The time from injury to surgery is an important factor affecting the mechanoreceptors at stump of torn anterior cruciate ligament

Çabuk, Haluk; Çabuk, Fatmagül Kuşku; Turan, Kaya

doi:10.1007/s00402-021-04310-3

Cited by 8 publications

(11 citation statements)

References 22 publications

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“…Although we did not find an association between language and meniscal injury, patients from families with PLOE did experience delays in surgery, which has been shown to be associated with meniscal tears in previous work [20, 22]. Delays have also been shown to result in persistent instability, chondral injury, reduced frequency of return to sport, and worse patient-reported outcomes [4, 13, 17, 33, 34, 36]. Therefore, despite the findings regarding meniscus injury in this study, we still advise prompt treatment of ACL injuries in this population.…”

Section: Discussioncontrasting

confidence: 63%

“…Further research is needed to evaluate the association of language with care and long-term outcomes after ACLR, as the present study was only able to evaluate pre-and perioperative findings. Although the impact of delayed surgery is well established [4,13,17,33,34,36], long-term follow-up of patients with PLOE is warranted. The study is also subject to assessment bias, as no patient-reported outcome measures were available in retrospective data collection.…”

Section: Limitationsmentioning

confidence: 99%

“…Recent systematic reviews have favored early operative management over delayed or nonoperative management after pediatric ACL injuries [20,33]. However, even among patients who primarily elect to undergo ACL reconstruction (ACLR), delays in surgery raise the risk of persistent instability, irreparable meniscal or chondral injury, reduced frequency of return to sport, and worse patient-reported outcomes [4,13,17,33,34,36].…”

Section: Introductionmentioning

confidence: 99%

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Is Preferred Language Other Than English Associated With Delayed Surgery After ACL Injury in Children and Adolescents?

Rosenberg

Chu

Ouweleen

et al. 2022

Clin Orthop Relat Res

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BackgroundPrevious studies have investigated the impact of social determinants of health, such as the type of healthcare insurance and household income, on children and adolescents with ACL tears. However, despite the increasing incidence of ACL injury in young patients and a substantial proportion of families who may prefer languages other than English, the relationship between language and clinical care remains unclear.Questions/purposesTo investigate the relationship between language and the care of children and adolescents with ACL tears, we asked: (1) Is a preferred language other than English (PLOE) associated with a delay between ACL injury and surgery? (2) Is a PLOE associated with a greater odds of a patient experiencing a meniscal tear and undergoing a meniscectomy than in those who prefer English?MethodsWe treated 591 patients surgically for ACL injuries between 2011 and 2021. Of those, we considered patients aged 18 years or younger who underwent primary ACL reconstruction for this retrospective, comparative study. Five percent (31 of 591) of patients were excluded because the date of injury was not clearly documented, 2% (11 of 591) were revision reconstructions, and 1% (6 of 591) underwent procedures that were intentionally delayed or staged, leaving 92% (543 of 591) for analysis. The mean age was 16 ± 2 years, and 51% (276 of 543) of patients were boys. The family’s preferred language was noted, as were demographic data, time between injury and surgery, and intraoperative findings. A language other than English was preferred by 21% (113 of 543) of patients. Of these, 94% (106 of 113) preferred Spanish. In a univariate analysis, we used independent-samples t-tests, Mann-Whitney U-tests, and Fisher exact tests, as appropriate. Purposeful-entry multivariable regression analyses were used to determine whether PLOE was associated with increased time to surgery, concomitant meniscus injury, or performance of meniscectomy while adjusting for confounding variables. Variables were included in multivariable models if they met the threshold for statistical significance in univariate testing (p < 0.05).ResultsThe median time between injury and ACL reconstruction was shorter in families who preferred English compared with those with a PLOE (69 days [IQR 80] versus 103 days [IQR 107)]; p < 0.001). After controlling for potentially confounding variables like insurance and age, we found that patients whose families had a PLOE had greater odds of undergoing surgery more than 60 days after injury (OR 2.2 [95% CI 1.3 to 3.8]; p = 0.005) and more than 90 days after injury (OR 1.8 [95% CI 1.1 to 2.8]; p = 0.02). After controlling for insurance, age, and other factors, PLOE was not associated with surgical delay beyond 180 days, concomitant meniscal tears, or performance of meniscectomy.ConclusionIn this study of children and adolescents undergoing primary ACL reconstruction, patients whose families prefer a language other than English experienced a longer delay between injury and surgery. In areas with a large p...

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Section: Discussioncontrasting

confidence: 63%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is Preferred Language Other Than English Associated With Delayed Surgery After ACL Injury in Children and Adolescents?

