Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 12/2010

01.12.2010 | Clinical Research

Sex Differences in Factors Influencing Recovery from Arthroscopic Knee Surgery

verfasst von: Patricia H. Rosenberger, PhD, Firdaus S. Dhabhar, PhD, Elissa Epel, PhD, Peter Jokl, MD, Jeannette R. Ickovics, PhD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 12/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

Many factors affect recovery from arthroscopic partial meniscectomy, including patient sex. However, sex differences in time to maximal recovery of knee function and factors influencing differential rates of recovery are unknown.

Questions/purposes

We determined (1) preoperative sex differences, (2) sex differences in rate and extent of recovery through 1 year postoperatively, and (3) clinical and fitness variables that could explain potential sex differences in recovery from partial meniscectomy.

Patients and Methods

The study sample consisted of 180 patients undergoing arthroscopic partial meniscectomy. Sex, age, body mass index, history of prior injury, length of time between knee injury/impairment and surgical evaluation, weekly exercise frequency, and self-reported fitness were assessed preoperatively, and extent of osteoarthritis was recorded postoperatively. We used the Tegner-Lysholm scale to assess knee function preoperatively and postoperatively at Weeks 1, 3, 8, 16, 24, and 48 followups.

Results

Females had worse knee function and delayed maximal recovery, requiring 1 year, compared with males, who required only 4 months. History of prior knee injury and lower self-reported fitness were associated with slower recovery in females but not in males. Osteoarthritis was associated with slower recovery but not related to sex. Body mass index, length of time between injury/impairment and surgical evaluation, and weekly exercise frequency did not influence rate of recovery.

Conclusions

Females have delayed recovery after arthroscopic partial meniscectomy. Prior knee injury and self-reported low fitness are associated with delayed recovery for females but not for males.

