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Articular Cartilage and Meniscus Predictors of Patient-Reported Outcomes 10 Years After Anterior Cruciate Ligament Reconstruction: A Multicenter Cohort Study.

Publication ,  Journal Article
Brophy, RH; Huston, LJ; Briskin, I; MOON Knee Group; Amendola, A; Cox, CL; Dunn, WR; Flanigan, DC; Jones, MH; Kaeding, CC; Marx, RG; Vidal, AF ...
Published in: Am J Sports Med
September 2021

BACKGROUND: Articular cartilage and meniscal damage are commonly encountered and often treated at the time of anterior cruciate ligament reconstruction (ACLR). Our understanding of how these injuries and their treatment relate to outcomes of ACLR is still evolving. HYPOTHESIS/PURPOSE: The purpose of this study was to assess whether articular cartilage and meniscal variables are predictive of 10-year outcomes after ACLR. We hypothesized that articular cartilage lesions and meniscal tears and treatment would be predictors of the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS) (all 5 subscales), and Marx activity level outcomes at 10-year follow-up after ACLR. STUDY DESIGN: Cohort study (prognosis); Level of evidence, 1. METHODS: Between 2002 and 2008, individuals with ACLR were prospectively enrolled and followed longitudinally using the IKDC, KOOS, and Marx activity score completed at entry, 2, 6, and 10 years. A proportional odds logistic regression model was built incorporating variables from patient characteristics, surgical technique, articular cartilage injuries, and meniscal tears and treatment to determine the predictors (risk factors) of IKDC, KOOS, and Marx outcomes at 10 years. RESULTS: A total of 3273 patients were enrolled (56% male; median age, 23 years at time of enrollment). Ten-year follow-up was obtained on 79% (2575/3273) of the cohort. Incidence of concomitant pathology at the time of surgery consisted of the following: articular cartilage (medial femoral condyle [MFC], 22%; lateral femoral condyle [LFC], 15%; medial tibial plateau [MTP], 4%; lateral tibial plateau [LTP], 11%; patella, 18%; trochlea, 8%) and meniscal pathology (medial, 37%; lateral, 46%). Variables that were predictive of poorer 10-year outcomes included articular cartilage damage in the patellofemoral (P < .01) and medial (P < .05) compartments and previous medial meniscal surgery (7% of knees; P < .04). Compared with no meniscal tear, a meniscal injury was not associated with 10-year outcomes. Medial meniscal repair at the time of ACLR was associated with worse 10-year outcomes for 2 of 5 KOOS subscales, while a medial meniscal repair in knees with grade 2 MFC chondrosis was associated with better outcomes on 2 KOOS subscales. CONCLUSION: Articular cartilage injury in the patellofemoral and medial compartments at the time of ACLR and a history of medial meniscal surgery before ACLR were associated with poorer 10-year ACLR patient-reported outcomes, but meniscal injury present at the time of ACLR was not. There was limited and conflicting association of medial meniscal repair with these outcomes.

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Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

September 2021

Volume

49

Issue

11

Start / End Page

2878 / 2888

Location

United States

Related Subject Headings

  • Young Adult
  • Patient Reported Outcome Measures
  • Orthopedics
  • Menisci, Tibial
  • Male
  • Humans
  • Female
  • Cohort Studies
  • Cartilage, Articular
  • Anterior Cruciate Ligament Reconstruction
 

Citation

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Brophy, R. H., Huston, L. J., Briskin, I., MOON Knee Group, Amendola, A., Cox, C. L., … Spindler, K. P. (2021). Articular Cartilage and Meniscus Predictors of Patient-Reported Outcomes 10 Years After Anterior Cruciate Ligament Reconstruction: A Multicenter Cohort Study. Am J Sports Med, 49(11), 2878–2888. https://doi.org/10.1177/03635465211028247
Brophy, Robert H., Laura J. Huston, Isaac Briskin, MOON Knee Group, Annunziato Amendola, Charles L. Cox, Warren R. Dunn, et al. “Articular Cartilage and Meniscus Predictors of Patient-Reported Outcomes 10 Years After Anterior Cruciate Ligament Reconstruction: A Multicenter Cohort Study.Am J Sports Med 49, no. 11 (September 2021): 2878–88. https://doi.org/10.1177/03635465211028247.
Brophy RH, Huston LJ, Briskin I, MOON Knee Group, Amendola A, Cox CL, et al. Articular Cartilage and Meniscus Predictors of Patient-Reported Outcomes 10 Years After Anterior Cruciate Ligament Reconstruction: A Multicenter Cohort Study. Am J Sports Med. 2021 Sep;49(11):2878–88.
Brophy, Robert H., et al. “Articular Cartilage and Meniscus Predictors of Patient-Reported Outcomes 10 Years After Anterior Cruciate Ligament Reconstruction: A Multicenter Cohort Study.Am J Sports Med, vol. 49, no. 11, Sept. 2021, pp. 2878–88. Pubmed, doi:10.1177/03635465211028247.
Brophy RH, Huston LJ, Briskin I, MOON Knee Group, Amendola A, Cox CL, Dunn WR, Flanigan DC, Jones MH, Kaeding CC, Marx RG, Matava MJ, McCarty EC, Parker RD, Vidal AF, Wolcott ML, Wolf BR, Wright RW, Spindler KP. Articular Cartilage and Meniscus Predictors of Patient-Reported Outcomes 10 Years After Anterior Cruciate Ligament Reconstruction: A Multicenter Cohort Study. Am J Sports Med. 2021 Sep;49(11):2878–2888.
Journal cover image

Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

September 2021

Volume

49

Issue

11

Start / End Page

2878 / 2888

Location

United States

Related Subject Headings

  • Young Adult
  • Patient Reported Outcome Measures
  • Orthopedics
  • Menisci, Tibial
  • Male
  • Humans
  • Female
  • Cohort Studies
  • Cartilage, Articular
  • Anterior Cruciate Ligament Reconstruction