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Risk Factors and Predictors of Subsequent ACL Injury in Either Knee After ACL Reconstruction: Prospective Analysis of 2488 Primary ACL Reconstructions From the MOON Cohort
Journal article   Open access   Peer reviewed

Risk Factors and Predictors of Subsequent ACL Injury in Either Knee After ACL Reconstruction: Prospective Analysis of 2488 Primary ACL Reconstructions From the MOON Cohort

Christopher C Kaeding, Angela D Pedroza, Emily K Reinke, Laura J Huston, Kurt P Spindler and Moon Consortium (Multicenter Orthopedic Outcomes Network)
The American journal of sports medicine, Vol.43(7), pp.1583-1590
07/2015
DOI: 10.1177/0363546515578836
PMCID: PMC4601557
PMID: 25899429
url
http://doi.org/10.1177/0363546515578836View
Open Access

Abstract

Anterior cruciate ligament (ACL) reinjury results in worse outcomes and increases the risk of posttraumatic osteoarthritis. To identify the risk factors for both ipsilateral and contralateral ACL tears after primary ACL reconstruction (ACLR). Cohort study; Level of evidence, 3. Data from the Multicenter Orthopaedic Outcomes Network (MOON), a prospective longitudinal cohort, were used to identify risk factors for ACL retear. Subjects with primary ACLR, no history of contralateral knee surgery, and a minimum of 2-year follow-up data were included. Age, sex, Marx activity score, graft type, lateral meniscal tear, medial meniscal tear, sport played at index injury, and surgical facility were evaluated to determine their contribution to both ipsilateral retear and contralateral ACL tear. A total of 2683 subjects with average age of 27 ± 11 years (1498 men; 56%) met all study inclusion/exclusion criteria. Overall there were 4.4% ipsilateral graft tears and 3.5% contralateral ACL tears. The odds of ipsilateral ACL retear were 5.2 times greater for an allograft (P < .01) compared with a bone-patellar tendon-bone (BTB) autograft; the odds of retear were not significantly different between BTB autograft and hamstring autograft (P = .12). The odds of an ipsilateral ACL retear decreased by 0.09 for every yearly increase in age (P < .01) and increased by 0.11 for every increased point on the Marx score (P < .01). These odds were not significantly influenced by sex, smoking status, sport played, medial or lateral meniscal tear, or consortium site (P > .05). The odds of a contralateral ACL tear decreased by 0.04 for every yearly increase in age (P = .04) and increased by 0.12 for every increased point on the Marx score (P < .01); these odds were not significantly different between sex, smoking status, sport played, graft type, medial meniscal tear, or lateral meniscal tear (P > .05). Younger age, higher activity level, and allograft graft type were predictors of increased odds of ipsilateral graft failure. Higher activity and younger age were found to be risk factors in contralateral ACL tears.
Anterior Cruciate Ligament Reconstruction - methods Prospective Studies Anterior Cruciate Ligament Injuries Humans Patellar Ligament - surgery Risk Factors Male Transplantation, Autologous Muscle, Skeletal - injuries Knee Injuries - surgery Young Adult Knee Joint - surgery Adolescent Adult Female Longitudinal Studies Osteoarthritis - etiology Cohort Studies

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