Young age, female gender, Caucasian race, and workers’ compensation claim are risk factors for reoperation following arthroscopic ACL reconstruction

Abstract

Purpose Given the increasing incidence of arthroscopic anterior cruciate ligament reconstruction (ACLR), mid‐ to long‐term rates of reoperations were investigated on the ipsilateral knee following ACLR. Methods New York Statewide Planning and Research Cooperative Systems (SPARCS) database was queried from 2003 to 2012 to identify patients with a primary ICD‐9 diagnosis for ACL tear and concomitant CPT code for ACLR. Patients were longitudinally followed for at least 2 years to determine incidence and nature of subsequent ipsilateral knee procedures. Results The inclusion criteria were met by 45,231 patients who had undergone ACLR between 2003 and 2012. Mean age was found to be 29.7 years (SD 11.6). Subsequent ipsilateral outpatient knee surgery after a mean of 25.7 ± 24.5 months was performed in 10.7% of patients. Revision ACLR was performed for nearly one‐third of reoperations. Meniscal pathology was addressed in 58% of subsequent procedures. Age 19 or younger, female gender, worker's compensation (WC) insurance, and Caucasian race were identified as independent risk factors for any ipsilateral reoperation. An initial isolated ACLR and initial ACLR performed by a high‐volume surgeon were found to be independently associated with lower reoperation rates. Tobacco use was not significant. Survival rates of 93.4%, 89.8% and 86.7% at 2‐, 5‐ and 10 years, respectively, were found for any ipsilateral reoperation. Conclusion A 10.7% ipsilateral reoperation rate at an average of 25.9 (SD 24.5) months after ACLR and an overall ACLR revision rate of 3.1% were demonstrated by the analysis. Meniscal pathology was addressed in the majority of subsequent interventions. Age 19 or younger, female gender, Caucasian race, and WC claim were associated with reoperation. Initial isolated ACLR and procedure performed by high‐volume surgeon were associated with reduced reoperation. Level of evidence Level III.

Strength, rate of force development, power and reactive strength in adult male athletic populations post anterior cruciate ligament reconstruction - A systematic review and meta-analysis

“…We decided to exclude adolescent and paediatric ACLR cohorts owing to the lack of substantial high quality evidence regarding management in this population (Ardern et al, 2018;Burland et al, 2018;Henry et al, 2009;Moksnes, Engebretsen, & Risberg, 2012). In addition, females were not examined due to their different anthropometric, hormonal, training and kinematic features when compared to males (Capogna, Mahure, Mollon, & Duenes, 2019;Ford, Myer, & Hewett, 2003;Herzberg et al, 2017;Hewett, Myer, & Ford, 2006;Lohmander, Ostenberg, Englund, & Roos, 2004;Mayhew, Hancock, Rollison, Ball, & Bowen, 2001;Sugimoto, Myer, McKeon, & Hewett, 2012;Walts et al, 2008). Finally, we included only articles where a control group was present; thus, decreasing the overall pool of studies in this review.…”

Social Determinants of Health Influence Access to Care and Outcomes in Patients Undergoing Anterior Cruciate Ligament Reconstruction: A Systematic Review

“…It is made up of 7 questions that evaluate bias in 4 domains: selection of study participants, comparability among study groups, ascertainment of exposures, and outcomes assessment. 22 Included studies were categorized as good, [23][24][25][26][27][28][29][30][31][32] fair, [33][34][35][36][37][38][39][40][41] or poor [42][43][44] quality on the basis of their NOS score. Appendix Table A1 provides a detailed breakdown of how scores were determined for each included study.…”

“…Nine primary studies (retrospective cohort [n ¼ 7], [23][24][25][26][27]30,44 cross-sectional [n ¼ 1], 33 and case-control [n ¼ 1] 41 ) evaluated the relationship between race/ ethnicity and ACLR outcomes. White race is an independent risk factor for revision ACLR, [24][25][26][27]30,41 contralateral ACLR, 41 and non-ACL knee surgery 25,46 after primary ACLR. Hispanic ethnicity 27,41 and Asian race 41 were associated with a significantly decreased risk for subsequent revision or contralateral ACLR.…”

Gender Differences of the ACL Insertion Sites

“…Влияние предикторов повреждений ПКС, количество которых при прочих равных условиях оказывается несколько большим у женщин, чем у мужчин, по-видимому, сохраняется и в связи с последующим хирургическим лечением, реабилитацией, а также возвращением к прежнему уровню физической активности или занятиям спортом. Тем не менее утверждение о более высоком риске повреждений реконструированной ПКС у лиц женского пола по сравнению с мужчинами на сегодняшний день не имеет весомых подтверждений и остается дискутабельным [10,37,38].…”