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Sex Differences in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: Data From the Swedish Knee Ligament Register.

Ageberg, Eva LU ; Forssblad, Magnus; Herbertsson, Pär LU and Roos, Ewa LU (2010) In American Journal of Sports Medicine 38(7). p.1334-1342
Abstract
BACKGROUND: Female gender is a risk factor for sustaining anterior cruciate ligament (ACL) injury. However, little is known about possible sex differences in patients with ACL injury/reconstruction. PURPOSE: To study sex differences in patient-reported outcomes before and at 1 and 2 years after ACL reconstruction and to present reference values. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Between 2005 and 2008, 10 164 patients (mean age, 27 years; SD, 9.8; 42% females) with primary ACL reconstruction were registered in the Swedish national knee ligament register. There were 4438 (44%) of these patients (42% females) who had completed the knee-specific questionnaire, Knee injury and Osteoarthritis Outcome Score (KOOS), and... (More)
BACKGROUND: Female gender is a risk factor for sustaining anterior cruciate ligament (ACL) injury. However, little is known about possible sex differences in patients with ACL injury/reconstruction. PURPOSE: To study sex differences in patient-reported outcomes before and at 1 and 2 years after ACL reconstruction and to present reference values. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Between 2005 and 2008, 10 164 patients (mean age, 27 years; SD, 9.8; 42% females) with primary ACL reconstruction were registered in the Swedish national knee ligament register. There were 4438 (44%) of these patients (42% females) who had completed the knee-specific questionnaire, Knee injury and Osteoarthritis Outcome Score (KOOS), and 5255 (52%) who had completed the generic score of health status, EQ-5D, before surgery and were included in this study. Independent t tests were used to study sex differences in KOOS and EQ-5D preoperatively, 1 and 2 years postoperatively, and over time. RESULTS: Preoperatively, female patients reported worse scores than male patients in 4 KOOS subscales (pain, symptoms, sport/recreation, quality of life) and EQ-5D, with the largest difference seen in KOOS sport/recreation (mean difference, 4.7; 95% confidence interval [CI], 3.0-6.3). At 1 year postoperatively, female patients reported worse scores than male patients in KOOS pain (mean difference, 1.4; 95% CI, 0.4-2.4) and KOOS sport/recreation (mean difference, 2.7; 95% CI, 0.9-4.4) and at 2 years postoperatively in KOOS sport/recreation (mean difference, 4.4; 95% CI, 2.1-6.7) and KOOS quality of life (mean difference, 2.4; 95% CI, 0.4-4.4). Female patients reported less improvement from 1 to 2 years postoperatively than male patients in KOOS sport/recreation (mean difference, 3.2; 95% CI, 0.3-6.1). In some age groups, female patients reported a clinically relevant worse KOOS sport/recreation score than male patients (mean difference >/=8). CONCLUSION: Female patients reported statistically significant worse outcomes than male patients before and at 1 and 2 years after ACL reconstruction. In some age groups, this difference was also clinically relevant. There were no clinically relevant sex differences in improvements over time. We suggest that possible sex differences be analyzed in future studies on evaluation after ACL injury/reconstruction. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
anterior cruciate ligament, patient outcome assessment, reconstructive, surgical procedures, gender
in
American Journal of Sports Medicine
volume
38
issue
7
pages
1334 - 1342
publisher
American Orthopaedic Society for Sports Medicine
external identifiers
  • wos:000279304200004
  • pmid:20410376
  • scopus:77954329356
ISSN
1552-3365
DOI
10.1177/0363546510361218
language
English
LU publication?
yes
id
525ce76e-8f20-45ab-a8fc-6a019735dff3 (old id 1594894)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20410376?dopt=Abstract
date added to LUP
2010-05-04 21:46:02
date last changed
2018-07-22 03:15:32
@article{525ce76e-8f20-45ab-a8fc-6a019735dff3,
  abstract     = {BACKGROUND: Female gender is a risk factor for sustaining anterior cruciate ligament (ACL) injury. However, little is known about possible sex differences in patients with ACL injury/reconstruction. PURPOSE: To study sex differences in patient-reported outcomes before and at 1 and 2 years after ACL reconstruction and to present reference values. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Between 2005 and 2008, 10 164 patients (mean age, 27 years; SD, 9.8; 42% females) with primary ACL reconstruction were registered in the Swedish national knee ligament register. There were 4438 (44%) of these patients (42% females) who had completed the knee-specific questionnaire, Knee injury and Osteoarthritis Outcome Score (KOOS), and 5255 (52%) who had completed the generic score of health status, EQ-5D, before surgery and were included in this study. Independent t tests were used to study sex differences in KOOS and EQ-5D preoperatively, 1 and 2 years postoperatively, and over time. RESULTS: Preoperatively, female patients reported worse scores than male patients in 4 KOOS subscales (pain, symptoms, sport/recreation, quality of life) and EQ-5D, with the largest difference seen in KOOS sport/recreation (mean difference, 4.7; 95% confidence interval [CI], 3.0-6.3). At 1 year postoperatively, female patients reported worse scores than male patients in KOOS pain (mean difference, 1.4; 95% CI, 0.4-2.4) and KOOS sport/recreation (mean difference, 2.7; 95% CI, 0.9-4.4) and at 2 years postoperatively in KOOS sport/recreation (mean difference, 4.4; 95% CI, 2.1-6.7) and KOOS quality of life (mean difference, 2.4; 95% CI, 0.4-4.4). Female patients reported less improvement from 1 to 2 years postoperatively than male patients in KOOS sport/recreation (mean difference, 3.2; 95% CI, 0.3-6.1). In some age groups, female patients reported a clinically relevant worse KOOS sport/recreation score than male patients (mean difference >/=8). CONCLUSION: Female patients reported statistically significant worse outcomes than male patients before and at 1 and 2 years after ACL reconstruction. In some age groups, this difference was also clinically relevant. There were no clinically relevant sex differences in improvements over time. We suggest that possible sex differences be analyzed in future studies on evaluation after ACL injury/reconstruction.},
  author       = {Ageberg, Eva and Forssblad, Magnus and Herbertsson, Pär and Roos, Ewa},
  issn         = {1552-3365},
  keyword      = {anterior cruciate ligament,patient outcome assessment,reconstructive,surgical procedures,gender},
  language     = {eng},
  number       = {7},
  pages        = {1334--1342},
  publisher    = {American Orthopaedic Society for Sports Medicine},
  series       = {American Journal of Sports Medicine},
  title        = {Sex Differences in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: Data From the Swedish Knee Ligament Register.},
  url          = {http://dx.doi.org/10.1177/0363546510361218},
  volume       = {38},
  year         = {2010},
}