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Age, Time From Injury To Surgery And Quadriceps Strength Affect The Risk Of Revision Surgery After Primary Acl Reconstruction

Riccardo Cristiani, MD, PhD, SWEDEN Magnus Forssblad, SWEDEN Gunnar Edman, MD, PhD, Prof., SWEDEN Karl Eriksson, MD, PhD, Prof., SWEDEN Anders Stalman, MD, PhD, Associate Professor, SWEDEN

Capio Artro Clinic, Stockholm Sports Trauma Research Center, Karolinska Institute, FIFA Medical Centre of Excellence, Stockholm, SWEDEN

2021 Congress Abstract Presentation 6 minutes rating (1)

Anatomic Location

Knee

Anatomic Structure

Ligaments Meniscus

Diagnosis / Condition

Instability

Treatment / Technique

Failed Repair / Reconstruction Single Bundle

Ligaments

ACL

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Summary: Younger age (< 25 years), shorter time from injury to primary ACLR (< 12 months) and a quadriceps strength LSI of => 90% 6 months after primary ACLR increased the odds of revision ACLR within 2 years.

Background

There is a need for a comprehensive and detailed analysis of preoperative, intraoperative and postoperative risk factors for revision ACLR. An awareness of the effect of multiple factors on the risk of revision ACLR could help clinicians to counsel patients undergoing primary ACLR about this complication. In addition, knowledge of potentially modifiable risk factors for revision ACLR might be used to target these factors and reduce the risk of this serious event.

Purpose

To identify preoperative, intraoperative and postoperative factors associated with revision ACLR within 2 years of primary ACLR.

Methods

Patients who underwent primary ACLR at our institution, from January 2005 to March 2017, were identified. The primary outcome was the occurrence of revision ACLR within 2 years of primary ACLR. Patients who underwent revision ACLR at our institution or other institutions in the country were identified through their unique personal identity number in the Swedish National Knee Ligament Registry. Univariate and multivariate logistic regression analyses were used to evaluate preoperative (age, gender, body mass index [BMI], time from injury to surgery, pre-injury Tegner activity level), intraoperative (graft type, graft diameter, medial meniscus [MM] and lateral meniscus [LM] resection or repair, cartilage injury) and postoperative (side-to-side [STS] KT-1000 anterior laxity, limb simmetry [LSI] for quadriceps and hamstring strength and single-leg-hop test performance at 6 months) risk factors for revision ACLR.

Results

A total of 6,510 primary ACLRs were included. The overall incidence of revision ACLR within 2 years was 2.5%. Univariate analysis showed that age < 25 years, BMI < 25, time from injury to surgery < 12 months, pre-injury Tegner activity level => 6, LM repair, STS laxity > 5 mm, quadriceps strength and single-leg-hop test LSI of => 90% increased the odds, whereas MM resection and the presence of a cartilage injury reduced the odds of reivision ACLR. Multivariate analysis revealed that revision ACLR was significantly related only to age < 25 years (OR 6.25; 95% CI, 3.57 - 11.11; P < 0.001), time from injury to surgery < 12 months (OR 2.27; 95% CI, 1.25 - 4.17; P = 0.007) and quadriceps strength LSI of => 90% (OR 1.70; 95% CI, 1.16 - 2.49; P = 0.006).

Conclusions

Age < 25 years, time from injury to surgery < 12 months and 6-month quadriceps strength LSI of => 90% increased the odds of revision ACLR within 2 years of primary ACLR. Understanding the risk factors for revision ACLR has important implications when it comes to the appropriated counselling for primary ACLR. We have analyzed a large spectrum of potential risk factors for revision ACLR in a large cohort. Advising patients regarding the results of an ACLR should also include potential risk factors for revision surgery.

