% of the female group and 97% of the male group were rated as negative. Regarding the pivot-shift test, 80% of the female group and 85% of the male group were rated as negative. No significant differences were found between the female and male groups in these tests. The average side-to-side differences in the KT-2000 knee ligament arthrometer values were 1.3 mm in the female group and 1.4 mm in the male group; this difference between females and males was not statistically significant. The average Lysholm scores were 96.7 points in the female group and 97.2 points in the male group. 73% of the female group and 74% of the male group were graded as normal on the IKDC evaluation. There were no significant differences in Lysholm score or IKDC evaluation between the female and male groups. Conclusion: The results of assessment for ligament laxity at the 2-year postoperative evaluation in the female group were approximately identical to those of the male group after anatomical double-bundle ACL reconstruction using autogenous hamstring tendons. Therefore, the present study suggests that anatomical double-bundle ACL reconstruction using autogenous hamstring tendons provides satisfactory knee stability to female patients as well as male patients.
著者
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Yasuda Kazunori
北海道大学 医学研究科人工関節･再生医学
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Yasuda Kazunori
Department Of Sports Medicine And Joint Reconstruction Surgery Hokkaido University Graduate School O
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