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The anterior cruciate ligament injury severity scale (ACLISS) is an effective tool to document and categorize the magnitude of associated tissue damage in knees after primary ACL injury and reconstruction.

Publication ,  Journal Article
Seil, R; Pioger, C; Siboni, R; Amendola, A; Mouton, C
Published in: Knee Surg Sports Traumatol Arthrosc
July 2023

PURPOSE: To develop a tool allowing to classify the magnitude of structural tissue damage occurring in ACL injured knees. The proposed ACL Injury Severity Scale (ACLISS) would provide an easy description and categorization of the wide spectrum of injuries in patients undergoing primary ACL reconstruction, reaching from isolated ACL tears to ACL injuries with a complex association of combined structural damage. METHODS: A stepwise approach was used to develop the ACLISS. The eligibility of each item was based on a literature search and a consensus between the authors after considering the diagnostic modalities and clinical importance of associated injuries to the menisci, subchondral bone, articular cartilage or collateral ligaments. Then, a retrospective analysis of associated injuries was performed in 100 patients who underwent a primary ACL reconstruction (ACLR) by a single surgeon. This was based on acute preoperative MRI (within 8 weeks after injury) as well as intraoperative arthroscopic findings. Depending on their prevalence, the number of selected items was reduced. Finally, an analysis of the overall scale distribution was performed to classify the patients according to different injury profiles. RESULTS: A final scoring system of 12 points was developed (12 = highest severity). Six points were attributed to the medial and lateral tibiofemoral compartment respectively. The amount of associated injuries increased with ACLISS grading. The median scale value was 4.5 (lower quartile 3.0; higher quartile 7.0). Based on these quartiles, a score < 4 was considered to be an injury of mild severity (grade I), a score between ≥ 4 and ≤ 7 was defined as moderately severe (grade II) and a score > 7 displayed the most severe cases of ACL injuries (grade III). The knees were graded ACLISS I in 35%, ACLISS II in 49% and ACLISS III in 16% of patients. Overall, damage to the lateral tibiofemoral compartment was predominant (p < 0.01), but a proportional increase of tissue damage could be observed in the medial tibiofemoral compartment with the severity of ACLISS grading (p < 0.01). CONCLUSIONS: The ACLISS allowed to easily and rapidly identify different injury severity profiles in patients who underwent primary ACLR. Injury severity was associated with an increased involvement of the medial tibiofemoral compartment. The ACLISS is convenient to use in daily clinical practice and represents a feasible grading and documentation tool for a reproducible comparison of clinical data in ACL injured patients. LEVEL OF EVIDENCE: Level III.

Duke Scholars

Published In

Knee Surg Sports Traumatol Arthrosc

DOI

EISSN

1433-7347

Publication Date

July 2023

Volume

31

Issue

7

Start / End Page

2983 / 2997

Location

Germany

Related Subject Headings

  • Retrospective Studies
  • Orthopedics
  • Menisci, Tibial
  • Knee Injuries
  • Humans
  • Cartilage, Articular
  • Anterior Cruciate Ligament Injuries
  • Anterior Cruciate Ligament
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science
 

Citation

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MLA
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Seil, R., Pioger, C., Siboni, R., Amendola, A., & Mouton, C. (2023). The anterior cruciate ligament injury severity scale (ACLISS) is an effective tool to document and categorize the magnitude of associated tissue damage in knees after primary ACL injury and reconstruction. Knee Surg Sports Traumatol Arthrosc, 31(7), 2983–2997. https://doi.org/10.1007/s00167-023-07311-4
Seil, Romain, Charles Pioger, Renaud Siboni, Annunziato Amendola, and Caroline Mouton. “The anterior cruciate ligament injury severity scale (ACLISS) is an effective tool to document and categorize the magnitude of associated tissue damage in knees after primary ACL injury and reconstruction.Knee Surg Sports Traumatol Arthrosc 31, no. 7 (July 2023): 2983–97. https://doi.org/10.1007/s00167-023-07311-4.
Seil, Romain, et al. “The anterior cruciate ligament injury severity scale (ACLISS) is an effective tool to document and categorize the magnitude of associated tissue damage in knees after primary ACL injury and reconstruction.Knee Surg Sports Traumatol Arthrosc, vol. 31, no. 7, July 2023, pp. 2983–97. Pubmed, doi:10.1007/s00167-023-07311-4.
Journal cover image

Published In

Knee Surg Sports Traumatol Arthrosc

DOI

EISSN

1433-7347

Publication Date

July 2023

Volume

31

Issue

7

Start / End Page

2983 / 2997

Location

Germany

Related Subject Headings

  • Retrospective Studies
  • Orthopedics
  • Menisci, Tibial
  • Knee Injuries
  • Humans
  • Cartilage, Articular
  • Anterior Cruciate Ligament Injuries
  • Anterior Cruciate Ligament
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science