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Which preoperative factors, including bone bruise, are associated with knee pain/symptoms at index anterior cruciate ligament reconstruction (ACLR)? A Multicenter Orthopaedic Outcomes Network (MOON) ACLR Cohort Study.

Publication ,  Journal Article
Dunn, WR; Spindler, KP; Amendola, A; Andrish, JT; Kaeding, CC; Marx, RG; McCarty, EC; Parker, RD; Harrell, FE; An, AQ; Wright, RW; Brophy, RH ...
Published in: Am J Sports Med
September 2010

BACKGROUND: Increased knee pain at the time of anterior cruciate ligament reconstruction may potentially predict more difficult rehabilitation, prolonged recovery, and/or be predictive of increased knee pain at 2 years. HYPOTHESIS: A bone bruise and/or other preoperative factors are associated with more knee pain/symptoms at the time of index anterior cruciate ligament reconstruction, and the presence of a bone bruise would be associated with specific demographic and injury-related factors. STUDY DESIGN: Cohort study (prevalence); Level of evidence, 2. METHODS: In 2007, the Multicenter Orthopaedic Outcomes Network (MOON) database began to prospectively collect surgeon-reported magnetic resonance imaging bone bruise status. A multivariable analysis was performed to (1) determine if a bone bruise, among other preoperative factors, is associated with more knee symptoms/pain and (2) examine the association of factors related to bone bruise. To evaluate the association of a bone bruise with knee pain/symptoms, linear multiple regression models were fit using the continuous scores of the Knee injury and Osteoarthritis Outcome Score (KOOS) symptoms and pain subscales and the Short Form 36 (SF-36) bodily pain subscale as dependent variables. To examine the association between a bone bruise and risk factors, a logistic regression model was used, in which the dependent variable was the presence or absence of a bone bruise. RESULTS: Baseline data for 525 patients were used for analysis, and a bone bruise was present in 419 (80%). The cohort comprises 58% male patients, with a median age of 23 years. The median Marx activity level was 13. Factors associated with more pain were higher body mass index (P < .0001), female sex (P = .001), lateral collateral ligament injury (P = .012), and older age (P = .038). Factors associated with more symptoms were a concomitant lateral collateral ligament injury (P = .014), higher body mass index (P < .0001), and female sex (P < .0001). Bone bruise is not associated with symptoms/pain at the time of index anterior cruciate ligament reconstruction. None of the factors included in the SF-36 bodily pain model were found to be significant. After controlling for other baseline factors, the following factors were associated with a bone bruise: younger age (P = .034) and not jumping at the time of injury (P = .006). CONCLUSION: After anterior cruciate ligament injury, risk factors associated with a bone bruise are younger age and not jumping at the time of injury. Bone bruise is not associated with symptoms/pain at the time of index anterior cruciate ligament reconstruction.

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Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

September 2010

Volume

38

Issue

9

Start / End Page

1778 / 1787

Location

United States

Related Subject Headings

  • Young Adult
  • Risk Factors
  • Preoperative Period
  • Pain Measurement
  • Pain
  • Orthopedics
  • Orthopedic Procedures
  • Nomograms
  • Male
  • Linear Models
 

Citation

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Dunn, W. R., Spindler, K. P., Amendola, A., Andrish, J. T., Kaeding, C. C., Marx, R. G., … MOON ACL Investigation. (2010). Which preoperative factors, including bone bruise, are associated with knee pain/symptoms at index anterior cruciate ligament reconstruction (ACLR)? A Multicenter Orthopaedic Outcomes Network (MOON) ACLR Cohort Study. Am J Sports Med, 38(9), 1778–1787. https://doi.org/10.1177/0363546510370279
Dunn, Warren R., Kurt P. Spindler, Annunziato Amendola, Jack T. Andrish, Christopher C. Kaeding, Robert G. Marx, Eric C. McCarty, et al. “Which preoperative factors, including bone bruise, are associated with knee pain/symptoms at index anterior cruciate ligament reconstruction (ACLR)? A Multicenter Orthopaedic Outcomes Network (MOON) ACLR Cohort Study.Am J Sports Med 38, no. 9 (September 2010): 1778–87. https://doi.org/10.1177/0363546510370279.
Dunn WR, Spindler KP, Amendola A, Andrish JT, Kaeding CC, Marx RG, McCarty EC, Parker RD, Harrell FE, An AQ, Wright RW, Brophy RH, Matava MJ, Flanigan DC, Huston LJ, Jones MH, Wolcott ML, Vidal AF, Wolf BR, MOON ACL Investigation. Which preoperative factors, including bone bruise, are associated with knee pain/symptoms at index anterior cruciate ligament reconstruction (ACLR)? A Multicenter Orthopaedic Outcomes Network (MOON) ACLR Cohort Study. Am J Sports Med. 2010 Sep;38(9):1778–1787.
Journal cover image

Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

September 2010

Volume

38

Issue

9

Start / End Page

1778 / 1787

Location

United States

Related Subject Headings

  • Young Adult
  • Risk Factors
  • Preoperative Period
  • Pain Measurement
  • Pain
  • Orthopedics
  • Orthopedic Procedures
  • Nomograms
  • Male
  • Linear Models