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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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Increased Osteoarthritis And Knee Instability Following Postoperative Septic Knee Arthritis After Anterior Cruciate Ligament Reconstruction with a Minimum 8 Year Follow-Up ePoster Presentation Thomas R. Pfeiffer, Prof., GERMANY Julius Stüber, cand. med., GERMANY Jan-Hendrik Naendrup, BS, MD, GERMANY Daniel Guenther, MD, PD, GERMANY Robin Otchwemah, MD, GERMANY Sven T. Shafizadeh, Prof., GERMANY Paola Kappel, MD, GERMANY Arasch Wafaisade, PD, GERMANY Sebastian Imach, MD, MBA, GERMANY
Predicting Subjective Failure of ACL Reconstruction: A Machine Learning Analysis of the Norwegian Knee Ligament Register and Patient Reported Outcomes Award Winner 5 minutes R. Kyle Martin, MD, FRCSC, UNITED STATES Solvejg Wastvedt, BA, UNITED STATES Ayoosh Pareek, MD, UNITED STATES Andreas Persson, MD, PhD, NORWAY Havard Visnes, MD, PT, PhD, NORWAY Anne Marie Fenstad, MSc, NORWAY Gilbert Moatshe, MD, PhD, NORWAY Julian Wolfson, PhD, UNITED STATES Lars Engebretsen, MD, PhD, NORWAY
Creating A Crosswalk For Knee Outcomes After ACLR From The KOOS(5) To The IKDC-SKF Abstract Presentation 6 minutes Jessica L. Johnson, DPT, PhD, UNITED STATES Aaron Boulton, PhD, UNITED STATES Kurt Paul Spindler, MD, UNITED STATES Laura J. Huston, MS, UNITED STATES Tim Spalding, FRCS(Orth), UNITED KINGDOM Laura Asplin, UNITED KINGDOM May Arna Risberg, PT, PhD, NORWAY Lynn Snyder-Mackler, PT, ScD, FAPTA, UNITED STATES
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
Adding A Lateral Extra-Articular Tenodesis Significantly Reduces Acl Graft Rupture Rates In Pediatric And Adolescent Patients When Compared To Isolated Acl Reconstruction Abstract Presentation 5 minutes Andrea Ferretti, Prof., ITALY Adnan Saithna, MD, FRCS, UNITED STATES Alessandro Carrozzo, MD, ITALY Alessandro Annibaldi, MD, ITALY Fabio Marzilli, MD, ITALY Edoardo Monaco, MD, ITALY
Survivability Of Primary Anterior Cruciate Ligament Reconstructions In A Physically High Demand Population Abstract Presentation 6 minutes Ashley Bee Anderson, MD, UNITED STATES Travis Dekker, MD, UNITED STATES Veronika Pav, MS, UNITED STATES Timonthy C Mauntel, PhD, UNITED STATES Matthew T. Provencher, MD, UNITED STATES John M. Tokish, MD, UNITED STATES Jon F. Dickens, MD, UNITED STATES
Validation of a Risk Calculator to Personalize Graft Choice and Reduce Rupture Rates for Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Hana Marmura, BSc, CANADA Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, CANADA Kurt Paul Spindler, MD, UNITED STATES Michael W Kattan, PhD, UNITED STATES Isaac Briskin, MA, UNITED STATES Dianne M. Bryant, PhD, CANADA
In Vivo Measurement of Anterior Cruciate Ligament Elongation and Strain Rate during Increasingly Demanding Activities ePoster Presentation Kyohei Nishida , MD, PhD, JAPAN Caiqi Xu, MD, CHINA Tom Gale, MS, UNITED STATES William Anderst, PhD, UNITED STATES Freddie H. Fu, MD, UNITED STATES
Predicting Patient Lost to Follow-up in the STABILITY 1 Study: A Multi-centre, International, Randomized Controlled Trial of Young, Active Patients Undergoing Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Andrew Firth, PhD, CANADA Dianne M. Bryant, PhD, CANADA Andrew Johnson, PhD, CANADA Stability Study Group, CANADA Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, CANADA
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
Contralateral versus ipsilateral quadriceps graft, for anterior cruciate ligament reconstruction. Abstract Presentation 6 minutes Franco Della Vedova, MD, ARGENTINA Hernan Galan, MD, ARGENTINA Daniel A. Slullitel, MD, Prof., ARGENTINA
Comparative Study Of “Concomitant Patellar Tendon Rupture With Anterior cruciate ligament tear and Patellar Tendon Rupture With Multi- Ligamentous Knee Injury –MLKI” Abstract Presentation 6 minutes Silvampatti Ramasamy Sundararajan, MS(Orth), INDIA Rajagopalakrishnan Ramakanth, D.ortho, DNB(ortho), D.SICOT, INDIA S Rajasekaran, MS(Orth),DOrth,DNB,FRCS(Ed),FRCS(Lon),MCh(Liv),PhD, INDIA

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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