title: Impact of Patient Sex on Clinical Outcomes: Data From an Anterior Cruciate Ligament Reconstruction Registry, 2008-2013.
abstract: BACKGROUND
  The Combined Quality Care Anterior Cruciate Ligament registry provides data for clinical research regarding primary anterior cruciate ligament (ACL) surgery.
  
  
  OBJECTIVE
  To explore the data with regard to the clinical outcomes between sexes after ACL reconstruction in a Dutch population.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  Data involving patients diagnosed with an ACL tear and eligible for surgery were recorded. Isokinetic muscle strength, functional muscle performance, and anterior-posterior translation of the knee joint were documented preoperatively and at 3, 6, 9, and 12 months postoperatively. Patients completed the Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm, and Tegner rating scales during each examination using a web-based questionnaire.
  
  
  RESULTS
  Approximately 90% of ACL injuries occurred during sport activities. The mean (SD) age at surgery was 28 (11) years for both men and women, and the majority of patients were treated with hamstring tendon autografts (94%). Four percent received bone-patellar tendon-bone autografts, and 2% of the patients received other grafts. Preoperatively, the KOOS, Lysholm, and Tegner scores were significantly higher in males. Twelve months postoperatively, both sexes showed comparable isokinetic strength (P = .336), knee laxity (P = .680), and hop test for distance (P = .122) when comparing the injured with the uninjured side. Self-reported knee function was comparable between sexes as assessed by the KOOS (P = .202), Lysholm (P = .872), and Tegner (P = .767) questionnaires during the 12-month follow-up.
  
  
  CONCLUSIONS
  One year after ACL surgery, all patients had improved greatly, showing only minor differences between sexes. The male group showed slightly better results when evaluating self-reported knee questionnaires. Comparable outcomes and knee function between sexes can therefore be presumed with patients who are treated with hamstring tendon autografts in a Dutch population.
  
  
  CONCLUSIONS
  These results can be used during the clinical evaluation of patients who are eligible for ACL reconstruction.
authors.affiliation: Department of Physical Therapy, Medicort Sports and Orthopedic Care, Naarden, the Netherlands. ; Combined Quality Care, Naarden, the Netherlands.
authors.forename: Xavier M
authors.initials: XM
authors.lastname: Teitsma
authors.affiliation: Combined Quality Care, Naarden, the Netherlands. ; Department of Orthopaedics, Bergman Clinics, Naarden, the Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: van der Hoeven
authors.affiliation: Department of Physical Therapy, Medicort Sports and Orthopedic Care, Naarden, the Netherlands. ; Combined Quality Care, Naarden, the Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: Tamminga
authors.affiliation: Department of Epidemiology and School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: Rob A
authors.initials: RA
authors.lastname: de Bie
keywords: anterior cruciate ligament; clinical outcome; epidemiology; sexes