青少年前交叉韧带重建术的性别特异性结局：一项倾向评分匹配队列研究
简介
该研究基于TriNetX数据库，纳入12–19岁青少年ACL重建患者，通过倾向评分匹配（1:1）控制年龄、肥胖及半月板修复等因素，比较男女术后并发症差异。关键发现：术后3个月，男性康复利用率更高（33.7% vs 31.1%）；术后6个月及1–2年，女性麻醉下手法松解及粘连松解率显著高于男性（均P<0.001），提示女性术后僵硬风险更高；但两组在ACL翻修、…
英文摘要
BACKGROUND: Sex-related differences in outcomes after adolescent anterior cruciate ligament reconstruction (ACLR) remain inadequately characterized in the literature. Preliminary studies suggest potential sex-based differences in postoperative complications, although findings regarding specific adverse outcomes remain inconsistent. PURPOSE: To evaluate sex-specific differences in postoperative complications after adolescent ACLR in a multicenter cohort with propensity matching and 2-year follow-up. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Data were retrospectively extracted from the TriNetX Research Network. Adolescents aged between 12 and 19 years who underwent ACLR were identified using Current Procedural Terminology codes. Male and female cohorts were propensity score-matched (1:1) for age, obesity, and concomitant meniscal repair. Outcomes at 3, 6, 12 months, and 2 years included subsequent ACLR revision, subsequent meniscal surgery, and other postoperative complications. Odds ratios with 95% CIs were calculated. RESULTS: A total of 7793 adolescents per sex were propensity-matched. At 3 months, male adolescents had greater rehabilitation utilization (33.7% vs 31.1%; P = .003). At 6 months, female adolescents had higher manipulation under anesthesia (MUA), and lysis of adhesions (all, P < .001), whereas rehabilitation use remained higher in male adolescents (P = .02). At 1- and 2-year follow-up, female patients experienced higher rates of MUA and lysis of adhesions (all, P < .001). No differences were observed in subsequent ACLR, meniscal surgery, or any knee reoperation. CONCLUSION: Distinct postoperative complication profiles were observed between male and female adolescents after ACLR. Female patients consistently demonstrated a higher likelihood of postoperative stiffness requiring secondary procedures. In contrast, no sex-based differences were identified in subsequent meniscal surgery or revision ACLR. These findings highlight postoperative stiffness as a sex-specific complication in adolescents and underscore the importance of incorporating sex-based considerations into postoperative monitoring and future outcome-focused research.