scholarly journals RISK FACTORS FOR FAILURE FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN A PEDIATRIC POPULATION: A NOVEL PREDICTION ALGORITHM

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0002
Author(s):  
Nicholas J. Lemme ◽  
Daniel S. Yang ◽  
Brooke Barrow ◽  
Ryan O’Donnell ◽  
Alan Daniels ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Revision Surgery ◽  
Pediatric Patients ◽  
Cruciate Ligament ◽  
Acl Revision ◽  
Risk Algorithm ◽  
Anterior Cruciate ◽  
Acl Revision Surgery

Background: Pediatric anterior cruciate ligament (ACL) reconstruction is becoming increasingly common, however, there is limited literature on the risk factors for failure in this demographic. Hypothesis/Purpose: In the present study we sought to: 1. To determine the rate of pediatric ACL reconstruction (ACLR) failure requiring revision surgery in a nationally representative sample. 2. To determine the associated patient/injury-specific risk factors for ACLR failure. 3. To examine the differences in the rate and risks of failure between pediatric and adult patients. Methods: Patient records were drawn from Humana individual health plans and Medicare medical records. Adult and pediatric patients who underwent primary ACLR and subsequent reoperation for either ACL revision surgery or a revision meniscal procedure between 2011-2016 were identified. Multivariate regression was used to determine the significant risk factors for ACL revision and overall reoperation rates in pediatric and adult patients. A risk algorithm was developed to predict the risk of ACL revision following pediatric ACL reconstruction. Results: Pediatric patients were significantly more likely to require ACL revision within one year (OR=1.97, 95%CI 1.57-2.45, p<0.0001) and five years (OR=3.22, 95%CI 2.77-3.72, p<0.0001) following their index ACLR compared to adults. Survivorship of the index ACL procedure was significantly decreased in pediatric patients (log-rank test p<0.0001) (Figure 1). Pediatric patients were also at higher risk of sustaining a contralateral ACL tear compared to adults (5.9% vs. 1.4%, respectively, p<0.0001). Meniscus injury was a risk factor for overall re-operation (OR=2.18, 95%CI 1.67-2.89 p<0.0001) as well as ACL revision (OR=2.28, 95%CI=1.66-3.21, p<0.0001) in the pediatric cohort. This increased risk was sustained despite the type of meniscal tear intervention, with patients undergoing concurrent meniscal repair (OR=1.84, 95%CI 1.43-2.38, p<0.0001) or meniscectomy (OR=2.20, 95%CI 1.72-2.82, p<0.0001) having a higher likelihood of requiring a revision ACLR. Concomitant MCL injury but not LCL injury was a risk factor for ACL revision in this cohort (OR=1.70, 95%CI 1.31-2.19, p<0.0001). Male sex and (OR=0.78, 95%CI 0.63-0.96, p=0.0204) and being >14 years old (OR=0.62, 95%CI 0.45-0.86, p=0.0035) was associated with a decreased risk of overall reoperation. The risk algorithm demonstrated the highest probability for ACLR failure in females, less than 15 years of age, with concomitant meniscus and MCL injury, demonstrating a 36% risk of failure (Table 1). Conclusion: Compared to adults, pediatric patients have an increased likelihood of ACL revision surgery, contralateral ACL tears, and meniscal reoperation within 5 years of an index ACLR. [Table: see text][Figure: see text]

Risk Factors for Requiring a Revision Anterior Cruciate Ligament Reconstruction: A Case-Control Study

2019 ◽  
Author(s):  
Todd P. Pierce ◽  
Jennifer Kurowicki ◽  
John J. Kelly ◽  
Kimona Issa ◽  
Anthony Festa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Family History ◽  
Acl Reconstruction ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
Revision Reconstruction ◽  
History Of ◽  
Anterior Cruciate

