title: Gender differences following computer-navigated single- and double-bundle anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  Female patients not only demonstrate an increased risk for injury, but also a poorer response following anterior cruciate ligament (ACL) rupture. However, no study has investigated gender-related differences between computer-navigated single-bundle (SB) and double-bundle (DB) ACL reconstruction. The aim of this study was to evaluate the effects of gender on the outcome of computer-navigated SB and DB ACL reconstruction and to present reference values.
  
  
  METHODS
  A retrospective review of 55 consecutive patients who underwent SB (15 males, 12 females) and DB (18 males, 10 females) ACL reconstruction with autogenous hamstring tendon grafts and showed a minimum follow-up of 24 months was conducted. Intraoperatively, the anteroposterior and rotational laxity were measured and the follow-up examination included pivot-shift testing, KT-1000 arthrometer testing, International Knee Documentation Committee (IKDC) form, the Lysholm score and Tegner score.
  
  
  RESULTS
  Pre-operatively, female patients showed a significant higher internal rotation in (p < 0.001) both the SB and DB group. Regarding the post-operative reduction in internal rotation, females in the SB group revealed a greater reduction compared to males (p < 0.001), whereas females in the DB group revealed a significantly greater post-operative reduction in anterior-posterior translation (p = 0.04). Female patients following DB ACL reconstruction presented a significant worse IKDC score, Lysholm score and Tegner score compared to male patients. All score values of the female DB group were worse than in the female SB group. In contrast, male patients showed better results of all examined clinical scores following DB procedure compared to SB technique.
  
  
  CONCLUSIONS
  Female patients who underwent computer-navigated DB ACL reconstruction exhibited significantly worse outcome scores than males who underwent DB ACL reconstruction. The gender-based relationship between joint function and outcome after ACL reconstruction remains unclear and requires further investigation.
  
  
  METHODS
  Retrospective case-control series, Level III.
authors.affiliation: Department of Trauma Surgery, General Hospital, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria, silke.aldrian@meduniwien.ac.at.
authors.forename: S
authors.initials: S
authors.lastname: Aldrian
authors.forename: P
authors.initials: P
authors.lastname: Valentin
authors.forename: B
authors.initials: B
authors.lastname: Wondrasch
authors.forename: I
authors.initials: I
authors.lastname: Krusche-Mandl
authors.forename: R C
authors.initials: RC
authors.lastname: Ostermann
authors.forename: P
authors.initials: P
authors.lastname: Platzer
authors.forename: M
authors.initials: M
authors.lastname: Hofbauer
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000601:surgery*; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012399:Rotation; D012737:Sex Factors; D025321:Surgery, Computer-Assisted; D013710:Tendons / Q000637:transplantation; D016896:Treatment Outcome; D055815:Young Adult
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