Risk Factors for Recurrent Anterior Cruciate Ligament Reconstruction

Wasserstein, David; Khoshbin, Amir; Dwyer, Tim; Chahal, Jaskarndip; Gandhi, Rajiv; Mahomed, Nizar N.

doi:10.1177/0363546513493580

Cited by 108 publications

(83 citation statements)

References 50 publications

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“…Furthermore, while excluding meniscal reoperation in the setting of concomitant revision ACL reconstruction, we found that patients requiring reoperation were significantly younger than those who did not require reoperation. While younger patient age has been identified as a risk factor for graft failure 1, 32, 33 and revision surgery 10 following ACL reconstruction in addition to need for reoperation following isolated meniscal repair 16 , this finding has not been previously reported when evaluating meniscus tears left untreated at the time of primary ACL reconstruction and warrants further investigation.…”

Section: Discussionmentioning

confidence: 84%

The Fate of Meniscus Tears Left In Situ at the Time of Anterior Cruciate Ligament Reconstruction

Duchman¹,

Westermann²,

Spindler³

et al. 2015

Am J Sports Med

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Background The management of meniscus tears identified at the time of primary ACL reconstruction is highly variable and includes repair, meniscectomy, and non-treatment. Hypothesis/Purpose The purpose of this study is to determine the reoperation rate for meniscus tears left untreated at the time of ACL reconstruction with minimum follow-up of 6 years. We hypothesize that small, peripheral tears identified at the time of ACL reconstruction managed with “no treatment” will have successful clinical outcomes. Study Design Retrospective study of a prospective cohort; Level of Evidence, 3 Methods Patients with meniscus tears left untreated at the time of primary ACL reconstruction were identified from a multicenter study group with minimum 6-year follow-up. Patient, tear, and reoperation data were obtained for analysis. Need for reoperation was used as the primary endpoint, with analysis performed to determine patient and tear characteristics associated with reoperation. Results There were 194 patients with 208 meniscus tears (71 medial; 137 lateral) left in situ without treatment with complete follow-up for analysis. Of these, 97.8% of lateral and 94.4% of medial untreated tears required no reoperation. Sixteen tears (7.7%) left in situ without treatment underwent subsequent reoperation: 9 tears (4.3%) underwent reoperation in the setting of revision ACL reconstruction and 7 tears (3.4%) underwent reoperation for isolated meniscus pathology. Patient age was significantly lower in patients requiring reoperation, while tears measuring ≥ 10 mm more frequently required reoperation. Conclusions Lateral and medial meniscus tears left in situ at the time of ACL reconstruction did not require reoperation at minimum 6-year follow-up for 97.8% and 94.4% of tears, respectively. These findings reemphasize the low reoperation rate following non-treatment of small, peripheral lateral meniscus tears while noting less predictable results for medial meniscus tears left without treatment.

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Section: Discussionmentioning

confidence: 84%

The Fate of Meniscus Tears Left In Situ at the Time of Anterior Cruciate Ligament Reconstruction

Duchman¹,

Westermann²,

Spindler³

et al. 2015

Am J Sports Med

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“…The included articles had the following designs: five retrospective cohort studies [5,8,[20][21][22], six prospective cohort studies [2,[23][24][25][26][27], four case series studies [28,-31], five controlled laboratory studies [32-36], three retrospective case control studies [13,15,37], and two prospective case control studies [16,38]. The risk factors catalogued in these studies are grouped into factors the patient can alter against factors the patient has no control over (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Patients undergo 6-12 months of rehabilitation after surgery to build strength, stability and range-of-motion before returning to activity [1,2]. The outcomes of initial ACL reconstruction remain excellent; the 5year survival rate in all patients with autografts is over 95% [3][4][5][6][7][8][9]. However, for the unfortunate 5%, re-rupture of the reconstructed ACL can be catastrophic.…”

Section: Introductionmentioning

confidence: 99%

“…Some patients who successfully rehabilitate and return to cutting/pivoting activities tear their native contralateral ACL [3,9]. The rate of contralateral ACL injury following primary ACL reconstruction has been reported between 3.0-20.5% [2,5,[7][8][9][10][11][12][13], increasing risk for bilateral knee pain, instability, and osteoarthritis. Graft failure and/or contralateral injury is financially, psychologically, and physiologically traumatic for the patient and his family.…”