AbstractAnterior cruciate ligament (ACL) reconstruction is considered as a successful orthopaedic procedure that attempts to help patients return to their preinjury level of activity. However, some patients may need to undergo revision surgery, and this potentially may be associated with certain surgery-specific or patient risk factors. Therefore, the purpose of this study was to assess the potential role of (1) demographics, (2) family history, (3) graft choice, (4) sport, and (5) mechanism of injury (contact vs. noncontact) in the risk for needing a revision ACL for improved clinical outcomes. All patients who had undergone a primary ACL reconstruction between 2012 and 2016 were identified from at a single institution. About 312 patients who had a mean age of 24 years (range, 9–62 years) and a mean follow-up of 4 years (range, 1–10). Patients were further evaluated to identify those who had a revision. There were 19 patients (6.1%) with a mean age of 22 years (range, 13–38 years) and a mean follow-up of 5 years (range, 1–10) that required a revision reconstruction. Gender ratios (p = 0.56) and mean age (p = 0.44) were similar among the cohorts. Family history of ACL reconstruction had no association with revision risk (p = 0.57). Those with tibialis anterior allografts (37 vs. 4%; p = 0.0001) and hamstring allografts (16 vs. 1%; p = 0.0001) were far more likely to undergo a revision. Bone-tendon-bone (BTB) patella autografts were less likely (26 vs. 73%; p = 0.0001). Sport did not play a role in revision with those injured playing basketball (p = 0.61), football (p = 0.52), lacrosse (p = 0.52), soccer (p = 0.83), and volleyball (p = 0.61). There were a greater percentage of contact injuries that required revision (95 vs. 77%; p = 0.07). Graft selection played a significant role in requiring revision surgery with allografts portending to higher revision rates and BTB patella autografts conferring a lower risk.

scholarly journals Extra articular lateral tenodesis in patients with revision anterior cruciate ligament (ACL) reconstruction and high-grade anterior instability

2020 ◽  
Vol 8 (5_suppl4) ◽  
pp. 2325967120S0030
Author(s):  
Lena Alm ◽  
Karl-Heinz Frosch ◽  
Ralph Akoto
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
High Grade ◽  
Anterior Instability ◽  
Lateral Tenodesis ◽  
Male Sex ◽  
Anterior Cruciate

Aims and Objectives: While patients following primary anterior cruciate ligament (ACL) surgery show satisfying results, the outcome after revision ACL reconstruction (ACLR) seems to be less favourable. Failure rates of 14 to 33% have been reported for revision ACLR. The purpose of this study was to evaluate the outcome of patients after revision ACLR. We hypothesize that peripheral knee instabilities are risk factors for failure of revision ACLR. Furthermore, we hypothesize that peripheral stabilisation will reduce the risk of failure. Materials and Methods: Between 2013 and 2016, 150 patients were operated with revision ACLR (revision surgery after primary ACL reconstruction). Out of these patients, 73 patients preoperative had a high-grade anterior instability and were included in the retrospective study. High-grade knee anterior instability was defined as high-grade pivot-shift and/or side- to- side difference of more than 5mm in Rolimeter®-testing. An additional extra articular tenodesis was performed in 59 patients during revision ACLR. Patients were clinically examined with a minimum of 2 years after revision surgery (mean 35±6 months) and identified as “failed revision ACLR” and “stable revision ACLR”. Results: Failure of the revision ACLR occurred in 8.2% (n=6) of the cases. Extra articular lateral tenodesis leads to significant lower failure rates in patients with high-grade anterior instability in comparison to patients without further peripheral stabilization (5% vs. 21%, p=0.045). Also, higher postoperative functional scores were shown in the group of additional extra articular lateral tenodesis (Lysholm 89.5±17 vs. 69.5±12, p=0.041; Tegner 6.6±1.4 vs. 4.5±1.4, p=0.009; Cincinnati Rating Scale 91.2±14 vs. 68.5±17, p=0.006). Failure was associated with male sex (n=6 male failures, p=0.017) and obesity (n=4 obese failures with a BMI >30 kg/m2, p<0.001). Conclusion: Additional extra articular tenodesis in patients with revision ACL instability and accompanying high-grade anterior instability significantly reduces the risk of failure of revision ACLR. General risk factors of failure of the revision ACLR are obesity and male sex.

scholarly journals Risk Factors for Failure After Anterior Cruciate Ligament Reconstruction in a Pediatric Population: A Prediction Algorithm

