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Higher Rates of Residual Postoperative Instability after Anterior Cruciate Ligament Reconstruction in Female Patients: A Systematic Review of Level II Studies
PURPOSE: To compare revision rates and residual postoperative instability after anterior cruciate ligament (ACL) reconstruction based on biological sex. METHODS: A systematic review was conducted according to the 2020 PRISMA guidelines. PubMed, Embase, MEDLINE, and Cochrane library databases were qu...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407150/ https://www.ncbi.nlm.nih.gov/pubmed/37560145 http://dx.doi.org/10.1016/j.asmr.2023.100772 |
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author | Jackson, Garrett R. Lee, Jonathan Tuthill, Trevor Chan, Jimmy Sugrañes, Joan Mowers, Colton C. Batra, Anjay Khan, Zeeshan A. Mameri, Enzo S. Brusalis, Christopher M. Chahla, Jorge Verma, Nikhil N. |
author_facet | Jackson, Garrett R. Lee, Jonathan Tuthill, Trevor Chan, Jimmy Sugrañes, Joan Mowers, Colton C. Batra, Anjay Khan, Zeeshan A. Mameri, Enzo S. Brusalis, Christopher M. Chahla, Jorge Verma, Nikhil N. |
author_sort | Jackson, Garrett R. |
collection | PubMed |
description | PURPOSE: To compare revision rates and residual postoperative instability after anterior cruciate ligament (ACL) reconstruction based on biological sex. METHODS: A systematic review was conducted according to the 2020 PRISMA guidelines. PubMed, Embase, MEDLINE, and Cochrane library databases were queried from database inception through October 2022. Level I and II prospectively-enrolling human clinical studies that compared revision rates and physical examination of postoperative stability after ACL reconstruction between male and female patients were included. Outcomes were stratified by patient sex and quantitatively compared using a χ(2) test. Study quality was assessed using the MINORS criteria. RESULTS: Four studies consisting of 406 patients (50% males) with a mean age of 25 years (range, 13.9-62 years) were identified. Mean follow-up time was 34.4 months (range, 22-60 months). Hamstring tendon autografts were used in 62% of ACL reconstructions in males and in 65% of ACL reconstructions in females, whereas bone-patellar tendon-bone autografts were used in 38% and 35% of procedures in males and females, respectively. A residual positive Lachman test result was more frequently reported among females compared to males (5.8% vs 0.6%; P = 0.03). No significant difference in revision rates or residual pivot-shift on examination was observed between males and females (P = 0.38 and P = 0.08, respectively). CONCLUSION: Female patients undergoing ACL reconstruction have higher reported rates of residual anterior instability with Lachman than male patients. However, no sex-based differences were identified with residual pivot-shift on examination or rate of revision ACL surgery. LEVEL OF EVIDENCE: II; Systematic Review of level II studies. |
format | Online Article Text |
id | pubmed-10407150 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-104071502023-08-09 Higher Rates of Residual Postoperative Instability after Anterior Cruciate Ligament Reconstruction in Female Patients: A Systematic Review of Level II Studies Jackson, Garrett R. Lee, Jonathan Tuthill, Trevor Chan, Jimmy Sugrañes, Joan Mowers, Colton C. Batra, Anjay Khan, Zeeshan A. Mameri, Enzo S. Brusalis, Christopher M. Chahla, Jorge Verma, Nikhil N. Arthrosc Sports Med Rehabil Systematic Review PURPOSE: To compare revision rates and residual postoperative instability after anterior cruciate ligament (ACL) reconstruction based on biological sex. METHODS: A systematic review was conducted according to the 2020 PRISMA guidelines. PubMed, Embase, MEDLINE, and Cochrane library databases were queried from database inception through October 2022. Level I and II prospectively-enrolling human clinical studies that compared revision rates and physical examination of postoperative stability after ACL reconstruction between male and female patients were included. Outcomes were stratified by patient sex and quantitatively compared using a χ(2) test. Study quality was assessed using the MINORS criteria. RESULTS: Four studies consisting of 406 patients (50% males) with a mean age of 25 years (range, 13.9-62 years) were identified. Mean follow-up time was 34.4 months (range, 22-60 months). Hamstring tendon autografts were used in 62% of ACL reconstructions in males and in 65% of ACL reconstructions in females, whereas bone-patellar tendon-bone autografts were used in 38% and 35% of procedures in males and females, respectively. A residual positive Lachman test result was more frequently reported among females compared to males (5.8% vs 0.6%; P = 0.03). No significant difference in revision rates or residual pivot-shift on examination was observed between males and females (P = 0.38 and P = 0.08, respectively). CONCLUSION: Female patients undergoing ACL reconstruction have higher reported rates of residual anterior instability with Lachman than male patients. However, no sex-based differences were identified with residual pivot-shift on examination or rate of revision ACL surgery. LEVEL OF EVIDENCE: II; Systematic Review of level II studies. Elsevier 2023-07-29 /pmc/articles/PMC10407150/ /pubmed/37560145 http://dx.doi.org/10.1016/j.asmr.2023.100772 Text en © 2023 Published by Elsevier Inc. on behalf of the Arthroscopy Association of North America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Systematic Review Jackson, Garrett R. Lee, Jonathan Tuthill, Trevor Chan, Jimmy Sugrañes, Joan Mowers, Colton C. Batra, Anjay Khan, Zeeshan A. Mameri, Enzo S. Brusalis, Christopher M. Chahla, Jorge Verma, Nikhil N. Higher Rates of Residual Postoperative Instability after Anterior Cruciate Ligament Reconstruction in Female Patients: A Systematic Review of Level II Studies |
title | Higher Rates of Residual Postoperative Instability after Anterior Cruciate Ligament Reconstruction in Female Patients: A Systematic Review of Level II Studies |
title_full | Higher Rates of Residual Postoperative Instability after Anterior Cruciate Ligament Reconstruction in Female Patients: A Systematic Review of Level II Studies |
title_fullStr | Higher Rates of Residual Postoperative Instability after Anterior Cruciate Ligament Reconstruction in Female Patients: A Systematic Review of Level II Studies |
title_full_unstemmed | Higher Rates of Residual Postoperative Instability after Anterior Cruciate Ligament Reconstruction in Female Patients: A Systematic Review of Level II Studies |
title_short | Higher Rates of Residual Postoperative Instability after Anterior Cruciate Ligament Reconstruction in Female Patients: A Systematic Review of Level II Studies |
title_sort | higher rates of residual postoperative instability after anterior cruciate ligament reconstruction in female patients: a systematic review of level ii studies |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407150/ https://www.ncbi.nlm.nih.gov/pubmed/37560145 http://dx.doi.org/10.1016/j.asmr.2023.100772 |
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