Incidence of Secondary Intra-articular Injuries With Time to Anterior Cruciate Ligament Reconstruction

Ralles, Steven; Agel, Julie; Obermeier, Michael; Tompkins, Marc

doi:10.1177/0363546515574061

Cited by 45 publications

(52 citation statements)

References 34 publications

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“…However, motion in the knee joint occurs across multiple planes of motion [2], and the stability of the knee is maintained by additional primary and secondary stabilizing structures that function to constrain the knee in the threedimensional context of motion [3]. ACL injuries are frequently accompanied by concomitant injuries to these stabilizing structures, and the resultant multifactorial instability has been shown to increase the risk of developing osteoarthritis (OA) [4][5][6]. Arthroscopic ACL reconstruction is widely accepted as the treatment of choice to address this problem, particularly for young patients with a high activity level and those who fail to cope with instability [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Kinematic outcomes following ACL reconstruction

Naendrup

Zlotnicki

Chao

et al. 2016

Curr Rev Musculoskelet Med

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Anterior cruciate ligament (ACL) reconstruction aims to restore the translational and rotational motion to the knee joint that is lost after injury. However, despite technical advancements, clinical outcomes are less than ideal, particularly in return to previous activity level. A major issue is the inability to standardize treatment protocols due to variations in materials and approaches used to accomplish ACL reconstruction. These include surgical techniques such as the transtibial and anteromedial portal methods that are currently under use and the wide availability of graft types that will be used to reconstruct the ACL. In addition, concomitant soft tissue injuries to the menisci and capsule are frequently present after ACL injury and, if left unaddressed, can lead to persistent instability even after the ACL has been reconstructed. Advances in the field of biomechanics that help to objectively measure motion of the knee joint may provide more precise data than current subjective clinical measurements. These technologies include extra-articular motion capture systems that measure the movement of the tibia in relation to the femur. With data gathered from these devices, a threshold for satisfactory knee stability may be established in order to correctly identify a successful reconstruction following ACL injury.

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Section: Introductionmentioning

confidence: 99%

Kinematic outcomes following ACL reconstruction

Naendrup

Zlotnicki

Chao

et al. 2016

Curr Rev Musculoskelet Med

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“…This is in line with findings from a study of 616 participants that reported more meniscal injury in patients who underwent ACLR more than 3 months after injury and more cartilage injury in those who received ACLR more than 6 months from injury (Razi et al, 2013). Similarly, a large study of 1434 individuals found a relationship between an increased period of time from injury to surgery and higher rates of concomitant joint injury when presenting for ACLR, including injury to meniscus and joint surfaces (Ralles, Agel, Obermeier, & Tompkins, 2015). People with concomitant injury to other knee structures at the time of ACLR report higher rates of osteoarthritis 10 to 20 years later (Claes et al, 2013;Keays, 2010;Magnussen et al, 2009;Murray et al, 2012;Øiestad et al, 2009;van Meer et al, 2015) and poorer patient-reported outcomes after ACLR including more knee pain, symptoms, poorer function and reduced QOL (Barenius et al, 2010;Cox et al, 2014;Dunn et al, 2015;Gerhard et al, 2012;Neuman et al, 2008;Røtterud et al, 2012;Røtterud et al, 2013).…”

Section: Time From Injury To Surgerymentioning

confidence: 98%

“…Similarly, a large study of 1434 patients found a relationship between an increased period of time from injury to surgery and higher rates of concomitant joint injury when presenting for ACLR, including injury to meniscus and joint surfaces (Ralles et al, 2015). Concomitant meniscus and cartilage injury have been associated with an increased likelihood for self-reported knee symptoms, pain, function and poorer QOL 2 to 16 years after ACLR (Barenius et al, 2010;Cox et al, 2014;Dunn et al, 2015;Gerhard et al, 2012;Neuman et al, 2008;Røtterud et al, 2012;Røtterud et al, 2013).…”