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712199116
Author(s):  
Nicholas J. Lemme ◽  
Daniel S. Yang ◽  
Brooke Barrow ◽  
Ryan O’Donnell ◽  
Alan H. Daniels ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Pediatric Patients ◽  
Cruciate Ligament ◽  
Adult Patients ◽  
Collateral Ligament ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Background: Anterior cruciate ligament reconstruction (ACLR) in pediatric patients is becoming increasingly common. There is growing yet limited literature on the risk factors for revision in this demographic. Purpose: To (1) determine the rate of pediatric revision ACLR in a nationally representative sample, (2) ascertain the associated patient- and injury-specific risk factors for revision ACLR, and (3) examine the differences in the rate and risks of revision ACLR between pediatric and adult patients. Study Design: Case-control study; Level of evidence, 3. Methods: The PearlDiver patient record database was used to identify adult patients (age ≥20 years) and pediatric patients (age <20 years) who underwent primary ACLR between 2010 and 2015. At 5 years postoperatively, the risk of revision ACLR was compared between the adult and pediatric groups. ACLR to the contralateral side was also compared. Multivariate logistic regression was used to determine the significant risk factors for revision ACLR and the overall reoperation rates in pediatric and adult patients; from these risk factors, an algorithm was developed to predict the risk of revision ACLR in pediatric patients. Results: Included were 2055 pediatric patients, 1778 adult patients aged 20 to 29 years, and 1646 adult patients aged 30 to 39 years who underwent ACLR. At 5 years postoperatively, pediatric patients faced a higher risk of revision surgery when compared with adults (18.0 % vs 9.2% [adults 20-29 years] and 7.1% [adults 30-39 years]; P < .0001), with significantly decreased survivorship of the index ACLR ( P < .0001; log-rank test). Pediatric patients were also at higher risk of undergoing contralateral ACLR as compared with adults (5.8% vs 1.6% [adults 20-29 years] and 1.9% [adults 30-39 years]; P < .0001). Among the pediatric cohort, boys (odds ratio [OR], 0.78; 95% CI, 0.63-0.96; P = .0204) and patients >14 years old (OR, 0.62; 95% CI, 0.45-0.86; P = .0035) had a decreased risk of overall reoperation; patients undergoing concurrent meniscal repair (OR, 1.84; 95% CI, 1.43-2.38; P < .0001) or meniscectomy (OR, 2.20; 95% CI, 1.72-2.82; P < .0001) had an increased risk of revision surgery. According to the risk algorithm, the highest probability for revision ACLR was in girls <15 years old with concomitant meniscal and medial collateral ligament injury (36% risk of revision). Conclusion: As compared with adults, pediatric patients had an increased likelihood of revision ACLR, contralateral ACLR, and meniscal reoperation within 5 years of an index ACLR. Families of pediatric patients—especially female patients, younger patients, and those with concomitant medial collateral ligament and meniscal injuries—should be counseled on such risks.

Strategies for revision surgery after primary double-bundle anterior cruciate ligament (ACL) reconstruction

2013 ◽  
Vol 21 (9) ◽  
pp. 2072-2080 ◽  
Author(s):  
Marcus Hofbauer ◽  
Bart Muller ◽  
Christopher D. Murawski ◽  
Michael Baraga ◽  
Carola Franziska van Eck ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
Double Bundle ◽  
Anterior Cruciate

The Incidence of Subsequent Meniscal Surgery Is Higher in the Anterior Cruciate Ligament–Reconstructed Knee Than in the Contralateral Knee

2017 ◽  
Vol 45 (14) ◽  
pp. 3216-3222 ◽  
Author(s):  
Brent R. Davis ◽  
Jason Chen ◽  
Maria C.S. Inacio ◽  
Rebecca Love ◽  
Heather A. Prentice ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Absolute Risk ◽  
Cruciate Ligament ◽  
Free Survival ◽  
Contralateral Knee ◽  
Meniscal Surgery ◽  
Anterior Cruciate ◽  
Reconstructed Knee

