Liza Kneebone , Peter Edwards , Nic Blackah , Ross Radic , Peter D’Alessandro , Jay R. Ebert
{"title":"Sex-based differences in physical and psychological recovery, and return to sport, following anterior cruciate ligament reconstruction","authors":"Liza Kneebone , Peter Edwards , Nic Blackah , Ross Radic , Peter D’Alessandro , Jay R. Ebert","doi":"10.1016/j.knee.2024.10.013","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>A robust comparison of the recovery pathway between sexes after anterior cruciate ligament reconstruction (ACLR) is lacking. This study investigated sex-based differences in physical and psychological recovery, and return to sport (RTS), after ACLR.</div></div><div><h3>Methods</h3><div>104 community-level patients underwent ACLR. Patients were evaluated at 6-, 12- and 24-months with the Anterior Cruciate Ligament Return to Sport after Injury Scale (ACL-RSI), International Knee Documentation Committee (IKDC) form and Tegner Activity Scale (TAS), a 4-hop test battery including the 6-meter timed hop (6MTH) and the single (SHD), triple (THD) and triple crossover (TCHD) hop tests for distance, and peak isokinetic knee extensor and flexor torque. Sex-based differences were assessed, while regression analysis modelled the relationship between patient characteristics and outcomes, with 24-month psychological readiness to RTS.</div></div><div><h3>Results</h3><div>All PROMS improved (p < 0.05), with males reporting higher 24-month ACL-RSI (p = 0.002), IKDC (p = 0.007) and TAS (p = 0.005) scores. A greater percentage of males returned to pivoting sports at 24 months (p = 0.030, males 60.0%, females 40.8%). Males demonstrated higher knee extensor strength LSIs at 6 (p = 0.037) and 24 (p = 0.047) months, and higher knee flexor strength LSIs at 6 (p = 0.007) and 12 (p = 0.002) months. IKDC knee scores (β = 24.9; 95% CI, 10.8 to 35.0), male sex (β = 12.2; 95% CI, 3.9 to 20.4) and the 6MTH LSI (β = 1.31; 95% CI, 0.6 to 2.1) were associated with the ACL-RSI.</div></div><div><h3>Conclusions</h3><div>In community-level ACLR patients, females demonstrated lower physical performance recovery, subjective function and psychological readiness, as well as a lower rate of RTS.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 22-31"},"PeriodicalIF":1.6000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0968016024001923","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
A robust comparison of the recovery pathway between sexes after anterior cruciate ligament reconstruction (ACLR) is lacking. This study investigated sex-based differences in physical and psychological recovery, and return to sport (RTS), after ACLR.
Methods
104 community-level patients underwent ACLR. Patients were evaluated at 6-, 12- and 24-months with the Anterior Cruciate Ligament Return to Sport after Injury Scale (ACL-RSI), International Knee Documentation Committee (IKDC) form and Tegner Activity Scale (TAS), a 4-hop test battery including the 6-meter timed hop (6MTH) and the single (SHD), triple (THD) and triple crossover (TCHD) hop tests for distance, and peak isokinetic knee extensor and flexor torque. Sex-based differences were assessed, while regression analysis modelled the relationship between patient characteristics and outcomes, with 24-month psychological readiness to RTS.
Results
All PROMS improved (p < 0.05), with males reporting higher 24-month ACL-RSI (p = 0.002), IKDC (p = 0.007) and TAS (p = 0.005) scores. A greater percentage of males returned to pivoting sports at 24 months (p = 0.030, males 60.0%, females 40.8%). Males demonstrated higher knee extensor strength LSIs at 6 (p = 0.037) and 24 (p = 0.047) months, and higher knee flexor strength LSIs at 6 (p = 0.007) and 12 (p = 0.002) months. IKDC knee scores (β = 24.9; 95% CI, 10.8 to 35.0), male sex (β = 12.2; 95% CI, 3.9 to 20.4) and the 6MTH LSI (β = 1.31; 95% CI, 0.6 to 2.1) were associated with the ACL-RSI.
Conclusions
In community-level ACLR patients, females demonstrated lower physical performance recovery, subjective function and psychological readiness, as well as a lower rate of RTS.
期刊介绍:
The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee.
The topics covered include, but are not limited to:
• Anatomy, physiology, morphology and biochemistry;
• Biomechanical studies;
• Advances in the development of prosthetic, orthotic and augmentation devices;
• Imaging and diagnostic techniques;
• Pathology;
• Trauma;
• Surgery;
• Rehabilitation.