It is tough being a guy. Despite popular assumptions that women’s knees are more prone to ligament injuries than are men’s, a major study in Sweden finds that men, at least in that country, have a greater number of anterior cruciate ligament (ACL) tears than do Swedish women. Moreover, men undergo more surgeries to repair them.
Gender Gap in ACL Tears
2 min read Premium comments
Secondary
According to Andrew M. Seaman, who wrote on July 6 in Reuters Health, the report is the first to count ACL injuries across the entire Swedish population and not just among the players of particular sports or who live in a certain region of the country. The study is published in the American Journal of Sports Medicine.
As Seaman explained, the ACL is the key stabilizing ligament in the knee, and is most often injured during sports that involve quick turns or pivoting movements, sports such as basketball, soccer and downhill skiing. Richard Nordenvall, M.D. of Karolinska University Hospital in Stockholm, and his colleagues used a nationwide database of patients to see how many Swedes had knee ligament injuries and how many had surgical repairs between 2002 and 2009.
Overall, 56, 659 people in Sweden tore a knee ligament during the study period which works out to an average of 78 tears for every 100, 000 Swedish citizens. Men accounted for about 34, 000 of those tears, or 60%. Men also had 59% of the reconstructive surgeries associated with knee ligament injuries.
Swedish women tended to experience ACL injuries at a younger age—between ages 11 and 20, versus 21-30 for men. When Nordenvall and his colleagues looked at the age groups with the highest injury rates, men still had far more knee troubles. The numbers worked out to about 144 tears per 100, 000 women between 11 and 20 years old and 225 tears per 100, 000 men aged 21-30.
Seaman estimates that 80, 000 cruciate ligament injuries, the majority of which are ACL, occur in the U.S. every year. Almost half are surgically repaired. He adds that the cost of surgical repair on an ACL ranges between $6, 000 and $8, 000 in the United States.
For Nordenvall, the next step is to follow up those who have had surgery. “I am right now studying if reconstruction of the cruciate ligament prevents development of osteoarthritis, ” he told Reuters Health. He wants people to understand how prevalent this injury is. “It’s a common injury and it’s more common than what has been thought of earlier, ” he said.
React:
Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
Join the conversation
Orthopedic professionals are discussing this. Sign in and upgrade to read every comment and add your voice.