Men at Risk for Knee Cartilage Damage

Although women are more likely to injure their anterior cruciate ligament (ACL), men with an ACL injury are more likely to develop a hole in their cartilage after surgical repair.

The ACL is one of four ligaments that connect the end of the femur (thighbone) to the top of the tibia (shinbone) at the knee. The ACL is in the middle of the knee, where it stabilizes the knee's rotation and prevents the tibia from dislocating.

Both male and female athletes who participate in sports that focus on jumping or tackling are prone to ACL injuries involving tears and overstretching. Those injuries are often repaired surgically, to reconstruct the torn ligament.

More men had lesions

Researchers at Akershus University Hospital in Lorenskog, Norway, looked at 15,800 people ages 8 to 69 who were treated surgically for ACL injuries between 2005 and 2008. They found that 6.4 percent had cartilage lesions. Among this subgroup of approximately 1,000 patients, 5.6 percent were women and 7 percent were men.

Orthopedic surgeon Matthew Matava, M.D., at the Washington University School of Medicine in St. Louis, says the findings were different from what he might have expected.

"It has been long known that girls have eight times the risk for an ACL injury than boys, due to the way they fire their quads and hamstrings in response to a sprain in the knee joint," says Dr. Matava. "So, in terms of cartilage injury risk, it's been assumed to be kind of the same situation in terms of gender."

Other risk factors

The researchers suggest that gender be added to the list of risk factors for cartilage lesions. Those factors already include advancing age, a history of past knee surgery, and a lag time of more than a year between injury and reconstructive surgery.

Another orthopedic expert says the findings should focus on the need to get ACL patients of either gender into surgery sooner rather than later, to reduce their overall risk for associated cartilage damage.

"Active people who are worried about doing more harm to their knee might consider surgery early after the injury, and not wait months or years," says C. David Geier Jr., M.D., at Medical University of South Carolina. "As orthopedic surgeons, we have few reliable options for reversing cartilage damage, and finding cartilage defects can potentially suggest poorer outcomes from ACL surgeries and long-term problems for those patients."

Always talk with your health care provider to find out more information.