Knee stability after posterior cruciate ligament reconstruction in female versus male patients: a prospective matched-group analysis

Abstract

Purpose: To analyze outcome differences after posterior cruciate ligament (PCL) reconstruction in male and female patients.

Methods: A prospective database of 234 PCL reconstructions (53 female and 181 male patients) with either isolated or combined procedures was analyzed. Patients were followed up for a mean of 62 months (range, 34 to 110 months) by use of stress radiography and the International Knee Documentation Committee score. We included 32 female patients for a matched-group analysis and compared them with 32 matching male patients. Matching parameters were number/type of reconstructed ligaments, revision/primary surgery, autograft/allograft use, preoperative tibial displacement, time interval from injury to surgery, follow-up interval, and age.

Results: There was no preoperative difference in posterior stress radiographs (12.9 ± 3.0 mm in female patients and 13.2 ± 2.3 mm in male patients). After surgery, both groups showed a significant reduction in posterior displacement (6.0 ± 2.5 mm [54% reduction] in female patients and 7.8 ± 2.2 mm [40% reduction] in male patients). There was a significant greater reduction of posterior laxity in female patients. International Knee Documentation Committee scoring showed a significant improvement in both groups.

Conclusions: We found in this specific patient series a superior reduction of posterior tibial laxity in female patients compared with male patients, indicating that possible gender-related differences exist after PCL surgery.

Level of evidence: Level III, retrospective comparative study using prospective data.