Comparative Influence of Sport Type on Outcome After Anterior Cruciate Ligament Reconstruction at Minimum 2-Year Follow-up

Nwachukwu, Benedict U.; Voleti, Pramod B.; Chang, Brenda; Berkanish, Patricia; Mahony, Gregory T.; Williams, Riley J.; Altchek, David W.; Allen, Answorth A.

doi:10.1016/j.arthro.2016.08.012

Cited by 15 publications

(17 citation statements)

References 30 publications

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“…That study found that skiers had significantly lower baseline outcome scores on the IKDC and Lysholm ( P < .05) and trended toward lower outcome scores on the Tegner and Marx ( P = .05) compared with those who participated in other sports. 23 In the present study, there were no significant differences in outcomes at baseline between skiers and non-skiers ( P > .05) for KOOS and IKDC. However, non-skiers demonstrated significantly higher baseline Marx scores ( P < .001) compared with skiers of all ages.…”

Section: Discussioncontrasting

confidence: 62%

“…Although several studies exist on the high incidence of ACL tears in skiing (incidence range, 7.1%-27.7%) 12,18,24 –26,28 and return to skiing after ACLR (return rate, 40%-80%), 10,13,16,22 few studies have focused on comparing PROs after primary ACLR between skiers and non-skiers. One study by Nwachukwu et al 23 compared PROs between skiers (n = 67) and participants in other sports including soccer, basketball, lacrosse, football, and tennis (n = 227). That study found that skiers had significantly lower baseline outcome scores on the IKDC and Lysholm ( P < .05) and trended toward lower outcome scores on the Tegner and Marx ( P = .05) compared with those who participated in other sports.…”

Section: Discussionmentioning

confidence: 99%

“…16,24 However, the majority of studies reporting outcomes after ACL reconstruction (ACLR) have included patients who are young and/or who are elite athletes. 10,13,22 A recent study by Nwachukwu et al 23 investigated differences among sport types for patient-reported outcomes (PROs) after ACLR. In that study, the investigators demonstrated that competitive skiers had significantly lower baseline International Knee Documentation Committee (IKDC) scores ( P = .08) and Lysholm scores ( P = .03) compared with other sports; however, the investigators did not include a subgroup analysis of the PROs by patient age.…”

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confidence: 99%

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Do Older Skiers Have Worse Outcomes After Anterior Cruciate Ligament Reconstruction Compared With Non-Skiers or Younger Skiers?

Schumacher

Houck

Vidal

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: There remains a paucity of literature comparing clinical outcomes after anterior cruciate ligament reconstruction (ACLR) between skiers and non-skiers, particularly in older patient populations. Purpose: To compare clinical outcomes after ACLR between skiers and non-skiers, with a subanalysis based on age. Study Design: Cohort study; Level of evidence, 3. Methods: A nested cohort of 128 patients from the Multicenter Orthopaedic Outcomes Network cohort who underwent primary ACLR completed a series of patient-reported outcomes pre- and postoperatively at 2 and 6 years including the Knee injury and Osteoarthritis Outcome Score (KOOS), Marx Activity Rating Scale, and subjective International Knee Documentation Committee (IKDC) score. Data including patient sex, age at surgery, graft type, and sport participation were analyzed. Patients were stratified by participation in skiing (skiers vs non-skiers) and by age subgroup (≤29, 30-39, and ≥40 years). Student t tests and analysis of variance were used to compare mean improvement between pre- and postoperative outcomes. Results: A total of 44 skiers (female, 59.1%; age, 35.3 ± 11.6 years) and 84 non-skiers (female, 34.5%; age, 27.7 ± 11.3 years) were included. ACLR was performed using allograft in 36.7% (22 skiers, 25 non-skiers), autograft in 58.6% (19 skiers, 56 non-skiers), or hybrid autograft-allograft in 4.7% (3 skiers, 3 non-skiers). Although both non-skiers and skiers demonstrated improvements in outcomes from baseline to 2 and 6 years, non-skiers demonstrated significantly less overall improvement from 2 to 6 years postoperatively in KOOS Symptoms ( P = .01), KOOS Pain ( P = .002), and KOOS Activities of Daily Living ( P = .03) subscales compared with skiers. There were 15 skiers who were 29 years or younger (34.1%), 14 skiers between 30 and 39 years (31.8%), and 15 skiers 40 years or older (34.1%). Skiers 40 years and older demonstrated significantly greater mean improvement in KOOS Symptoms ( P = .02) and KOOS Quality of Life (QoL) ( P = .01) subscales at 2 years and KOOS QoL ( P = .01) at 6 years postoperatively compared with skiers 29 years or younger. Conclusion: Compared with non-skiers, skiers demonstrated significantly greater mean improvements in KOOS scores between 2 and 6 years after ACLR. In addition, skiers 40 years or older showed greater improvement in KOOS QoL compared with younger skiers. This information can be used to counsel skiers, especially those older than 40 years, as to their expected outcomes after ACLR.

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Do Older Skiers Have Worse Outcomes After Anterior Cruciate Ligament Reconstruction Compared With Non-Skiers or Younger Skiers?