Level of Evidence

Level I, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Cameron ML, Briggs KK, Steadman JR. Reproducibility and reliability of the Outerbridge classification for grading chondral lesions of the knee arthroscopically. Am J Sports Med. 2003;31:83–86.PubMed Cameron ML, Briggs KK, Steadman JR. Reproducibility and reliability of the Outerbridge classification for grading chondral lesions of the knee arthroscopically. Am J Sports Med. 2003;31:83–86.PubMed
2.
Zurück zum Zitat Daniel DM. Selecting patients for ACL surgery. In: Jackson DW, Arnoczky SP, Woo S, Frank C, Simon T, eds. The Anterior Cruciate Ligament: Current and Future Concepts. New York, NY: Raven Press; 1993. Daniel DM. Selecting patients for ACL surgery. In: Jackson DW, Arnoczky SP, Woo S, Frank C, Simon T, eds. The Anterior Cruciate Ligament: Current and Future Concepts. New York, NY: Raven Press; 1993.
3.
Zurück zum Zitat Donner A, Klar N. Statistical considerations in the design and analysis of community intervention trials. J Clin Epidemiol. 1996;49:435–439.CrossRefPubMed Donner A, Klar N. Statistical considerations in the design and analysis of community intervention trials. J Clin Epidemiol. 1996;49:435–439.CrossRefPubMed
4.
Zurück zum Zitat Fabricant PD, Rosenberger PH, Jokl P, Ickovics J. Surgical outcomes after arthroscopic partial meniscectomy. J Am Acad Orthop Surg. 2007;15:647–653.PubMed Fabricant PD, Rosenberger PH, Jokl P, Ickovics J. Surgical outcomes after arthroscopic partial meniscectomy. J Am Acad Orthop Surg. 2007;15:647–653.PubMed
5.
Zurück zum Zitat Hedeker D, Gibbons RD, Waternaux C. Sample size estimation for longitudinal designs with attrition: comparing time-related contrasts between two groups. J Educ Behav Stat. 1999;24:70–93. Hedeker D, Gibbons RD, Waternaux C. Sample size estimation for longitudinal designs with attrition: comparing time-related contrasts between two groups. J Educ Behav Stat. 1999;24:70–93.
6.
Zurück zum Zitat Hoser C, Fink C, Brown C, Reichkendler M, Hackl W, Bartlett J. Long-term results of arthroscopic partial lateral meniscectomy in knees without associated damage. J Bone Joint Surg Br. 2001;83:513–516.CrossRefPubMed Hoser C, Fink C, Brown C, Reichkendler M, Hackl W, Bartlett J. Long-term results of arthroscopic partial lateral meniscectomy in knees without associated damage. J Bone Joint Surg Br. 2001;83:513–516.CrossRefPubMed
7.
Zurück zum Zitat Johnson DL, Fu FH. Anterior cruciate ligament reconstruction: why do failures occur? Instr Course Lect. 1995;44:391–406.PubMed Johnson DL, Fu FH. Anterior cruciate ligament reconstruction: why do failures occur? Instr Course Lect. 1995;44:391–406.PubMed
8.
Zurück zum Zitat Kartus JT, Russell VJ, Salmon LJ, Magnusson LC, Brandsson S, Pehrsson NG, Pinczewski LA. Concomitant partial meniscectomy worsens outcome after arthroscopic anterior cruciate ligament reconstruction. Acta Orthop Scand. 2002;73:179–185.CrossRefPubMed Kartus JT, Russell VJ, Salmon LJ, Magnusson LC, Brandsson S, Pehrsson NG, Pinczewski LA. Concomitant partial meniscectomy worsens outcome after arthroscopic anterior cruciate ligament reconstruction. Acta Orthop Scand. 2002;73:179–185.CrossRefPubMed
9.
Zurück zum Zitat Katz JN, Wright EA, Guadagnoli E, Liang MH, Karlson EW, Cleary PD. Differences between men and females undergoing major orthopedic surgery for degenerative arthritis. Arthritis Rheum. 1994;37:687–694.CrossRefPubMed Katz JN, Wright EA, Guadagnoli E, Liang MH, Karlson EW, Cleary PD. Differences between men and females undergoing major orthopedic surgery for degenerative arthritis. Arthritis Rheum. 1994;37:687–694.CrossRefPubMed
10.
Zurück zum Zitat Marx RG, Jones EC, Allen AA, Altchek DW, O’Brien SJ, Rodeo SA, Williams RJ, Warren RF, Wickiewicz TL. Reliability, validity, and responsiveness of four knee outcome scales for athletic patients. J Bone Joint Surg Am. 2001;83:1459–1469.PubMed Marx RG, Jones EC, Allen AA, Altchek DW, O’Brien SJ, Rodeo SA, Williams RJ, Warren RF, Wickiewicz TL. Reliability, validity, and responsiveness of four knee outcome scales for athletic patients. J Bone Joint Surg Am. 2001;83:1459–1469.PubMed
11.
Zurück zum Zitat McConville OR, Kipnis JM, Richmond JC, Rocket SE, Michaud MJ. The effect of meniscal status on knee stability and function after anterior cruciate ligament reconstruction. Arthroscopy. 1993;9:431–439.CrossRefPubMed McConville OR, Kipnis JM, Richmond JC, Rocket SE, Michaud MJ. The effect of meniscal status on knee stability and function after anterior cruciate ligament reconstruction. Arthroscopy. 1993;9:431–439.CrossRefPubMed
