title: Is gender influencing the biomechanical results after autologous chondrocyte implantation?
abstract: OBJECTIVE
  The influence of gender on the biomechanical outcome after autologous chondrocyte implantation (ACI) including isokinetic muscle strength measurements has not been investigated. The present prospective study was performed to evaluate gender-specific differences in the biomechanical function 48 months after ACI.
  
  
  METHODS
  Fifty-two patients (mean age 35.6 ± 8.5 years) that met our inclusion criteria, underwent ACI with Bioseed C(®) and were evaluated with the KOOS score preoperatively, 6, 12 and 48 months after surgery. At final follow-up, 44 out of the 52 patients underwent biomechanical evaluation with isokinetic strength measurements of both knees. All data were evaluated separately for men and women and compared for each time interval using the Mann-Whitney U test.
  
  
  RESULTS
  Clinical scores improved significantly over the whole study period (p < 0.05). Male patients demonstrated significantly better scores during the follow-up in the KOOS score (p < 0.05). Isokinetic strength measurements after 48 months revealed a significant strength deficit of the treated knee in all test modes compared to the healthy extremity (p < 0.05). Furthermore, male patients achieved significantly higher strength values compared to female patients (p < 0.05).
  
  
  CONCLUSIONS
  ACI is a viable treatment option for full-thickness chondral defects in the knee of both genders. Isokinetic muscle strength measures are significantly worse in women (p < 0.05), but physiological and may play a role for the explanation of gender-specific results after ACI.
authors.affiliation: Department of Orthopaedic Surgery, University Medical Center Rostock, Doberanerstr. 142, 18057, Rostock, Germany, peter.kreuz@uni-rostock.de.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Kreuz
authors.forename: Sebastian
authors.initials: S
authors.lastname: Müller
authors.forename: Christoph
authors.initials: C
authors.lastname: Erggelet
authors.forename: Arvind
authors.initials: A
authors.lastname: von Keudell
authors.forename: Thomas
authors.initials: T
authors.lastname: Tischer
authors.forename: Christian
authors.initials: C
authors.lastname: Kaps
authors.forename: Philipp
authors.initials: P
authors.lastname: Niemeyer
authors.forename: Anja
authors.initials: A
authors.lastname: Hirschmüller
mesh_terms: D000328:Adult; D064592:Autografts; D001696:Biomechanical Phenomena; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D019637:Orthopedic Procedures / Q000379:methods*; D011446:Prospective Studies; D012737:Sex Factors; D014182:Transplantation, Autologous