Schumacher

Houck

Vidal

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…There was very little change between 1 year, 2 years and 5 years postoperatively. The overall decrease in the Marx activity scale postoperatively has also been reported for patients undergoing ACL reconstruction [ 37 , 44 ].…”

Section: Resultsmentioning

confidence: 71%

Satisfactory patient-reported outcomes at 5 years following primary repair with suture tape augmentation for proximal anterior cruciate ligament tears

Hopper

Aithie

Jenkins

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose An enhanced understanding of anterior cruciate ligament (ACL) healing and advancements in arthroscopic instrumentation has resulted in a renewed interest in ACL repair. Augmentation of a ligament repair with suture tape reinforces the ligament and acts as a secondary stabilizer. This study assesses the 5-year patient-reported outcomes of primary repair with suture tape augmentation for proximal ACL tears. Methods Thirty-seven consecutive patients undergoing ACL repair with suture tape augmentation for an acute proximal rupture were prospectively followed up for a minimum of 5 years. Patients with midsubstance and distal ruptures, poor ACL tissue quality, retracted ACL remnants and multiligament injuries were excluded. Patient-reported outcome measures were collated using the Knee Injury and Osteoarthritis Outcomes Score (KOOS), Visual Analogue Pain Scale (VAS-pain), Veterans RAND 12-Item Health Survey (VR-12) and the Marx Activity Scale. Patients with a re-rupture were identified. Results Three patients were lost to follow-up leaving 34 patients in the final analysis (91.9%). The mean KOOS at 5 years was 88.5 (SD 13.8) which improved significantly from 48.7 (SD 18.3) preoperatively (p < 0.01). The VAS score improved from 2.3 (SD 1.7) to 1.0 (SD 1.5) and the VR-12 score improved from 35.9 (SD 10.3) to 52.4 (SD 5.9) at 5 years (p < 0.01). However, the Marx activity scale decreased from 12.4 (SD 3.4) pre-injury to 7.3 (SD 5.2) at 5 years (p = 0.02). Six patients had a re-rupture (17.6%) and have since undergone a conventional ACL reconstruction for their revision surgery with no issues since then. These patients were found to be younger and have higher initial Marx activity scores than the rest of the cohort (p < 0.05). Conclusion Primary repair with suture tape augmentation for proximal ACL tears demonstrates satisfactory outcomes in 28 patients (82.4%) at 5-year follow-up. Six patients sustained a re-rupture and have no ongoing problems following treatment with a conventional ACL reconstruction. These patients were significantly younger and had higher initial Marx activity scores. Level of evidence Level IV.

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“…Subjective outcomes after surgery, such as the IKDC score, have been reported to vary by sport. 21 ACL injury rates vary depending on the type of sport in which athletes participate and the presence or absence of contact. 19 Thus, in terms of psychological readiness after reconstruction, it is important to clarify the characteristics of each type of sport in which athletes participate.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Psychological Readiness to Return to Sports With Cutting, Pivoting, and Jump-Landings After Primary ACL Reconstruction

Aizawa

Hirohata

Ohji

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: High psychological readiness is an important element for returning to sports after anterior cruciate ligament (ACL) reconstruction. Identifying factors that contribute to psychological readiness is essential for planning interventions to return to play. No studies have used multivariate analysis to clarify factors associated with psychological readiness to return to specific sports. Hypothesis: To identify factors that contribute to an athlete’s psychological readiness to return after ACL reconstruction to sports that require cutting, pivoting, and jump-landings. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Study participants were athletes who before injury had participated in sports with limited contact that required cutting, pivoting, and jump-landings (basketball, soccer, futsal, volleyball, badminton, tennis, and frisbee) and hoped to return to the same sport after reconstruction. Psychological readiness was measured using the Anterior Cruciate Ligament–Return to Sport After Injury Scale (ACL-RSI) in athletes more than 6 months after primary ACL reconstruction. To clarify factors associated with the ACL-RSI, univariate regression analysis and multivariate regression analysis were performed using the following independent variables: age, sex, body mass index, time from injury to reconstruction, time from reconstruction to testing, meniscal surgery, modified Tegner activity scale before injury, kinesiophobia, limb symmetry index of knee strength, limb symmetry indices of single-leg hop (SLH) distances, and subjective running ability. Results: Higher subjective running ability, a lower kinesiophobia score, and greater limb symmetry in the lateral SLH were positively associated with psychological readiness. Conclusion: The psychological readiness of athletes aiming to return after ACL reconstruction to limited-contact sports that require cutting, pivoting, and jump-landings was affected by subjective running ability, kinesiophobia, and asymmetry of lateral SLH distance. This information may be useful in planning appropriate interventions and thereby increasing the likelihood of an athlete’s returning to such sports.

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Comparative Influence of Sport Type on Outcome After Anterior Cruciate Ligament Reconstruction at Minimum 2-Year Follow-up

Cited by 15 publications

References 30 publications

Do Older Skiers Have Worse Outcomes After Anterior Cruciate Ligament Reconstruction Compared With Non-Skiers or Younger Skiers?

Do Older Skiers Have Worse Outcomes After Anterior Cruciate Ligament Reconstruction Compared With Non-Skiers or Younger Skiers?

Satisfactory patient-reported outcomes at 5 years following primary repair with suture tape augmentation for proximal anterior cruciate ligament tears

Factors Associated With Psychological Readiness to Return to Sports With Cutting, Pivoting, and Jump-Landings After Primary ACL Reconstruction

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