CONTEXT

Patient reported outcomes (PROs) are utilized to track recovery and inform clinical decision-making following anterior cruciate ligament reconstruction (ACLR). It remains unclear if sex influences the trajectory of improvements in PROs over time post-ACLR.

OBJECTIVE

1) to examine the effect of sex on the association between months post-ACLR and Knee Osteoarthritis Outcome Scores (KOOS) Quality of Life (QOL) scores in individuals with ACLR; and 2) to assess sex differences in KOOS QOL at selected timepoints post-ACLR.

DESIGN

Cross-sectional

SETTING

Laboratory

PATIENTS OR OTHER PARTICIPANTS

133 females (20±3 yrs) and 85 males (22±4 yrs) within 6–60 months of primary, unilateral ACLR.

MAIN OUTCOME MEASURES

KOOS QOL was completed at a single follow-up timepoint post-ACLR. A multivariate, linear regression model was utilized to assess the interaction of sex on the association between months post-ACLR and KOOS QOL. Sex-specific, linear regression models were then used to predict KOOS QOL estimated marginal means (EMM) at each clinical timepoint (6,12, 24, 36, 48 and 60 months post-ACLR) and compared between sex.

RESULTS

In the primary model (R2=0.16, p<0.0001), a significant interaction existed between sex and time post-ACLR (β=−0.46, p<0.01). Greater months post-ACLR associated with better KOOS QOL for males (R2=0.29, β=0.69, p<0.001); months post-ACLR was a weaker predictor of KOOS QOL for females (R2=0.04, β=0.23, p<0.02). EMM for KOOS QOL were significantly greater for males in comparison to females at 36 (t210=2.76, p<0.01), 48 (t210=3.02, p<0.01), and 60 months post-ACLR (t210=3.09, p=0.02).

CONCLUSION

Males appear to exhibit PROs improvement post-ACLR at increasing months post-ACLR, while females do not demonstrate the same magnitude of linear increase in KOOS QOL. Females may require extended intervention to improve clinical outcomes post-ACLR and address a plateau in QOL.

This content is only available as a PDF.