A Rigorous Comparison Between the Sexes of Results and Complications After Anterior Cruciate Ligament Reconstruction

Although there is a higher relative incidence of anterior cruciate ligament injuries in female than in comparable male athletes according to the literature, the majority of populations studied after reconstruction are male-dom inated. We wished to determine whether a selection bias for reconstruction based on sex is warranted ac cording to complications and outcome. Ninety-four pa tients (47 of each sex) were matched for chronicity of injury, age, preoperative sports activity levels, articular cartilage condition, and months of followup. All had patellar tendon autogenous reconstruction and a sim ilar program of immediate knee motion and early return to function. The results were rated with the Cincinnati Knee Rating System. At a mean of 26 months postop eratively, there were no significant differences for com plications or outcome between men and women. Women required an average of six more rehabilitation visits than men; however, none required additional surgery for knee motion complications and the rate of patellofemoral crepitus conversion was only 7%, lower than that found for men (15%). The overall failure rate was low, only 6% for women and 4% for men. We concluded that the functional rehabilitation program was effective, postoperative complications were few, and no scientific basis exists to use sex alone as a selection criteria for anterior cruciate ligament reconstruction.