Sex differences in factors influencing recovery from arthroscopic knee surgery

Background: Many factors affect recovery from arthroscopic partial meniscectomy, including patient sex. However, sex differences in time to maximal recovery of knee function and factors influencing differential rates of recovery are unknown. Questions/purposes: We determined (1) preoperative sex differences, (2) sex differences in rate and extent of recovery through 1 year postoperatively, and (3) clinical and fitness variables that could explain potential sex differences in recovery from partial meniscectomy. Patients and Methods: The study sample consisted of 180 patients undergoing arthroscopic partial meniscectomy. Sex, 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 were assessed preoperatively, and extent of osteoarthritis was recorded postoperatively. We used the Tegner-Lysholm scale to assess knee function preoperatively and postoperatively at Weeks 1, 3, 8, 16, 24, and 48 followups. Results: Females had worse knee function and delayed maximal recovery, requiring 1 year, compared with males, who required only 4 months. History of prior knee injury and lower self-reported fitness were associated with slower recovery in females but not in males. Osteoarthritis was associated with slower recovery but not related to sex. Body mass index, length of time between injury/impairment and surgical evaluation, and weekly exercise frequency did not influence rate of recovery. Conclusions: Females have delayed recovery after arthroscopic partial meniscectomy. Prior knee injury and self-reported low fitness are associated with delayed recovery for females but not for males. Level of Evidence: Level I, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.