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Clinical, fitness variables may explain differences in recovery between men and women after knee surgery
Rosenberger PH. Clin Orthop Relat Res. doi:10.1007/s11999-010-1562-7.
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Women have delayed recovery after arthroscopic partial meniscectomy, Yale University investigators found.
In this study, Patricia H. Rosenberger, PhD, and colleagues at Yale University in New Haven, Conn., examined how gender differences influence time to maximal recovery after arthroscopic partial meniscectomy. The study included 180 patients undergoing arthroscopic partial meniscectomy.
Preoperatively, the investigators evaluated gender, 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. They also recorded the extent of osteoarthritis after surgery. They used the Tegner-Lysholm scale to evaluate knee function preoperatively and postoperatively at weeks 1, 3, 8, 16, 24 and 48.
The results showed that women had worse knee function and delayed maximal recovery compared with men. Women required 1 year to achieve maximal recovery, whereas men needed 4 months. For women, the investigators saw a link between history of prior knee injury and lower self-reported fitness; they did not find this association in men. Although not related to gender, osteoarthritis was linked to slower recovery. Body mass index, length of time between injury/impairment and surgical evaluation and weekly exercise frequency did not affect recovery rate, the investigators found.
In this study, the authors looked at factors affecting the recovery after arthroscopic procedures. They evaluated 180 patients undergoing partial menisectomy. Sex, age, body mass index, history of prior injury, length of time between knee injury and surgical evaluation, weekly exercise frequency, and self-reported fitness and degenerative changes were assessed as possible factors affecting recovery.
The most important finding of this study was that female sex was associated with delayed recovery. For women, lower fitness level and prior knee injury negatively affected the outcome of partial menisectomy. Alignment, which was not evaluated in this study, could also contribute to the outcome, as females tend to be more in valgus than males.
This study emphasizes the importance of recognizing patient-specific factors that could negatively affect surgical outcome. Surgeons should evaluate for these factors, discuss them with their patients and attempt to treat them. An individualized approach tailored to the patient's wants and needs will result in the best possible outcome for each patient.
— Freddie H. Fu, MD, DSc(Hon), DPs(Hon)
Orthopedics Today Editorial Board member