12.
Zurück zum Zitat Murray D. Design and Analysis of Group-randomized Trials. New York, NY: Oxford University Press; 1998. Murray D. Design and Analysis of Group-randomized Trials. New York, NY: Oxford University Press; 1998.
13.
Zurück zum Zitat O’Conner MI. Sex differences in osteoarthritis of the hip and knee. J Am Acad Orthop Surg. 2007;15(suppl 1):S22–S25. O’Conner MI. Sex differences in osteoarthritis of the hip and knee. J Am Acad Orthop Surg. 2007;15(suppl 1):S22–S25.
14.
Zurück zum Zitat Rosenberger PH, Ickovics JR, Epel E, Nadler E, Jokl P, Fulkerson JP, Tillie JM, Dhabhar FS. Surgical stress induced immune cell redistribution profiles predict short-term and long-term postsurgical recovery: a prospective study. J Bone Joint Surg Am. 2009;91:2783–2794.CrossRefPubMed Rosenberger PH, Ickovics JR, Epel E, Nadler E, Jokl P, Fulkerson JP, Tillie JM, Dhabhar FS. Surgical stress induced immune cell redistribution profiles predict short-term and long-term postsurgical recovery: a prospective study. J Bone Joint Surg Am. 2009;91:2783–2794.CrossRefPubMed
15.
Zurück zum Zitat Rosenberger PH, Ickovics JR, Epel ES, D’Entremont D, Jokl P. Physical recovery in arthroscopic knee surgery: unique contributions of coping behaviors to clinical outcomes and stress reactivity. Psychol Health. 2004;19:307–320.CrossRef Rosenberger PH, Ickovics JR, Epel ES, D’Entremont D, Jokl P. Physical recovery in arthroscopic knee surgery: unique contributions of coping behaviors to clinical outcomes and stress reactivity. Psychol Health. 2004;19:307–320.CrossRef
16.
Zurück zum Zitat Rosenberger PH, Jokl P, Ickovics JR. Psychosocial factors and surgical outcome: an evidence-based literature review. J Am Acad Orthop Surg. 2006;14:397–405.PubMed Rosenberger PH, Jokl P, Ickovics JR. Psychosocial factors and surgical outcome: an evidence-based literature review. J Am Acad Orthop Surg. 2006;14:397–405.PubMed
17.
Zurück zum Zitat Schimmer RC, Brulhart KB, Duff C, Glinz W. Arthroscopic partial meniscectomy: a 12-year follow-up and two-step evaluation of the long-term course. Arthroscopy. 1998;14:136–142.CrossRefPubMed Schimmer RC, Brulhart KB, Duff C, Glinz W. Arthroscopic partial meniscectomy: a 12-year follow-up and two-step evaluation of the long-term course. Arthroscopy. 1998;14:136–142.CrossRefPubMed
18.
Zurück zum Zitat Singh JA, Gabriel S, Lewallen D. The impact of gender, age, and preoperative pain severity on pain after TKA. Clin Orthop Relat Res. 2008;466:2717–2723.CrossRefPubMed Singh JA, Gabriel S, Lewallen D. The impact of gender, age, and preoperative pain severity on pain after TKA. Clin Orthop Relat Res. 2008;466:2717–2723.CrossRefPubMed
19.
Zurück zum Zitat Swenson TM, Harner CD. Knee ligament and meniscal injuries: current concepts. Orthop Clin North Am. 1995;26:529–546.PubMed Swenson TM, Harner CD. Knee ligament and meniscal injuries: current concepts. Orthop Clin North Am. 1995;26:529–546.PubMed
20.
Zurück zum Zitat Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;198:43–49.PubMed Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;198:43–49.PubMed
21.
Zurück zum Zitat Tosi LL, Boyan BD, Boskey AL. Does sex matter in musculoskeletal health? A workshop report. Orthop Clin North Am. 2006;37:523–529.CrossRefPubMed Tosi LL, Boyan BD, Boskey AL. Does sex matter in musculoskeletal health? A workshop report. Orthop Clin North Am. 2006;37:523–529.CrossRefPubMed
22.
Zurück zum Zitat Weitzel PP, Richmond JC. Critical evaluation of different scoring systems of the knee. Sports Med Arthrosc. 2002;10;183–190.CrossRef Weitzel PP, Richmond JC. Critical evaluation of different scoring systems of the knee. Sports Med Arthrosc. 2002;10;183–190.CrossRef
Metadaten
Titel
Sex Differences in Factors Influencing Recovery from Arthroscopic Knee Surgery
verfasst von
Patricia H. Rosenberger, PhD
Firdaus S. Dhabhar, PhD
Elissa Epel, PhD
Peter Jokl, MD
Jeannette R. Ickovics, PhD
Publikationsdatum
01.12.2010
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 12/2010
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1562-7

Weitere Artikel der Ausgabe 12/2010

Clinical Orthopaedics and Related Research® 12/2010 Zur Ausgabe

Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society

Cemented Total Hip Arthroplasty With Subtrochanteric Osteotomy in Dysplastic Hips

Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society

Algorithm for Femoral and Periacetabular Osteotomies in Complex Hip Deformities

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.