Background: A goal of anterior cruciate ligament (ACL) reconstruction is to provide a meniscal protective effect for the knee. Purpose: (1) To evaluate whether there was a different likelihood of subsequent meniscal surgery in the ACL-reconstructed knee or in the normal contralateral knee and (2) to compare the risk factors associated with subsequent meniscal surgery in the ACL-reconstructed knee and contralateral knee. Study Design: Cohort study; Level of evidence, 3. Methods: Using an integrated health care system’s ACL reconstruction registry, patients undergoing primary ACL reconstruction, with no meniscal injury at the time of index surgery and a normal contralateral knee, were evaluated. Subsequent meniscal tears associated with ACL graft revision were excluded. Subsequent meniscal surgery in either knee was the outcome of interest. Sex, age, and graft type were assessed as potential risk factors. Survival analysis was used to compare meniscal surgery–free survival rates and to assess risk factors of subsequent meniscal surgery. Results: Of 4087 patients, there were 32 (0.78%) patients who underwent subsequent meniscal surgery in the index knee and 9 (0.22%) in the contralateral knee. The meniscal surgery–free survival rate at 4 years was 99.08% (95% CI, 98.64%-99.37%) in the index knee and 99.65% (95% CI, 99.31%-99.82%) in the contralateral knee. There was a 3.73 (95% CI, 1.73-8.04; P < .001) higher risk of subsequent meniscal surgery in the index knee compared with the contralateral knee, or a 0.57% absolute risk difference. After adjustments, allografts (hazard ratio [HR], 5.06; 95% CI, 1.80-14.23; P = .002) and hamstring autografts (HR, 3.11; 95% CI, 1.06-9.10; P = .038) were risk factors for subsequent meniscal surgery in the index knee compared with bone–patellar tendon–bone (BPTB) autografts. Conclusion: After ACL reconstruction, the overall risk of subsequent meniscal surgery was low. However, the relative risk of subsequent meniscal surgery in the ACL-reconstructed knee was higher compared with the contralateral knee. Only graft type was found to be a risk factor for subsequent meniscal surgery in the ACL-reconstructed knee, with a higher risk for allografts and hamstring autografts compared with BPTB autografts.

Risk factors for progression of articular cartilage damage after anatomical anterior cruciate ligament reconstruction

2018 ◽  
Vol 100-B (3) ◽  
pp. 285-293 ◽  
Author(s):  
A. Nakamae ◽  
N. Adachi ◽  
M. Deie ◽  
M. Ishikawa ◽  
T. Nakasa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Articular Cartilage ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Cartilage Damage ◽  
Significant Risk ◽  
Articular Cartilage Damage ◽  
Anterior Cruciate

Aims To investigate the risk factors for progression of articular cartilage damage after anatomical anterior cruciate ligament (ACL) reconstruction. Patients and Methods A total of 174 patients who underwent second-look arthroscopic evaluation after anatomical ACL reconstruction were enrolled in this study. The graded condition of the articular cartilage at the time of ACL reconstruction was compared with that at second-look arthroscopy. Age, gender, body mass index (BMI), ACL reconstruction technique, meniscal conditions, and other variables were assessed by regression analysis as risk factors for progression of damage to the articular cartilage. Results In the medial compartment, multivariable logistic regression analysis indicated that partial medial meniscectomy (odds ratio (OR) 6.82, 95% confidence interval (CI) 2.11 to 22.04, p = 0.001), pivot-shift test grade at the final follow-up (OR 3.53, CI 1.39 to 8.96, p = 0.008), BMI (OR 1.15, CI 1.03 to 1.28, p = 0.015) and medial meniscal repair (OR 3.19, CI 1.24 to 8.21, p = 0.016) were significant risk factors for progression of cartilage damage. In the lateral compartment, partial lateral meniscectomy (OR 10.94, CI 4.14 to 28.92, p < 0.001) and side-to-side differences in anterior knee laxity at follow-up (OR 0.63, p = 0.001) were significant risk factors. Conclusion Partial meniscectomy was found to be strongly associated with the progression of articular cartilage damage despite r anatomical ACL reconstruction. Cite this article: Bone Joint J 2018;100-B:285–93.

Ten-Year Risk Factors for Inferior Knee Injury and Osteoarthritis Outcome Score After Anterior Cruciate Ligament Reconstruction: A Study of 874 Patients From the Swedish National Knee Ligament Register

2018 ◽  
Vol 46 (12) ◽  
pp. 2851-2858 ◽  
Author(s):  
Eric Hamrin Senorski ◽  
Eleonor Svantesson ◽  
Kurt P. Spindler ◽  
Eduard Alentorn-Geli ◽  
David Sundemo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Risk Factor ◽  
Acl Reconstruction ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Knee Ligament ◽  
Related Risk ◽  
Anterior Cruciate

