Risk Factors and Predictors of Significant Chondral Surface Change From Primary to Revision Anterior Cruciate Ligament Reconstruction: A MOON and MARS Cohort Study

Robert A Magnussen; James R Borchers; Angela D Pedroza; Laura J Huston; Amanda K Haas; Kurt P Spindler; Rick W Wright; Christopher C Kaeding; Christina R Allen; Allen F Anderson; Daniel E Cooper; Thomas M DeBerardino; Warren R Dunn; Brett A Lantz; Barton Mann; Michael J Stuart; John P Albright; Annunziato Amendola; Jack T Andrish; Christopher C Annunziata; Robert A Arciero; Bernard R Bach Jr; Champ L Baker III; Arthur R Bartolozzi; Keith M Baumgarten; Jeffery R Bechler; Jeffrey H Berg; Geoffrey A Bernas; Stephen F Brockmeier; Robert H Brophy; Charles A Bush-Joseph; J Brad Butler V; John D Campbell; James L Carey; James E Carpenter; Brian J Cole; Jonathan M Cooper; Charles L Cox; R Alexander Creighton; Diane L Dahm; Tal S David; David C Flanigan; Robert W Frederick; Theodore J Ganley; Elizabeth A Garofoli; Charles J Gatt Jr; Steven R Gecha; James Robert Giffin; Sharon L Hame; Jo A Hannafin; Christopher D Harner; Norman Lindsay Harris Jr; Keith S Hechtman; Elliott B Hershman; Rudolf G Hoellrich; Timothy M Hosea; David C Johnson; Timothy S Johnson; Morgan H Jones; Ganesh V Kamath; Thomas E Klootwyk; Bruce A Levy; C Benjamin Ma; G Peter Maiers II; Robert G Marx; Matthew J Matava; Gregory M Mathien; David R McAllister; Eric C McCarty; Robert G McCormack; Bruce S Miller; Carl W Nissen; Daniel F O'Neill; Brett D Owens; Richard D Parker; Mark L Purnell; Arun J Ramappa; Michael A Rauh; Arthur C Rettig; Jon K Sekiya; Kevin G Shea; Orrin H Sherman; James R Slauterbeck; Matthew V Smith; Jeffrey T Spang; Steven J Svoboda; Timothy N Taft; Joachim J Tenuta; Edwin M Tingstad; Armando F Vidal; Darius G Viskontas; Richard A White; James S Williams Jr; Michelle L Wolcott; Brian R Wolf; James J York

doi:10.1177/0363546517741484

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Risk Factors and Predictors of Significant Chondral Surface Change From Primary to Revision Anterior Cruciate Ligament Reconstruction: A MOON and MARS Cohort Study

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Peer reviewed

Risk Factors and Predictors of Significant Chondral Surface Change From Primary to Revision Anterior Cruciate Ligament Reconstruction: A MOON and MARS Cohort Study

Robert A Magnussen, James R Borchers, Angela D Pedroza, Laura J Huston, Amanda K Haas, Kurt P Spindler, Rick W Wright, Christopher C Kaeding, Christina R Allen, Allen F Anderson, …

The American journal of sports medicine, Vol.46(3), pp.557-564

03/2018

DOI: 10.1177/0363546517741484

PMCID: PMC7004295

PMID: 29244532

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https://www.ncbi.nlm.nih.gov/pmc/articles/7004295View

Open Access

Abstract

Background: Articular cartilage health is an important issue following anterior cruciate ligament (ACL) injury and primary ACL reconstruction. Factors present at the time of primary ACL reconstruction may influence the subsequent progression of articular cartilage damage. Hypothesis: Larger meniscus resection at primary ACL reconstruction, increased patient age, and increased body mass index (BMI) are associated with increased odds of worsened articular cartilage damage at the time of revision ACL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: Subjects who had primary and revision data in the databases of the Multicenter Orthopaedics Outcomes Network (MOON) and Multicenter ACL Revision Study (MARS) were included. Reviewed data included chondral surface status at the time of primary and revision surgery, meniscus status at the time of primary reconstruction, primary reconstruction graft type, time from primary to revision ACL surgery, as well as demographics and Marx activity score at the time of revision. Significant progression of articular cartilage damage was defined in each compartment according to progression on the modified Outerbridge scale (increase ≥1 grade) or >25% enlargement in any area of damage. Logistic regression identified predictors of significant chondral surface change in each compartment from primary to revision surgery. Results: A total of 134 patients were included, with a median age of 19.5 years at revision surgery. Progression of articular cartilage damage was noted in 34 patients (25.4%) in the lateral compartment, 32 (23.9%) in the medial compartment, and 31 (23.1%) in the patellofemoral compartment. For the lateral compartment, patients who had >33% of the lateral meniscus excised at primary reconstruction had 16.9-times greater odds of progression of articular cartilage injury than those with an intact lateral meniscus (P < .001). For the medial compartment, patients who had <33% of the medial meniscus excised at the time of the primary reconstruction had 4.8-times greater odds of progression of articular cartilage injury than those with an intact medial meniscus (P = .02). Odds of significant chondral surface change increased by 5% in the lateral compartment and 6% in the medial compartment for each increased year of age (P ≤ .02). For the patellofemoral compartment, the use of allograft in primary reconstruction was associated with a 15-fold increased odds of progression of articular cartilage damage relative to a patellar tendon autograft (P < .001). Each 1-unit increase in BMI at the time of revision surgery was associated with a 10% increase in the odds of progression of articular cartilage damage (P = .046) in the patellofemoral compartment. Conclusion: Excision of the medial and lateral meniscus at primary ACL reconstruction increases the odds of articular cartilage damage in the corresponding compartment at the time of revision ACL reconstruction. Increased age is a risk factor for deterioration of articular cartilage in both tibiofemoral compartments, while increased BMI and the use of allograft for primary ACL reconstruction are associated with an increased risk of progression in the patellofemoral compartment.

