Female patients had worse clinical outcomes after MPFL reconstruction vs. male patients
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COLORADO SPRINGS, Colo. — Female patients had worse clinical outcomes after medial patellofemoral ligament reconstruction compared with male patients, according to results presented here.
Kirk A. Campbell, MD, and colleagues retrospectively evaluated Kujala score, VAS score, patient satisfaction, willingness to undergo surgery again, revisions, return to play and MPFL-return to sport after injury score among 131 patients who underwent MPFL reconstruction for symptomatic patellar instability. Researchers compared clinical outcomes between male (30%) and female (69.5%) patients.
“In terms of outcomes, there were no significant differences found between sexes in terms of VAS at rest, Kujala score or mean satisfaction,” Campbell said in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting.
Campbell noted male patients had significantly higher return to sport rates compared with female patients. Male patients also had significantly lower VAS scores during sport activities, according to Campbell.
“The psychological ratings on return to sport after MPFL reconstruction was found to be significantly higher in male patients, with a score of 56 determined to be psychologically ready,” Campbell said. “None of the female patients met that.”
Although female patients tended to want to undergo the procedure again compared with male patients, he noted this was not significant.
“Subjective recurrent instability, again, no significant differences; although, it did trend to be a bit higher in our female patients,” Campbell said.
Perspective
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Though I did not have the advantage of reading the article in its entirety, I was present for the AOSSM presentation and its question-and-answer session. I do believe that sex-based differences merit further investigation; however, this finding has to be understood in the context of the following:
- Female patients report pain differently than male patients, frequently at higher rates.
- We do not know if the anatomic risk factors were similar between the groups. Seeing as female patients had higher rates of additional surgery and higher rates of subjective instability, it is possible that we are not comparing comparable patient anatomy for a similar procedure.
- Return to sports for both male and female patients are age dependent, particularly for female patients. There are many social reasons why female patients do not return to sport that are unrelated to their surgical procedure.
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Markus D, et al. Paper 52. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 13-17, 2022; Colorado Springs, Colo.
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