Background: Factors relating to the patient and anterior cruciate ligament (ACL) reconstruction may help to identify prognostic factors of long-term outcome after reconstruction. Purpose: To determine 10-year risk factors for inferior knee function after ACL reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: Prospectively collected data from the Swedish National Knee Ligament Register were extracted for patients who underwent ACL reconstruction between January 2005 and December 2006. Patients who had no data at the 10-year follow-up for the Knee injury and Osteoarthritis Outcome Score (KOOS) were excluded. Multivariable proportional odds regression modeling was used to assess 10-year patient- and surgery-related risk factors across all the KOOS subscales and the KOOS4 (mean score of 4 subscales: pain, knee-related symptoms, function in sport and recreation, and knee-related quality of life). Results: A total of 874 (41%) patients were included (male, 51.5%; median age at the time of ACL reconstruction, 27.5 years [range, 11.2-61.5 years]). An increase in the severity of concomitant articular cartilage injuries resulted in a reduced KOOS on 4 subscales (odds ratio, 0.64-0.80; P < .05). A higher preoperative KOOS pain score increased the odds of a higher score on the pain, symptoms, and sport subscales and the KOOS4. In addition, a higher preoperative body mass index was a significant risk factor for lower scores on 3 KOOS subscales and the KOOS4. No patient- or surgery-related predictor was significant across all KOOS subscales. Conclusion: This 10-year risk factor analysis identified several factors that can affect long-term knee function after ACL reconstruction. Most risk factors were related to preoperative patient-reported outcome and potentially modifiable. On the other hand, most of the surgery-related risk factors were nonmodifiable. Nevertheless, this information may be helpful to physicians and physical therapists counseling patients on their expectations of outcome after ACL reconstruction.

scholarly journals Risk Factors for Revision Anterior Cruciate Ligament Reconstruction and Frequency With Which Patients Change Surgeons

2019 ◽  
Vol 7 (11) ◽  
pp. 232596711988048 ◽  
Author(s):  
Kirsty Sutherland ◽  
Mark Clatworthy ◽  
Kevin Chang ◽  
Richard Rahardja ◽  
Simon W. Young
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
Significant Proportion ◽  
Primary Procedure ◽  
Subsequent Revision ◽  
Low Volume ◽  
Anterior Cruciate

Background: Revision surgery is a known complication after anterior cruciate ligament (ACL) reconstruction (ACLR), but the proportion of patients who seek a different surgeon for their revision procedure is unknown. Purpose: To determine the rate and risk factors for revision ACLR in New Zealand and to find the proportion of patients undergoing revision ACLR who see a different surgeon compared with their primary procedure as well as the factors that may influence this decision. Study Design: Case series; Level of evidence, 4. Methods: Data from New Zealand’s single government insurer, the Accident Compensation Corporation (ACC), were analyzed. All primary ACLR procedures performed between January 1, 2009, and December 31, 2014 were evaluated, and revision ACLR procedures performed between January 1, 2009, and December 31, 2016, were evaluated to allow for a minimum 2-year follow-up period. Cases undergoing subsequent revision were divided into those with the same or a different surgeon compared with the primary procedure. Risk factors for revision and change of surgeons were assessed, including age, sex, time from injury to surgery, time between primary and revision procedures, surgeon volume, and ethnicity. Results: A total of 15,212 primary ACLR procedures were recorded in 14,926 patients. The mean patient age was 29.2 years, and 61% were male patients. There were 676 subsequent revision procedures and 510 contralateral procedures during the study period, resulting in a 5-year survival rate of 95.5% for the ACL graft and 96.5% for the contralateral ACL. Risk factors for revision surgery included male sex, age <20 years, and <1 year from injury to surgery. Of the revision procedures, 44.5% (n = 301) were performed by a different surgeon compared with primary ACLR. For primary ACLR procedures performed by low-volume surgeons, 75.0% of patients requiring revision ACLR changed surgeons, compared with 21.5% for high-volume surgeons (≤10 vs >50 primary ACLR/y; hazard ratio, 10.70 [95% CI, 6.01-19.05]; P < .001). Other factors associated with change of surgeons included older age, longer time between primary and revision surgery, and Asian and Maori ethnicities. Conclusion: A significant proportion of patients change surgeons when requiring revision ACLR. In the absence of formal follow-up systems such as registries, surgeons, particularly those with a low volume of ACLRs, may underestimate their personal revision rate.

Incidence and Risk Factors of Subsequent Meniscal Surgery After Successful Anterior Cruciate Ligament Reconstruction: A Retrospective Study With a Minimum 2-Year Follow-up

2020 ◽  
Vol 48 (14) ◽  
pp. 3525-3533
Author(s):  
Yuka Kimura ◽  
Eiji Sasaki ◽  
Yuji Yamamoto ◽  
Shizuka Sasaki ◽  
Eiichi Tsuda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Anterior Laxity ◽  
Meniscal Surgery ◽  
Anterior Cruciate ◽  
Femoral Tunnel Drilling ◽  
Primary Acl Reconstruction

