Can Gender and Time Affect your Injury?

 Knee injuries in sports have been known to be very common.  Specifically anterior cruciate ligament (ACL) injuries.  Males and females can suffer from knee injuries whether their sport involves or does not involve contact.  Not only to athletes, but to every human, the knee is a crucial part to the human body.  Obviously, without a knee there would be no way for a human to walk, run, jump or do regular every day things.  Depending on the knee injury, people can be kept out of activity for several months, then has to go through rehab for even longer. 

            Studies have shown that males have more meniscal tears than females, which may be due to the fact that males play sports that involve a higher level of contact.  After having surgery done to repair a person’s knee, that person is expected to have a more stable and more functional knee.  A possible long- term risk that has been seen after ACL injuries and surgeries is osteoarthritis.  Scientists are trying to find out about patients outcomes at least ten years after the ACL reconstruction was done and whether sex and graft choice will have an effect on the patient- reported outcomes.

            Scientists have conducted studies that have shown that males have more meniscal tears than females, which may be due to the fact that males play sports that involve a higher level of contact, but cannot be completely proven because there are knee injuries of unknown causes, or even non- contact or non sport- related injuries.  There have been three studies that analyze the outcomes depending on the sex of the patient.  Barenius et al noted that there was no significant differences in KOOS based on patient sex, while Bourke et al and Labet et al also noted no significant difference based on sex, but this time in subjective IKDC scores.  The data they had to collect in order to get their results included the technique, type of graft, femoral and tibial fixation, time to partial and full weight bearing, brace use and time to full activity.  Scientists have also checked as to whether the graft choice would create different outcomes in patients after the repair of their ACL.

            There were four studies that evaluated the impact of autograft choice on patient- reported outcomes.  Barenius et al conducted a randomized control trial that once again noted no significant difference in the KOOS subscales based on graft choice.  Like Barenius et al, Holm et al also noted no differences in any of the Cincinnati and Lysholm scores based on graft choice.  Sajovek et al also agreed with Holm et al and lastly, Bourke et al along with the other scientists noticed no significant differences based on graft type, but in subjective IKDC scores.

            Based on these results, there were generally good outcomes that were reported by the patients after ten years or more after their surgery.  As stated before, the performed studies proved that sex and graft choice had no effect on the patients reported outcomes.  Something that did differ by sex was predictors of comorbid intra-articular injuries.  Some scientists hypothesized that predictors of intra- articular injuries and meniscal tear management would differ by sex and their findings supported this hypothesis.  They were able to identify sex- specific predictors of meniscal and chondral lesions in patients that were undergoing ACL reconstruction.  The data they had to collect in order to get their findings included sex, date of the injury, age at injury, body mass index (BMI), which side was injured, history of any surgeries and the type of injury.  Male predictors included age, BMI, type of injury, interval from ACL injury to surgery and number of instability episodes.   Whereas female predictors included only age, BMI and number of instability episodes. 

            People may be wondering why scientists are doing these studies and how it will benefit those with knee injuries, but what they do not realize is that finding differences that have to do with gender will allow them to do further research to hopefully treat knee injuries more effectively.  Also, discovering the long term problems will also help them to fix the surgical factors that are not allowing patients to have a completely stable knee.

References:

Melissa A. Kluczynski,* MS, John M. Marzo,* MD, Michael A. Rauh,* MD, Geoffrey A. Bernas,* MD, and Leslie J. Bisson,*† MD Investigation performed at the University at Buffalo, The State University of New York, Buffalo, New York, USA (February 2015)

Robert A. Magnussen,*†‡ MD, Megan Verlage,†‡ AB, David C. Flanigan,†‡ MD, Christopher C. Kaeding,†‡ MD, and Kurt P. Spindler,§ MD Investigation performed at The Ohio State University, Columbus, Ohio, USA (March 2015)