Patient-reported outcome and healing biomarkers in patients treated by female versus male surgeons – a cohort study on achilles tendon ruptures

Abstract

Background. Woman and men practice medicine differently. One recent study showed that patients operated on by female surgeons exhibited better outcome. We hypothesized that the sex of the surgeon would not affect patient outcome, adverse events and the biological processes of healing after surgical repair of Achilles tendon rupture (ATR). Methods. A total of 111 patients with acute ATR were surgically repaired by the surgeon on duty. A specific surgeon could not be decided by the patient. At two-weeks, levels of healing biomarkers collagen I and III were quantified in microdialysates from the operated tendons. At 12-months post-surgery, patient-reported outcome was assessed using the validated Achilles tendon Total Rupture Score (ATRS), and adverse events were measured. Results. Patients treated by female versus male surgeons exhibited higher levels of collagen I (p=0.034) and reported better ATRS (88±8.2 vs. 81±14, p=0.011). Moreover, patients reported less limitations in daily living activity, more strength and less stiffness in the ankle when treated on by female as compared to male surgeons (all p<0.05). No significant difference in the incidence of adverse events was observed between male and female surgeons. Conclusions. The present findings suggest further exploration of the determinating factors including care and communication related to surgeons to improve outcome.