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Ligamentous Laxity, Male Sex, Chronicity, Meniscus Injury And Posterior Tibial Slope Are Associated With A High-Grade Pre-Operative Pivot Shift: A Post Hoc Analysis Of The Stability Study Abstract Presentation 6 minutes Lachlan Batty, FRACS, AUSTRALIA Andrew Firth, PhD, CANADA Gilbert Moatshe, MD, PhD, NORWAY Dianne M. Bryant, PhD, CANADA S. Mark A. Heard, MD, FRCS, CANADA Robert G. McCormack, MD, CANADA Alex Rezansoff, MD, FRCSC, CANADA Devin Clarke Peterson, MD, FRCSC, Dip Sport Med, CANADA Davide Bardana, MD, CANADA Peter B. MacDonald, MD, FRCS, Dip Sport Med, CANADA Tim Spalding, FRCS(Orth), UNITED KINGDOM Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
Clinical Outcomes Of Primary Acl Reconstruction With Tibial Attachment Preserving Quadrupled Hamstring Graft: Does Graft Size Matter? - A Prospective Study With Review Of Literature Abstract Presentation 5 minutes Shaival Dalal, M.S.MRCS(Edinburgh), UNITED KINGDOM Ghislain N. Aminake, MBBS, MMed(Ortho),MRCPS(Glasg), CAMEROON Randy Guro, BSc, UNITED KINGDOM Amit Pramod Chandratreya, FRCS(Tr&Orth), MS(Orth), MCh(Orth), UNITED KINGDOM Rahul Kotwal, FRCS(Ortho), UNITED KINGDOM
The Outcome Of Non-circular (Rectangle, Oval) Femoral Tunnel ACL Reconstruction, Does It Improve The Outcome Of ACL Reconstruction Surgery? Abstract Presentation 6 minutes S. Ali Ghasemi, MD, UNITED STATES Joseph McCahon, DO, UNITED STATES Arthur R Bartolozzi, MD, UNITED STATES
Effect Of Graft Choice On 6-Year Outcomes Of Revision Anterior Cruciate Ligament Reconstruction In The Multicenter ACL Revision Study (Mars) Cohort Abstract Presentation 6 minutes Rick W. Wright, MD, UNITED STATES
Why, When and Who Fails Non-Operative Treatment of Anterior Cruciate Ligament Injury – An Exploratory Analysis of the COMPARE Trial Abstract Presentation 5 minutes Sabine van der Graaff, MD, NETHERLANDS Duncan E. Meuffels, MD, PhD, Prof., NETHERLANDS Sita Bierma-Zeinstra, MD, NETHERLANDS Eline van Es, MSc, NETHERLANDS Jan Verhaar, MD, PhD, Prof., NETHERLANDS Vincent Eggerding, MD, NETHERLANDS Max Reijman, PhD, NETHERLANDS
Return To Sports After Paediatric Anterior Cruciate Ligament Reconstruction (ACLR): Normal Population Vs An ACLR Cohort Abstract Presentation 6 minutes Alexander S. Nicholls, MSc, FRACS, AUSTRALIA Jillian Lee, BHB, MBChB, FRACS (Ortho), NEW ZEALAND Yoong Lim, BEng, PhD, AUSTRALIA Quang Dao, FRACS, AUSTRALIA
Inter- and Intra-Rater Reliability of Measurenebt of ACL TUnnels with Radiographs, CT, and MRI Abstract Presentation 4 minutes Robert A Magnussen, MD, MPH, UNITED STATES Alexander Sparks, BS, UNITED STATES Jacy Leon, BS, UNITED STATES Matthew Colatruglio, BS, UNITED STATES Joshua Bowler, MD James Oosten, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Joshua Scott Everhart, MD, MPH, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES David C. Flanigan, MD, UNITED STATES
Coach Education Improves Implementation Of ACL Injury Prevention Programs: A Cluster-Randomized Controlled Trial Abstract Presentation 5 minutes Daphne Ling, PhD, MPH, TAIWAN Caroline Boyle, UNITED STATES Brandon Schneider, MS, UNITED STATES Joseph Janosky, DrPHc, MS, PT, ATC, UNITED STATES James Kinderknecht, UNITED STATES Robert G. Marx, MD, UNITED STATES
Impingement Due to Graft Buckling Is More Prevalent after ACL Reconstructions with an Adjustable-Loop Compared to a Fixed-Loop Abstract Presentation 5 minutes Julian De Rover, NETHERLANDS Inge Van Den Akker-Scheek, PhD, NETHERLANDS Hugo Christiaan van der Veen, MD, PhD, NETHERLANDS
The Effect of Lateral Extra-Articular Tenodesis on Medial and Lateral Menisci Loading in Response To Simulated Tests of the Pivot Shift and Anterior Laxity Abstract Presentation 6 minutes Niv Marom, MD, ISRAEL Hamid Jahandar, BS, UNITED STATES Zaid Zayyad, MD, MS, UNITED STATES thomas fraychineaud, MD, UNITED STATES Herve Ouanezar, MD, UNITED ARAB EMIRATES Ronak M. Patel, MD, UNITED STATES Carl W Imhauser, PhD, UNITED STATES Thomas L. Wickiewicz, MD, UNITED STATES Andrew D. Pearle, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
Contralateral versus ipsilateral quadriceps graft, for anterior cruciate ligament reconstruction. Abstract Presentation 6 minutes Franco Della Vedova, ARGENTINA Hernan Galan, MD, ARGENTINA Daniel A. Slullitel, MD, Prof., ARGENTINA
Relationship Between Posterior Tibial Slope And Sagittal Plane Mechanics During Jump Landing After Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Robert A. Duerr, MD, UNITED STATES Jennifer Perry, MS, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES Benjamin Ormseth, BS, UNITED STATES Robert Siston, PhD, UNITED STATES Andrew Garrone, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Laura C. Schmitt, PT, PhD, UNITED STATES
Concurrent Treatment Of A Displaced Bucket Handle And Anterior Cruciate Ligament Reconstruction: A Higher Risk Of Stiffness? Abstract Presentation 5 minutes Etienne Deroche, MD, FRANCE Cécile Batailler, MD, PhD, FRANCE John Swan, MBBS, FRANCE Sebastien Lustig, MD, PhD, Prof., FRANCE Elvire Servien, MD, PhD, Prof., FRANCE

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Age, Time From Injury To Surgery And Quadriceps Strength Affect The Risk Of Revision Surgery After Primary Acl Reconstruction

Age, Time From Injury To Surgery And Quadriceps Strength Affect The Risk Of Revision Surgery After Primary Acl Reconstruction

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Age, Time From Injury To Surgery And Quadriceps Strength Affect The Risk Of Revision Surgery After Primary Acl Reconstruction

Age, Time From Injury To Surgery And Quadriceps Strength Affect The Risk Of Revision Surgery After Primary Acl Reconstruction

Background

Purpose

Methods

Results

Conclusions

More ISAKOS 2021: Global Content