Abstract
Background
The purpose of this study was to investigate risk factors affecting anterior cruciate
ligament (ACL) tears and outcomes following ACL reconstruction in males versus females.
This study also analyzed oral contraceptive pill (OCP) use, demographics (e.g., body
mass index [BMI], age group), comorbidities (e.g., diabetes, hypertension), and post-operative
systemic complications (e.g., anemia, malignant hyperthermia) in patients undergoing
ACL reconstruction.
Methods
Medical records of patients undergoing ACL reconstruction from 2010–2018 were queried
from the PearlDiver administrative claims database current procedural terminology
(CPT) and international classification of disease (ICD) codes. The following information
was collected using ICD-9/ICD-10 codes: concurrent use of OCPs, concomitant meniscus
repair, demographics, age, comorbidities, and systemic complications. The number of
ACL reconstructions in females and males were analyzed using multivariate regressions.
Results
Of 11,498 ACL reconstructions, 5,967 (51.9%) were in females and 5,531 (48.1%) were
in males. The majority of patients were ages 15–19 (24.1%) and were not obese (BMI < 30 kg/m2) (35.9%). A greater proportion of female patients undergoing ACL reconstruction were
between 15–19 years old (P < 0.001) and obese (BMI > 40 kg/m2) (P < 0.001). A larger proportion of females aged 15–39 taking OCPs underwent ACL
reconstruction compared to those not taking OCPs within the same age group (P < 0.001).
Conclusion
ACL tears are more common in female patients compared to males and are more commonly
treated with ACL reconstruction. This study identified several factors that may be
associated with the increased risk of ACL tears in females, including young age (age
15–39), obesity (BMI > 40 kg/m2), and the use of OCPs prior to ACL reconstruction, which warrant further investigation
and attention from surgeons.
Keywords
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Article info
Publication history
Published online: November 23, 2022
Accepted:
November 3,
2022
Received in revised form:
September 11,
2022
Received:
June 4,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
