scholarly journals The Influence of Hamstring Autograft Size on Patient-Reported Outcomes and Risk of Revision After Anterior Cruciate Ligament Reconstruction: A Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study

2013 ◽  
Vol 29 (12) ◽  
pp. 1948-1953 ◽  
Author(s):  
Michael W. Mariscalco ◽  
David C. Flanigan ◽  
Joshua Mitchell ◽  
Angela D. Pedroza ◽  
Morgan H. Jones ◽  
...  
Author(s):  
Robert A. Duerr ◽  
Kirsten D. Garvey ◽  
Jakob Ackermann ◽  
Elizabeth G. Matzkin

Several studies have identified graft diameter as a risk factor for failure following anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to evaluate the effect of graft diameter on patient reported outcome measures (PROMS) following ACLR. We performed a retrospective review of prospectively collected data using a global surgical registry. 153 of 287 patients (53.3%) had complete data for each timepoint. Effect of graft diameter, graft type, femoral tunnel drilling technique, patient age, sex, and body mass index were evaluated. At 1-year post-operatively, a 1-mm increase in graft diameter was found to correlate with a 5.7-point increase in the Knee Injury and Osteoarthritis Outcome Score (KOOS) activity of daily living score (p = 0.01), a 10.3-point increase in the sport score (p=0.003), and a 9.8-point increase in the quality of life score (p=0.013). At 2-years post-operatively, a 1-mm increase in graft size was found to be marginally correlated with KOOS symptoms and sport scores. Patients undergoing hamstring autograft ACLR, increasing graft diameter can result in improved PROMS, specifically improved KOOS subscale scores at 1 and 2-years post-operative.


Author(s):  
Kyle G. Wallace ◽  
Steven J. Pfeiffer ◽  
Laura S. Pietrosimone ◽  
Matthew S. Harkey ◽  
Xiaopeng Zong ◽  
...  

Context: Hypertrophy of the Infrapatellar Fat Pad (IFP) in idiopathic knee osteoarthritis has been linked to deleterious synovial changes and joint pain related to mechanical tissue impingement; yet, little is known regarding the IFP's volumetric changes following anterior cruciate ligament reconstruction (ACLR). Objective: To examine changes in IFP volume between 6 and 12 months following ACLR and determine associations between patient-reported outcomes and IFP volume at each time point, as well as volume change over time. In a subset of individuals, we examined inter-limb IFP volume differences 12 months post-ACLR. Study Design: Prospective cohort study Setting: Laboratory Patients or Other Participants: We included 26 participants (13 females, 13 males, 21.88±3.58 years, 23.82±2.21 kg/m2) for our primary aims and 13 of those participants (8 females, 5 males, 21.15±3.85 years, 23.01±2.01 kg/m2) for our exploratory aim. Main Outcome Measure(s): Using magnetic resonance imaging, we evaluated IFP volume change between 6 and 12 months post-ACLR in the ACLR limb and between-limb differences at 12 months in a subset of participants. International Knee Documentation Committee subjective knee evaluation (IKDC) scores were collected at 6-month and 12-month follow-ups and associations between IFP volume and patient-reported outcomes were determined. Results: IFP volume in the ACLR limb significantly increased from 6 (19.67±6.30 cm3) to 12 (21.26±6.91 cm3) months post-ACLR. Greater increases of IFP volume between 6 and 12 months significantly associated with better 6-month IKDC scores (r=0.44, P=0.03). IFP volume was significantly greater in the uninjured limb (22.71±7.87 cm3) compared to the ACLR limb (20.75±9.03 cm3) 12 months post-ACLR. Conclusions: IFP volume increased between 6 and 12 months post-ACLR; however, the IFP volume of the ACLR limb remained smaller than the uninjured limb at 12-months. Additionally, those with better knee function 6 months post-ACLR demonstrated greater increases in IFP volume between 6 and 12 months post-ACLR. This suggests greater IFP volumes may play a role in long-term joint health following ACLR.


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