Body Mass Index

Prospective Studies

Humans

Risk Factors

Logistic Models

Male

Transplantation, Autologous

Anterior Cruciate Ligament Injuries - surgery

Case-Control Studies

Transplantation, Homologous

Young Adult

Adolescent

Anterior Cruciate Ligament Reconstruction

Reoperation - statistics & numerical data

Cartilage, Articular - injuries

Cartilage, Articular - surgery

Menisci, Tibial - surgery

Adult

Female

Patellar Ligament - transplantation

Details

Title: Subtitle: Risk Factors and Predictors of Significant Chondral Surface Change From Primary to Revision Anterior Cruciate Ligament Reconstruction: A MOON and MARS Cohort Study
Creators: Robert A Magnussen - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
James R Borchers - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Angela D Pedroza - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Laura J Huston - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Amanda K Haas - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Kurt P Spindler - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Rick W Wright - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Christopher C Kaeding - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Christina R Allen - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Allen F Anderson - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Daniel E Cooper - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Thomas M DeBerardino - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Warren R Dunn - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Brett A Lantz - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Barton Mann - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Michael J Stuart - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
John P Albright - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Annunziato Amendola - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Jack T Andrish - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Christopher C Annunziata - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Robert A Arciero - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Bernard R Bach Jr - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Champ L Baker III - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Arthur R Bartolozzi - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Keith M Baumgarten - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Jeffery R Bechler - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Jeffrey H Berg - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Geoffrey A Bernas - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Stephen F Brockmeier - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Robert H Brophy - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Charles A Bush-Joseph - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
J Brad Butler V - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
John D Campbell - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
James L Carey - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
James E Carpenter - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Brian J Cole - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Jonathan M Cooper - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Charles L Cox - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
R Alexander Creighton - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Diane L Dahm - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Tal S David - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
David C Flanigan - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Robert W Frederick - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Theodore J Ganley - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Elizabeth A Garofoli - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Charles J Gatt Jr - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Steven R Gecha - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
James Robert Giffin - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Sharon L Hame - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Jo A Hannafin - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Christopher D Harner - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Norman Lindsay Harris Jr - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Keith S Hechtman - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Elliott B Hershman - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Rudolf G Hoellrich - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Timothy M Hosea - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
David C Johnson - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Timothy S Johnson - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Morgan H Jones - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Ganesh V Kamath - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Thomas E Klootwyk - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Bruce A Levy - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
C Benjamin Ma - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
G Peter Maiers II - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Robert G Marx - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Matthew J Matava - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Gregory M Mathien - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
David R McAllister - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Eric C McCarty - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Robert G McCormack - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Bruce S Miller - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Carl W Nissen - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Daniel F O'Neill - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Brett D Owens - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Richard D Parker - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Mark L Purnell - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Arun J Ramappa - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Michael A Rauh - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Arthur C Rettig - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Jon K Sekiya - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Kevin G Shea - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Orrin H Sherman - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
James R Slauterbeck - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Matthew V Smith - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Jeffrey T Spang - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Steven J Svoboda - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Timothy N Taft - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Joachim J Tenuta - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Edwin M Tingstad - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Armando F Vidal - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Darius G Viskontas - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Richard A White - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
James S Williams Jr - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Michelle L Wolcott - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Brian R Wolf - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
James J York - Investigation performed at The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Resource Type: Journal article
Publication Details: The American journal of sports medicine, Vol.46(3), pp.557-564
DOI: 10.1177/0363546517741484
PMID: 29244532
PMCID: PMC7004295
NLM abbreviation: Am J Sports Med
ISSN: 0363-5465
eISSN: 1552-3365
Publisher: United States
Grant note: R01 AR060846 / NIAMS NIH HHS
Language: English
Date published: 03/2018
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9984040559402771

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