Section: Introductionmentioning

confidence: 99%

“…While prevention of primary ACL injury has been heavily studied, it is of interest to study the factors associated with recurrent and subsequent contralateral ACL reconstructions. A review of the literature reveals numerous reports of associated modifiable and nonmodifiable factors [2][3][5][6][7][8][12][13][14][15][16][17][18][19]], but no comprehensive evaluation. Awareness of modifiable and non-modifiable factors allows for intervention to decrease rates of recurring ACL rupture.…”

Section: Introductionmentioning

confidence: 99%

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A Systematic Review of Factors Associated with both Bilateral and Recurrent Anterior Cruciate Ligament Disruption

Kakalecik

Reynolds

Torg

2019

JAMMR

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Background: Numerous studies have reported factors associated with recurrent or subsequent contralateral anterior cruciate ligament disruption, but a comprehensive review of the literature has not been performed. Purpose: This study attempts to systematically review the literature and provide an overview of the currently reported risk factors for recurrent and subsequent contralateral ACL reconstructions in order to allow for more efficient identification and intervention of high-risk patients. Study Design: Systematic Review. Methods: The Pubmed and Embase databases were searched using a combination of keywords such as "ACL reconstruction" and "bilateral or recurrent" and "risk factors" and medical subject headings. All studies were screened by two independent reviewers, and articles that met inclusion criteria (non-contact ACL injury, study analyzed risk factors for contralateral ACL injury or graft rupture) were downloaded and read. Results: The initial search yielded 129 articles, of which 36 met inclusion criteria. After duplicates Kakalecik et al.; JAMMR, 29(6): 1-12, 2019; Article no.JAMMR.47906 2 were removed, 23 articles remained. The reference lists of included articles were cross-referenced, and an additional 2 articles were included. Conclusion: Graft harvest site, allograft usage, return to sport, younger age, a positive family history, increased posterior tibial slope, and the number of previous ACL reconstructions are wellreported risk factors for second ACL injury. Recent studies suggest a patients who have negative psychological states in the perioperative periods have worse long-term functional outcomes. Review Article

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A new technique of surgical planning for anterior cruciate ligament reconstruction

et al. 2017

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There is currently no method to quantify the quality of the harvested graft before anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to explore a method for measuring stiffness of the normal tendon of the semitendinosus muscle using shear wave elastography (SWE). Our investigation comprised two steps. First, we determined orientation of the semitendinosus tendon fibers in 20 lower legs of embalmed cadavers. Second, we investigated the feasibility of quantifying stiffness of the normal semitendinosus tendon by SWE in 24 subjects (48 legs: 24 male and 24 female subjects) in vivo. Measured values were compared between male and female subjects. The point at the intersection of the semitendinosus tendon with the axial section through the center of the patella mostly was the middle of the semitendinosus tendon in the cadavers. The SWE modulus in all of the subjects could be measured on this point in vivo. The SWE modulus of males and females were 474.0 ± 71.9 kPa and 396.9 ± 104.5 kPa, respectively. The SWE modulus of males was significantly larger than that of females (P < 0.01). This study demonstrates that stiffness of the tendon of the semitendinosus muscle can be measured by SWE. It also shows that tendon of the semitendinosus muscle in males is stiffer than in females. Clin. Anat. 31:404-408, 2018. © 2017 Wiley Periodicals, Inc.

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Risk Factors for Recurrent Anterior Cruciate Ligament Reconstruction

Abstract: Contralateral ACLR was more frequent than revision ACLR in this population, while both surgical procedures were most common in patients younger than 20 years. Academic hospital status, but not surgeon volume, as well as the use of allograft also increased the risk for revision ACLR.

Cited by 108 publications

References 50 publications

The Fate of Meniscus Tears Left In Situ at the Time of Anterior Cruciate Ligament Reconstruction

The Fate of Meniscus Tears Left In Situ at the Time of Anterior Cruciate Ligament Reconstruction

A Systematic Review of Factors Associated with both Bilateral and Recurrent Anterior Cruciate Ligament Disruption

A new technique of surgical planning for anterior cruciate ligament reconstruction

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