Rosenberg

Chu

Ouweleen

et al. 2022

Clin Orthop Relat Res

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“…In addition, Gao et al 12 reported that the number of mechanoreceptors in the ACL stump and the volume of the stump decreased with time from injury to surgery. A recent study 8 noted that the number of Golgi-Mazzoni corpuscles decreased significantly with time. In the present study, there were significant differences in the time from injury to surgery between the remnant groups (groups AA and NA) and group NR.…”

Section: Discussionmentioning

confidence: 95%

Effects of Preserving Anatomically Positioned and Adequate Remnant ACL Tissue in Double-Bundle ACL Reconstruction

Sato

Inoue

Kasahara

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: The advantages of remnant tissue preservation in anterior cruciate ligament (ACL) reconstruction (ACLR) remain controversial. Hypothesis: It was hypothesized that a large amount of remnant tissue, especially if anatomically positioned, would improve patient-reported outcomes and second-look graft appearance after preserved double-bundle ACLR (DB-ACLR). Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study included 89 consecutive patients who underwent unilateral remnant-preserving DB-ACLR using 2 hamstring tendon autografts. The authors categorized the arthroscopic findings into 3 groups according to the location and volume of the ACL remnant tissue in the femoral notch: (1) anatomical attachment (group AA; n = 34); (2) nonanatomical attachment (group NA; n = 33); and (3) no remnant (group NR; n = 22). Based on second-look arthroscopy, the reconstructed graft was graded as excellent, fair, or poor. Patient-reported outcomes were evaluated at 2 years after surgery using the Knee injury and Osteoarthritis Outcome Score (KOOS) and the Japanese Anterior Cruciate Ligament Questionnaire–25 (JACL-25). Results: The AA and NA groups had a significantly shorter time from injury to surgery compared with the NR group ( P = .0165). Considering the second-look arthroscopic findings, the authors found a significant difference in synovial coverage of the grafts between the 3 groups ( P = .0018). There were no significant differences in the overall KOOS and JACL-25 score among the 3 groups; however, the KOOS–Sport and Recreation and KOOS–Quality of Life subscale scores were significantly higher in the AA group compared with the NA and NR groups ( P = .0014 and .0039, respectively). The JACL-25 score for middle- to high-speed flexion and extension was significantly better in the AA group versus the NR group ( P = .0261). Conclusion: This study showed that preserving anatomically positioned and adequate remnant tissue during DB-ACLR improved second-look graft appearance and KOOS–Sport and Recreation and KOOS–Quality of Life scores.

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“…Evidence further indicates that individuals with ACL reconstruction (ACLR) have lesser bilateral corticospinal excitability than those without injury, which may have a detrimental effect on muscle recovery ( Rush et al, 2021 ). The initial trauma and potential surgical reconstruction causes loss of neural elements such as Golgi tendon organ-like receptors ( Cabuk et al, 2022 ). These receptors contribute with afferent information to the central nervous system (CNS) regarding proprioceptive sensations such as movement and position ( Dhillon et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Brain Response to a Knee Proprioception Task Among Persons With Anterior Cruciate Ligament Reconstruction and Controls

Strong

Grip

Boraxbekk

et al. 2022

Front. Hum. Neurosci.

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Knee proprioception deficits and neuroplasticity have been indicated following injury to the anterior cruciate ligament (ACL). Evidence is, however, scarce regarding brain response to knee proprioception tasks and the impact of ACL injury. This study aimed to identify brain regions associated with the proprioceptive sense of joint position at the knee and whether the related brain response of individuals with ACL reconstruction differed from that of asymptomatic controls. Twenty-one persons with unilateral ACL reconstruction (mean 23 months post-surgery) of either the right (n = 10) or left (n = 11) knee, as well as 19 controls (CTRL) matched for sex, age, height, weight and current activity level, performed a knee joint position sense (JPS) test during simultaneous functional magnetic resonance imaging (fMRI). Integrated motion capture provided real-time knee kinematics to activate test instructions, as well as accurate knee angles for JPS outcomes. Recruited brain regions during knee angle reproduction included somatosensory cortices, prefrontal cortex and insula. Neither brain response nor JPS errors differed between groups, but across groups significant correlations revealed that greater errors were associated with greater ipsilateral response in the anterior cingulate (r = 0.476, P = 0.009), supramarginal gyrus (r = 0.395, P = 0.034) and insula (r = 0.474, P = 0.008). This is the first study to capture brain response using fMRI in relation to quantifiable knee JPS. Activated brain regions have previously been associated with sensorimotor processes, body schema and interoception. Our innovative paradigm can help to guide future research investigating brain response to lower limb proprioception.

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The time from injury to surgery is an important factor affecting the mechanoreceptors at stump of torn anterior cruciate ligament

Cited by 8 publications

References 22 publications

Is Preferred Language Other Than English Associated With Delayed Surgery After ACL Injury in Children and Adolescents?

Is Preferred Language Other Than English Associated With Delayed Surgery After ACL Injury in Children and Adolescents?

Effects of Preserving Anatomically Positioned and Adequate Remnant ACL Tissue in Double-Bundle ACL Reconstruction

Brain Response to a Knee Proprioception Task Among Persons With Anterior Cruciate Ligament Reconstruction and Controls

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