Individual and Combined Anatomic Risk Factors for the Development of an Anterior Cruciate Ligament Rupture in Men: A Multiple Factor Analysis Case-Control Study

2022 ◽  
pp. 036354652110625
Author(s):  
Abdulhamit Misir ◽  
Gokhan Sayer ◽  
Erdal Uzun ◽  
Betul Guney ◽  
Ahmet Guney
Keyword(s):  
Case Control Study ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Case Control ◽  
Acl Rupture ◽  
Notch Width ◽  
Anterior Cruciate ◽  
The Individual ◽  
Healthy Participants ◽  
Control Study

Background: No comparative studies have evaluated anatomic risk factors in a large cohort including both patients with anterior cruciate ligament (ACL) ruptures and healthy participants. Purpose: To determine which anatomic parameters are independently associated with an ACL rupture and the diagnostic values of the individual and combined anatomic parameters. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 352 male patients who underwent arthroscopic ACL reconstruction because of a primary ACL rupture and 350 age-, sex-, body mass index–, and side dominance–matched healthy participants were included. Measurements of 32 previously determined parameters and 7 calculations were performed. Between-group differences were calculated. Univariate and multivariate logistic regression models and receiver operating characteristic curve analysis were conducted for the individual and combined independently associated factors. Results: The mean age and body mass index of all participants were 29.9 ± 7.7 years and 27.2 ± 3.1, respectively. There were significant differences between the groups regarding the notch width (NW), notch shape index, anterior tibial slope, notch width index, NW–eminence width (NW:EW) ratio, notch height, axial lateral wall angle, medial intercondylar ridge thickness, alpha angle, medial tibial depth (MTD), lateral tibial slope (LTS), coronal tibial plateau width, eminence width index, tibial proximal anteroposterior distance (TPAP), lateral condylar anteroposterior distance (LCAP)/TPAP, ACL cross-sectional area, ACL volume, medial and lateral meniscal cartilage height, medial and lateral meniscal cartilage angle (MCA), and medial and lateral meniscal cartilage bone height. The NW:EW ratio (odds ratio [OR], 4.419; P = .017), MTD (OR, 8.617; P = .001), LTS (OR, 2.254; P = .011), LCAP/TPAP (OR, 2.782; P = .037), and medial MCA (OR, 1.318; P = .010) were independently associated with the development of an ACL rupture. Combining the independently associated factors revealed a sensitivity of 93% and a specificity of 94% (area under the curve, 0.968). Conclusion: Patients with ACL ruptures could be distinguished from uninjured controls with high sensitivity and specificity via the combined use of the NW:EW ratio, MTD, LTS, LCAP/TPAP, and medial MCA. In clinical practice, these findings may contribute to the development of preventive strategies for ACL ruptures.

The Association Between Tibial Slope and Revision Anterior Cruciate Ligament Reconstruction in Patients ≤21 Years Old: A Matched Case-Control Study Including 317 Revisions

2019 ◽  
Vol 47 (14) ◽  
pp. 3330-3338 ◽  
Author(s):  
Joseph D. Cooper ◽  
Wei Wang ◽  
Heather A. Prentice ◽  
Tadashi T. Funahashi ◽  
Gregory B. Maletis
Keyword(s):  
Ligament Reconstruction ◽  
Case Control Study ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Case Control ◽  
Matched Case ◽  
Slope Difference ◽  
Anterior Cruciate ◽  
Matched Case Control Study ◽  
Control Study

Background: There is evidence that tibial slope may play a role in revision risk after anterior cruciate ligament reconstruction (ACLR); however, prior studies are inconsistent. Purpose: To determine (1) whether there is a difference in lateral tibial posterior slope (LTPS) or medial tibial posterior slope (MTPS) between patients undergoing revised ACLR and those not requiring revision and (2) whether the medial-to-lateral slope difference is different between these 2 groups. Study Design: Case-control study; Level of evidence, 3. Methods: We conducted a matched case-control study (2006-2015). Cases were patients aged ≤21 years who underwent revision surgery after primary unilateral ACLR; controls were patients aged ≤21 years without revision who were identified from the same source population. Controls were matched to cases by age, sex, body mass index, race, graft type, femoral fixation device, and post-ACLR follow-up time. Tibial slope measurements were made by a single blinded reviewer using magnetic resonance imaging. The Wilcoxon signed rank test and McNemar test were used for continuous and categorical variables, respectively. Results: No difference was observed between revised and nonrevised ACLR groups for LTPS (median: 6° vs 6°, P = .973) or MTPS (median: 4° vs 5°, P = .281). Furthermore, no difference was found for medial-to-lateral slope difference (median: −1 vs −1, P = .289). A greater proportion of patients with revised ACLR had an LTPS ≥12° (7.6% vs 3.8%) and ≥13° (4.7% vs 1.3%); however, this was not statistically significant after accounting for multiple testing. Conclusion: We failed to observe an association between revision ACLR surgery and LTPS, MTPS, or medial-to-lateral slope difference. However, there was a greater proportion of patients in the revision ACLR group with an LTPS ≥12°, suggesting that a minority of patients who have more extreme values of LTPS have a higher revision risk after primary ACLR. A future cohort study evaluating the angle that best differentiates patients at highest risk for revision is needed.

