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Are men more likely to have ACL issues

Q: I'm an orthopedic surgical nurse. I notice a lot of guys of all ages coming in these days for ACL repairs. Are men more likely to have these injuries or just more willing to have surgery? I know women are participating in sports and susceptible to ACL tears. I just don't see them in our operating room.

A: That's an interesting observation that might actually be true across the board. At least according to one large study from Kaiser Permanente, it looks like females make up more of the younger age group with anterior cruciate ligament (ACL) injuries.

This finding might reflect the fact that females tend to peak in sports participation earlier and at a younger age than males. Men tend to participate in active sports longer so they injure themselves across a broader range of ages.

The information for each patient in this study who was treated surgically to reconstruct a ruptured ACL was placed into the computer database. Information included patient demographics (age, occupation, sex, date-of-injury, date-of-surgery). The record for each patient also included type of soft tissue injury and results of surgical repair (repair rates).

Being male and older age were also risk factors for meniscal and cartilage injuries. Men were at greater risk of lateral meniscus injury and combined injuries (e.g., ACL tear plus meniscus AND cartilage damage).

The presence of combined injuries in males might also account for the higher number of patients who have surgery for this problem. It's possible that women are able to recover sufficiently without surgery by following a rehab program. Studies are needed to confirm the differences between males and females pursuing surgery for ACL reconstruction.

Reference: Ankur M. Chhadia, MD, et al. Are Meniscus and Cartilage Injuries Related to Time to Anterior Cruciate Ligament Reconstruction? In The American Journal of Sports Medicine. September 2011. Vol. 39. No. 9. Pp. 1894-1899.