Section: Time From Injury To Surgerymentioning

confidence: 99%

“…Individuals who are more physically active or those experiencing episodes of instability before undergoing ACLR appear to be at greater risk of joint injury with increased time from ACL rupture to ACLR (Kluczynski, Marzo, & Bisson, 2013;Ralles et al, 2015). However, these scenarios do not necessarily support an early ACLR over trialling conservative management.…”

Section: Time From Injury To Surgerymentioning

confidence: 99%

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Long-term quality of life following anterior cruciate ligament injury and reconstruction

Filbay¹

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The anterior cruciate ligament (ACL) serves to stabilise the knee complex and prevent intraarticular knee structures from sustaining damage during multiaxial, high impact movement. An ACL rupture most commonly occurs in adolescents and young adults taking part in competitive sports and causes substantial disruption to the knee joint. Anterior cruciate ligament reconstruction (ACLR) is the most common treatment offered to ACL-ruptured individuals worldwide. Individuals undergoing this surgery often have high expectations that rarely match surgical outcomes. Return to sport rates are low, re-injury fears are widespread and many individuals develop knee osteoarthritis within ten years of ACLR. This mismatch between expectations and actual outcomes has great potential to impact longer-term quality of life (QOL). The primary aims of this thesis were to: (i) generate a detailed picture of longer-term QOL following ACLR, and (ii) identify factors related to longer-term QOL in people with knee pain, symptoms or functional limitations following ACLR.The first study in this thesis is a systematic review that revealed impaired knee-related QOL at 5 to 20 years after ACLR. However, it became evident that research into factors impacting upon QOL in this population was scarce. The systematic review found that having a subsequent knee injury, an additional knee surgery after ACLR, and developing severe radiographic osteoarthritis were associated with worse QOL outcomes. The second study in this thesis is a systematic review that investigated QOL more than five years after ACL rupture in individuals who remained ACL-deficient (did not undergo ACLR) and compared QOL between ACLdeficient and ACL-reconstructed groups. This systematic review found that ACL-deficient individuals reported comparable QOL outcomes to those who underwent ACLR 5 to 25 years previously. All studies that reported QOL after ACLR included asymptomatic participants without knee difficulties, which may underestimate the degree of QOL impairment experienced by people with ongoing knee difficulties.The third study in this thesis used a cross-sectional design to describe QOL outcomes in 162 individuals with knee pain, symptoms or functional limitations 5 to 20 years following ACLR.It showed that individuals who did not return to sport after ACLR reported poorer knee-related and health-related QOL, compared to people who returned to pre-injury levels of sport. Higher body mass index (BMI) and subsequent surgery were also related to worse QOL after ACLR.This was the first study to show that return to sport was associated with QOL impairment more than five years after ACLR. However, quantitative assessment of QOL may overlook important considerations with regard to an individual's life priorities, expectations, values and concerns.To provide a detailed understanding of QOL following ACLR, qualitative interviews were performed with 17 individuals with knee difficulties 5 to 20 years following ACLR. This was the first qualitative study to explore QOL following...

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“…186 Injuries in the medial meniscus are also more common after initial ACL injury. 160,186 ACL injury with concomitant meniscal damage has been associated with worse subjective outcomes as well as increased prevalence of osteoarthritis. 17,40,102 ACL injuries with concurrent meniscal damage requiring surgical intervention significantly shortens professional sports careers comparing to an ACL injury alone.…”

Section: Incidence Of Anterior Cruciate Ligament Injuriesmentioning

confidence: 99%

Biomechanical Adaptations After Fatiguing Exercise in Healthy and ACL Reconstructed Individuals

Slater

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Incidence of Secondary Intra-articular Injuries With Time to Anterior Cruciate Ligament Reconstruction

Cited by 45 publications

References 34 publications

Kinematic outcomes following ACL reconstruction

Kinematic outcomes following ACL reconstruction

Long-term quality of life following anterior cruciate ligament injury and reconstruction

Biomechanical Adaptations After Fatiguing Exercise in Healthy and ACL Reconstructed Individuals

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