Is There a Role of Meniscal Morphology in the Risk of Noncontact Anterior Cruciate Ligament Rupture? A Case–Control Study

2020 ◽  
Author(s):  
Melih Unal ◽  
Ozkan Kose ◽  
Cemil Aktan ◽  
Gurkan Gumussuyu ◽  
Hasan May ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Lateral Meniscus ◽  
Tibial Slope ◽  
Case Control ◽  
Posterior Horn ◽  
Acl Rupture ◽  
Notch Width ◽  
Notch Width Index ◽  
Control Study

AbstractThe purpose of this study was to identify the anatomical risk factors and determine the role of meniscal morphology in noncontact anterior cruciate ligament (ACL) rupture. A total of 126 patients (63 with noncontact ACL rupture and 63 age- and sex-matched controls) with intact menisci were included in this retrospective case–control study. On knee magnetic resonance imaging (MRI), meniscal morphometry (anterior, corpus, and posterior heights and widths of each meniscus), tibial slope (medial and lateral separately), notch width index, roof inclination angle, anteromedial bony ridge, tibial eminence area, and Q-angle measurements were assessed. The data were analyzed using multiple regression analyses to identify independent risk factors associated with ACL rupture. Using a univariate analysis, medial and lateral menisci anterior horn heights (p < 0.001; p < 0.003), medial and lateral menisci posterior horn heights (p < 0.001; p < 0.001), lateral meniscus corpus width (p < 0.004), and notch width index (p < 0.001) were significantly higher in the control group. Lateral tibial slope (p < 0.001) and anteromedial bony ridge thickness (p < 0.001) were significantly higher in the ACL rupture group. Multivariate analysis revealed that decreased medial meniscus posterior horn height (odds ratio [OR]: 0.242; p < 0.001), increased lateral meniscus corpus width (OR: 2.118; p < 0.002), increased lateral tibial slope (OR: 1.95; p < 0.001), and decreased notch width index (OR: 0.071; p = 0.046) were independent risk factors for ACL rupture. Notch stenosis, increased lateral tibial slope, decreased medial meniscus posterior horn height, and increased lateral meniscus corpus width are independent anatomical risk factors for ACL rupture. Meniscal morphological variations also play a role in ACL injury. Level of Evidence Level III, retrospective case–control study.

scholarly journals Oral contraceptive use and anterior cruciate ligament injury: comparison of active comparator new user cohort and case-control study designs

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Mackenzie M. Herzog ◽  
Jessica C. Young ◽  
Jennifer L. Lund ◽  
Virginia Pate ◽  
Christina D. Mack ◽  
...  
Keyword(s):  
Case Control Study ◽  
Cruciate Ligament ◽  
Cohort Analysis ◽  
Acl Injury ◽  
Case Control ◽  
Case Control Studies ◽  
Active Comparator ◽  
Protective Association ◽  
Anterior Cruciate ◽  
Control Study

Abstract Background This study further investigates a protective association between oral contraceptive (OC) use and anterior cruciate ligament (ACL) injury noted in prior case-control studies. Methods Active comparator new user cohort analysis of women aged 13–45 years in the United States from the IBM MarketScan Commercial Claims and Encounters database who newly-initiated low-dose OCs (exposed) or underwent intrauterine device (IUD) insertion (comparison group) from 2000 to 2014. Women were followed for ACL injury starting 90 days after OC initiation or IUD insertion until OC or IUD discontinuation or end of continuous enrollment. Adjusted hazard ratios (adjHR) and 95% confidence intervals (CI) were estimated controlling for age. Secondary analysis replicated previously-published case-control studies assessing “ever” versus “never” OC use over 1- and 5-year periods among women who underwent ACL reconstruction compared to age-matched controls. Results In the cohort analysis, 2,370,286 women initiated OCs and 621,798 underwent IUD insertion. There were 3571 (0.15%) ACL injuries during an average 370.6 days of continuous OC use and 1620 (0.26%) during an average 590.5 days of IUD use. No difference in risk of ACL injury was observed between OC initiators and IUD users (adjHR = 0.95; 95%CI 0.89, 1.01). The case-control analysis replicated the slight protective association observed in prior studies over a 5-year period (OR = 0.90; 95%CI 0.85, 0.94). Conclusions This cohort study suggests no association between OC use and ACL injury, while the case-control study suggested bias from uncontrolled confounding and selection factors may have influenced previous findings that suggested a protective association between OC use and ACL injury.

Clinical examination of partial ruptures of the anterior cruciate ligament: A retrospective case–control study

The Knee ◽  
2020 ◽  
Vol 27 (6) ◽  
pp. 1866-1873
Author(s):  
Daniel Guenther ◽  
Caiyan Zhang ◽  
Fernando Ferlin ◽  
Cara Vernacchia ◽  
Volker Musahl ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Clinical Examination ◽  
Case Control Study ◽  
Cruciate Ligament ◽  
Case Control ◽  
Retrospective Case ◽  
Anterior Cruciate ◽  
Control Study
Sign in / Sign up

Export Citation Format

Share Document