Purpose
The purpose of this study was to evaluate the impact of patient sex on outcomes after
treatment of osteochondritis dissecans (OCD) lesions of the knee through a systematic
review of current evidence.
Methods
This review was conducted according to the PRISMA guidelines using the PubMed, PubMed
Central, Embase, Ovid Medline, Cochrane Libraries, and the Cumulative Index to Nursing
and Allied Health Literature (CINAHL) databases. Relevant outcomes included functional
(e.g., International Knee Documentation Committee and Subjective Knee Evaluation,
Lysholm Knee Score) and clinical outcomes (e.g., symptom/pain resolution, reoperation
rates) for males and females after operative or nonoperative treatment of knee OCD
lesions.
Results
Ten articles with a total of 691 (73%) males and 260 (27%) females were included.
Mean age ranged from 11.3 ± 2.1 years to 34.5 ± 10.3 years, and follow-up ranged from
6 months to 16.3 years. In four studies reporting functional outcomes, no significant
differences were found between males and females in any metric assessed (all P > .05). Seven studies reported clinical outcomes after treatment of knee OCD lesions.
One study determined males were more likely to have a successful nonoperative outcome
than females (OR: 1.85, 95% CI: 1.00-3.40). Another study found males had a lower
risk of developing symptomatic knee pain following operative or nonoperative treatment
at a mean 14-year follow-up (HR: 0.24; 95% CI: 0.07-0.81). The remaining 5 studies
reported statistically comparable clinical outcomes between males and females (all
P > .05).
Conclusion
The present systematic review found mostly comparable clinical and functional outcomes
between males and females following treatment of knee OCD lesions. Despite sex-related
differences in the prevalence of these lesions and limited evidence of differences
in clinical outcomes, these data suggest that sex does not independently predict outcomes
after treatment.
Level of Evidence
III, systematic review of Level II and III studies.
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Article info
Publication history
Published online: March 22, 2022
Accepted:
March 2,
2022
Received:
October 10,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: B.V. reports personal fees from DePuy Synthes Products, Inc., and research support from Stryker, outside the submitted work. M.K.M reports personal fees and nonfinancial support from Arthrex, personal fees from Alon Medical Technology; outside the submitted work. She is a board or committee member of AAOS, American Orthopaedic Association, and the American Orthopaedic Society for Sports Medicine. She is on the editorial or governing board of the American Journal of Sports Medicine, Electronic Media, and Arthroscopy. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
