{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T15:48:35Z","timestamp":1792079315086,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare early functional recovery and 5\u2010year clinical, sports and psychological outcomes after anterior cruciate ligament reconstruction (ACLR) according to sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included consecutive patients who underwent primary ACLR between January 2017 and December 2019, with standardized 6\u2010month functional and psychological assessment and available 5\u2010year follow\u2010up. Patients were analyzed according to sex. Baseline characteristics, 6\u2010month quadriceps strength and hop\u2010test performance, and 5\u2010year patient\u2010reported and sports outcomes were compared between groups. The primary outcome was recovery of preinjury activity level at 5 years, defined as a post\u2010operative Tegner score greater than or equal to the preoperative Tegner score. Multivariable logistic regression was used to identify factors independently associated with the primary outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 479 patients were included, comprising 173 women (36.1%) and 306 men (63.9%). At 6 months, men demonstrated higher quadriceps limb symmetry and lower hop\u2010test deficits than women, whereas anterior cruciate ligament return to sport after injury (ACL\u2010RSI) did not differ significantly between groups. At 5 years, overall return\u2010to\u2010sport rates were similar between sexes (187 [61.2%] men vs. 103 [59.5%] women,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.85), but men had higher post\u2010operative Tegner (6 [5\u20137] vs. 5 [4\u20137],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), IKDC (82.5 [75.7\u201387.3] vs. 79.5 [72.8\u201386.3],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and ACL\u2010RSI scores (77.5 [55.8\u201392.5] vs. 69.2 [53.3\u201385.8],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and were more likely to recover their preinjury activity level (137 [45.1%] vs. 48 [28.1%], p\u2009&lt;\u20090.001). In the baseline\u2010adjusted multivariable model, male sex was independently associated with recovery of preinjury activity level (odds ratio [OR]\u2009=\u20092.16, 95% confidence interval [CI]\u2009=\u20091.40\u20133.39;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). This association persisted after inclusion of 6\u2010month recovery variables (OR\u2009=\u20091.93, 95% CI\u2009=\u20091.20\u20133.15;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), while lower single\u2010hop deficit was also independently associated with the outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Men and women did not demonstrate the same recovery profile after ACLR. Early differences were mainly functional, whereas 5\u2010year differences involved recovery of preinjury activity level, subjective knee function and psychological readiness, despite similar overall return\u2010to\u2010sport rates. These findings suggest that return to sport should not be interpreted as equivalent recovery quality after ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70651","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T15:27:21Z","timestamp":1792078041000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex\u2010related differences after ACL reconstruction differ between early functional recovery and 5\u2010year outcomes"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4478-6650","authenticated-orcid":false,"given":"Thibault","family":"Marty\u2010Diloy","sequence":"first","affiliation":[{"name":"Clinique du Sport Bordeaux M\u00e9rignac M\u00e9rignac France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Graveleau","sequence":"additional","affiliation":[{"name":"Clinique du Sport Bordeaux M\u00e9rignac M\u00e9rignac France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8300-5653","authenticated-orcid":false,"given":"Nicolas","family":"Bouguennec","sequence":"additional","affiliation":[{"name":"Clinique du Sport Bordeaux M\u00e9rignac M\u00e9rignac France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-093842"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513489284"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07230-w"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1941738118786454"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05576-2"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05396-4"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1941738120978240"},{"issue":"6","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","DOI":"10.1177\/23259671251343073","article-title":"Establishing threshold values for the patient acceptable symptom state after anterior cruciate ligament reconstruction for the self knee value and the anterior cruciate ligament\u2010return to sport after injury scale","volume":"13","author":"Gerfroit A","year":"2025","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.12.032"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465251386027"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05774-y"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2024.10.013"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092299"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2025.104434"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518825258"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2015-095898"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/jisakos-2020-000495"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3261-5"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05703-z"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.17.00170"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4294-8"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120969425"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2007.09.003"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518773757"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-4893-7"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70651","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ksa.70651","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70651","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T15:27:22Z","timestamp":1792078042000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.70651"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":25,"alternative-id":["10.1002\/ksa.70651"],"URL":"https:\/\/doi.org\/10.1002\/ksa.70651","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]},"assertion":[{"value":"2026-05-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ksa.70651"}}