Traumatic graft rupture after primary and revision anterior cruciate ligament reconstruction: retrospective analysis of incidence and risk factors in 2915 cases

Schlumberger, Michael; Schuster, Philipp; Schulz, Martin; Immendörfer, Micha; Mayer, Philipp; Bartholomä, Jochen; Richter, Joachim

doi:10.1007/s00167-015-3699-0

Cited by 70 publications

(68 citation statements)

References 32 publications

(72 reference statements)

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“…In our study, 70% of the ACL graft ruptures occurred during the first 6 months after RTS, which extends previous findings to the Gulf Region population 32 37…”

Section: Discussionsupporting

confidence: 90%

Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture

et al. 2016

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“…In our study, 70% of the ACL graft ruptures occurred during the first 6 months after RTS, which extends previous findings to the Gulf Region population 32 37…”

Section: Discussionsupporting

confidence: 90%

Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture

et al. 2016

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“…We are aware of no previous studies that evaluate this relationship. Knee laxity should be considered along with other previously identified risk factors including age, 1, 14, 29 graft factors (autograft versus allograft 7, 13, 14 and hamstring graft size 18, 21 ), and activity level 1, 14 when assessing risk of revision ACL surgery.…”

Section: Discussionmentioning

confidence: 99%

Effect of High-Grade Preoperative Knee Laxity on Anterior Cruciate Ligament Reconstruction Outcomes

et al. 2016

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Background Knee laxity in the setting of suspected ACL injury is frequently assessed through physical examination using the Lachman, pivot-shift, and anterior drawer tests. The degree of laxity noted on these examinations may influence treatment decisions and prognosis. Hypothesis We hypothesized that increased pre-operative knee laxity would be associated with increased risk of subsequent revision ACL reconstruction and poorer patient-reported outcomes two years postoperatively. Study design Cohort study. Methods From an ongoing prospective cohort study, 2333 patients who underwent primary isolated ACL reconstruction without collateral or posterior cruciate ligament injury were identified. Patients reported by the operating surgeons as having an International Knee Documentation Committee Grade D Lachman, anterior drawer, or pivot-shift examination were classified as having a high-grade laxity. Multiple logistic regression modeling was used to evaluate whether having high-grade pre-operative laxity was associated with increased odds of undergoing revision ACL reconstruction within two years of the index procedure, controlling for patient age, sex, Marx activity level, level of competition, and graft type. Multiple linear regression modeling was used to evaluate whether having high-grade pre-operative laxity was associated with poorer IKDC or KOOS-QOL scores at a minimum 2 years postoperative, controlling for baseline score, patient age, ethnicity, sex, BMI, marital status, smoking status, sport participation, competition level, Marx activity rating score, graft type, and articular cartilage and meniscus status. Results Pre-reconstruction laxity data were available for 2325 patients (99.7%). Two year revision data were available for 2259 patients (96.8%) and patient-reported outcomes were available for 1979 patients (84.8%). High-grade pre-operative laxity was noted in 743 patients (31.9%). The mean postoperative IKDC score was 81.8 ± 15.9 and the mean KOOS-QOL score was 72.0 ± 22.0. The presence of high-grade pre-reconstruction laxity was associated with significantly increased odds of ACL graft revision (OR=1.87, 95% CI: 1.19 – 2.95, p = 0.007). The presence of high-grade pre-reconstruction laxity was not associated with any difference in postoperative IKDC (β = −0.56, p = 0.44) or KOOS-QOL (β = 0.04, p = 0.97). Conclusion The presence of high-grade pre-reconstruction knee laxity as assessed by manual physical examination under anesthesia is associated with significantly increased odds of revision ACL surgery, but has no association with patient-reported outcome scores at 2 years following ACL reconstruction.

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“…Patients undergo 6-12 months of rehabilitation after surgery to build strength, stability and range-of-motion before returning to activity [1,2]. The outcomes of initial ACL reconstruction remain excellent; the 5year survival rate in all patients with autografts is over 95% [3][4][5][6][7][8][9]. However, for the unfortunate 5%, re-rupture of the reconstructed ACL can be catastrophic.…”

Section: Introductionmentioning

confidence: 99%

“…Some patients who successfully rehabilitate and return to cutting/pivoting activities tear their native contralateral ACL [3,9]. The rate of contralateral ACL injury following primary ACL reconstruction has been reported between 3.0-20.5% [2,5,[7][8][9][10][11][12][13], increasing risk for bilateral knee pain, instability, and osteoarthritis. Graft failure and/or contralateral injury is financially, psychologically, and physiologically traumatic for the patient and his family.…”

Section: Introductionmentioning

confidence: 99%

“…While prevention of primary ACL injury has been heavily studied, it is of interest to study the factors associated with recurrent and subsequent contralateral ACL reconstructions. A review of the literature reveals numerous reports of associated modifiable and nonmodifiable factors [2][3][5][6][7][8][12][13][14][15][16][17][18][19]], but no comprehensive evaluation. Awareness of modifiable and non-modifiable factors allows for intervention to decrease rates of recurring ACL rupture.…”

Section: Introductionmentioning

confidence: 99%

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A Systematic Review of Factors Associated with both Bilateral and Recurrent Anterior Cruciate Ligament Disruption

Kakalecik

Reynolds

Torg

2019

JAMMR

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Background: Numerous studies have reported factors associated with recurrent or subsequent contralateral anterior cruciate ligament disruption, but a comprehensive review of the literature has not been performed. Purpose: This study attempts to systematically review the literature and provide an overview of the currently reported risk factors for recurrent and subsequent contralateral ACL reconstructions in order to allow for more efficient identification and intervention of high-risk patients. Study Design: Systematic Review. Methods: The Pubmed and Embase databases were searched using a combination of keywords such as "ACL reconstruction" and "bilateral or recurrent" and "risk factors" and medical subject headings. All studies were screened by two independent reviewers, and articles that met inclusion criteria (non-contact ACL injury, study analyzed risk factors for contralateral ACL injury or graft rupture) were downloaded and read. Results: The initial search yielded 129 articles, of which 36 met inclusion criteria. After duplicates Kakalecik et al.; JAMMR, 29(6): 1-12, 2019; Article no.JAMMR.47906 2 were removed, 23 articles remained. The reference lists of included articles were cross-referenced, and an additional 2 articles were included. Conclusion: Graft harvest site, allograft usage, return to sport, younger age, a positive family history, increased posterior tibial slope, and the number of previous ACL reconstructions are wellreported risk factors for second ACL injury. Recent studies suggest a patients who have negative psychological states in the perioperative periods have worse long-term functional outcomes. Review Article

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Traumatic graft rupture after primary and revision anterior cruciate ligament reconstruction: retrospective analysis of incidence and risk factors in 2915 cases

Abstract: Retrospective case series, Level IV.

Cited by 70 publications

References 32 publications

Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture

Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture

Effect of High-Grade Preoperative Knee Laxity on Anterior Cruciate Ligament Reconstruction Outcomes

A Systematic Review of Factors Associated with both Bilateral and Recurrent Anterior Cruciate Ligament Disruption

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