Background: One of the goals of anterior cruciate ligament (ACL) reconstruction is a meniscal protective effect on the knee. Despite the advancement of ACL reconstruction techniques, subsequent meniscal tears after ACL reconstruction remain a problem, and the risk factors for recurring lesions are still unclear. Purpose: To investigate the incidence of subsequent meniscal surgery after primary ACL reconstruction without revision ACL surgery and to determine the risk factors associated with this reoperation. Study Design: Case series; Level of evidence, 4. Methods: Overall, 518 patients who underwent primary ACL reconstruction between 2004 and 2012 at one instution participated in this study. Data on body mass index, graft type and femoral tunnel-drilling technique of ACL reconstruction, and location and type of meniscal injury and its treatment at ACL reconstruction were collected from medical records. Clinical outcomes were investigated, including side-to-side difference of anterior laxity, pivot-shift grade, and subsequent meniscal surgery without ACL insufficiency (at minimum 2-year follow-up). Results: The prevalence of tears to the medial meniscus (MM) at the primary ACL reconstruction was 43.6% (226/518), 140 of which were repaired; on the contrary, tears of the lateral meniscus (LM) had a prevalence of 55.8% (289/518), 42 of which were repaired. At a mean 30.3 months (range, 8-124 months) after ACL reconstruction, 20 patients (3.9%; 14 MM tears, 3 LM tears, 3 MM + LM tears) required meniscal surgery without ACL reinjury or recurrence of instability. Of these, 14 MMs and 3 LMs had been repaired at primary ACL reconstruction. The failure rates of repaired MM and LM were 10.0% (14/140) and 7.1% (3/42), respectively. The failure rate of MM repair using the all-inside technique (6/36) was significantly higher compared with no treatment, inside-out repair, or partial resection ( P = .045). In multiple regression analysis, the presence of MM injury at the time of ACL reconstruction (odds ratio [OR], 7.81; P = .003), the side-to-side difference of postoperative anterior tibial translation (OR, 1.91; P = .032), and follow-up period after ACL reconstruction (OR, 1.02; P = .003) were risk factors of subsequent meniscal surgery after ACL reconstruction. Conclusion: Incidence of subsequent meniscal surgery after successful ACL reconstruction was <5%. Presence of MM tear at the time of ACL reconsturuction, small amount of increased anterior laxity, and long-term period after ACL reconstruction were predictive of subsequent meniscal surgery.

The 50 Most Cited Articles in the Indications, Risk Factors, Techniques, and Outcomes of ACL Revision Surgery

2020 ◽  
Author(s):  
Hayley E. Ennis ◽  
Kevin Bondar ◽  
Johnathon McCormick ◽  
Clark Jia-Long Chen ◽  
Chester J. Donnally ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Risk Factor ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Future Research ◽  
Revision Acl Reconstruction ◽  
Anterior Cruciate ◽  
Number Of Citations

AbstractThe rate of anterior cruciate ligament (ACL) retear remains high and revision ACL reconstruction has worse outcomes compared with primaries. To make advances in this area, a strong understanding of influential research is necessary. One method for systematically evaluating the literature is by citation analysis. This article aims to establish and evaluate “classic” articles. With consideration of these articles, this article also aims to evaluate gaps in the field and determine where future research should be directed. The general approach for data collection and analysis consisted of planning objectives, employing a defined strategy, reviewing search results using a multistep and multiauthor approach with specific screening criteria, and analyzing data. The collective number of citations for all publications within the list was 5,203 with an average of 104 citations per publication. “Biomechanical Measures during Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury after Anterior Cruciate Ligament Reconstruction and Return to Sport” by Paterno et al contained both the highest number of total citations and the highest number of citations per year, with 403 total citations and 43.9 citations per year. The most recurring level of evidence were level II (n = 18) and level III (n = 17). “Clinical Outcomes” was the most common article type (n = 20) followed by “Risk Factors” (n = 10). The American Journal of Sports Medicine had the highest recorded Cite Factor with over 50% of the articles (n = 27) published. The most productive authors included R.W. Wright (n = 6), S.D. Barber-Westin (n = 5), F.R. Noyes (n = 5), and K.P. Spindler (n = 5). Historically, influential studies have been published in the realms of clinical outcome and risk factor identification. It has been established that revision ACL reconstruction has worse outcomes and more high-level studies are needed. Additionally, prospective studies that apply the knowledge for current known risk factor mitigation are needed to determine if graft tear rates can be lowered.

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