Graft Fixation and Timing of Surgery Are Predictors of Early Anterior Cruciate Ligament Revision
Background:. The identification of surgical risk factors for early anterior cruciate ligament (ACL) revision is important when appropriate treatment for patients undergoing primary ACL reconstruction is selected. The purposes of this study were to determine the short-term ACL revision rate of patien...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2019-12-01
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| Series: | JBJS Open Access |
| Online Access: | http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.19.00037 |
| _version_ | 1797375057291378688 |
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| author | Thorkell Snaebjörnsson, MD, PhD Eric Hamrin Senorski, PhD Eleonor Svantesson, MD Olof Westin, MD, PhD Andreas Persson, MD, PhD Jon Karlsson, MD, PhD Kristian Samuelsson, MD, PhD |
| author_facet | Thorkell Snaebjörnsson, MD, PhD Eric Hamrin Senorski, PhD Eleonor Svantesson, MD Olof Westin, MD, PhD Andreas Persson, MD, PhD Jon Karlsson, MD, PhD Kristian Samuelsson, MD, PhD |
| author_sort | Thorkell Snaebjörnsson, MD, PhD |
| collection | DOAJ |
| description | Background:. The identification of surgical risk factors for early anterior cruciate ligament (ACL) revision is important when appropriate treatment for patients undergoing primary ACL reconstruction is selected. The purposes of this study were to determine the short-term ACL revision rate of patients undergoing primary ACL reconstruction and to identify surgical risk factors for ACL revision within 2 years of primary ACL reconstruction.
Methods:. This study was based on data collected prospectively from the Norwegian and Swedish National Knee Ligament Registries. Patients who underwent primary ACL reconstruction from 2004 through 2014 were included. We examined revisions through 2016. The relative risks (RRs) of revision ACL reconstruction dependent on graft fixation, the time interval between injury and surgical procedure, and meniscal and cartilage injury were estimated by using generalized linear models with a binomial distribution and log-link function. The outcome was set as revision ACL reconstruction during the first 2 years.
Results:. A total of 58,692 patients were assessed for eligibility; of these, 18,425 patients were included. The overall 2-year revision rate was 2.1%. Patients treated with a metal interference screw had an increased risk of ACL revision when compared with patients who were treated with other femoral fixations (RR, 1.78 [95% confidence interval (CI), 1.38 to 2.29]; p < 0.001). The use of the RIGIDFIX Cross Pin System (DePuy Synthes) entailed a lower risk of ACL revision compared with other femoral fixations (RR, 0.58 [95% CI, 0.42 to 0.82]; p = 0.0017). Patients undergoing ACL reconstruction within 3 months of the injury had an increased risk of ACL revision (RR, 2.07 [95% CI, 1.64 to 2.61]; p < 0.001).
Conclusions:. Patients undergoing ACL reconstruction within 3 months of an injury, as well as patients treated with a metal interference screw in the femur, had a significantly higher risk of ACL revision, and patients treated with the RIGIDFIX Cross Pin in the femur had a significantly lower risk of ACL revision.
Level of Evidence:. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. |
| first_indexed | 2024-03-08T19:16:44Z |
| format | Article |
| id | doaj.art-9df24d74cc05401ab77bd2c2bbdb0119 |
| institution | Directory Open Access Journal |
| issn | 2472-7245 |
| language | English |
| last_indexed | 2024-03-08T19:16:44Z |
| publishDate | 2019-12-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | JBJS Open Access |
| spelling | doaj.art-9df24d74cc05401ab77bd2c2bbdb01192023-12-27T06:50:38ZengWolters KluwerJBJS Open Access2472-72452019-12-0144e003710.2106/JBJS.OA.19.00037JBJSOA1900037Graft Fixation and Timing of Surgery Are Predictors of Early Anterior Cruciate Ligament RevisionThorkell Snaebjörnsson, MD, PhD0Eric Hamrin Senorski, PhD1Eleonor Svantesson, MD2Olof Westin, MD, PhD3Andreas Persson, MD, PhD4Jon Karlsson, MD, PhD5Kristian Samuelsson, MD, PhD61 Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden3 Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden1 Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden1 Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden4 Oslo Sports Trauma Research Center, Department of Sport Medicine, Norwegian School of Sport Science, Oslo, Norway1 Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden1 Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenBackground:. The identification of surgical risk factors for early anterior cruciate ligament (ACL) revision is important when appropriate treatment for patients undergoing primary ACL reconstruction is selected. The purposes of this study were to determine the short-term ACL revision rate of patients undergoing primary ACL reconstruction and to identify surgical risk factors for ACL revision within 2 years of primary ACL reconstruction. Methods:. This study was based on data collected prospectively from the Norwegian and Swedish National Knee Ligament Registries. Patients who underwent primary ACL reconstruction from 2004 through 2014 were included. We examined revisions through 2016. The relative risks (RRs) of revision ACL reconstruction dependent on graft fixation, the time interval between injury and surgical procedure, and meniscal and cartilage injury were estimated by using generalized linear models with a binomial distribution and log-link function. The outcome was set as revision ACL reconstruction during the first 2 years. Results:. A total of 58,692 patients were assessed for eligibility; of these, 18,425 patients were included. The overall 2-year revision rate was 2.1%. Patients treated with a metal interference screw had an increased risk of ACL revision when compared with patients who were treated with other femoral fixations (RR, 1.78 [95% confidence interval (CI), 1.38 to 2.29]; p < 0.001). The use of the RIGIDFIX Cross Pin System (DePuy Synthes) entailed a lower risk of ACL revision compared with other femoral fixations (RR, 0.58 [95% CI, 0.42 to 0.82]; p = 0.0017). Patients undergoing ACL reconstruction within 3 months of the injury had an increased risk of ACL revision (RR, 2.07 [95% CI, 1.64 to 2.61]; p < 0.001). Conclusions:. Patients undergoing ACL reconstruction within 3 months of an injury, as well as patients treated with a metal interference screw in the femur, had a significantly higher risk of ACL revision, and patients treated with the RIGIDFIX Cross Pin in the femur had a significantly lower risk of ACL revision. Level of Evidence:. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.19.00037 |
| spellingShingle | Thorkell Snaebjörnsson, MD, PhD Eric Hamrin Senorski, PhD Eleonor Svantesson, MD Olof Westin, MD, PhD Andreas Persson, MD, PhD Jon Karlsson, MD, PhD Kristian Samuelsson, MD, PhD Graft Fixation and Timing of Surgery Are Predictors of Early Anterior Cruciate Ligament Revision JBJS Open Access |
| title | Graft Fixation and Timing of Surgery Are Predictors of Early Anterior Cruciate Ligament Revision |
| title_full | Graft Fixation and Timing of Surgery Are Predictors of Early Anterior Cruciate Ligament Revision |
| title_fullStr | Graft Fixation and Timing of Surgery Are Predictors of Early Anterior Cruciate Ligament Revision |
| title_full_unstemmed | Graft Fixation and Timing of Surgery Are Predictors of Early Anterior Cruciate Ligament Revision |
| title_short | Graft Fixation and Timing of Surgery Are Predictors of Early Anterior Cruciate Ligament Revision |
| title_sort | graft fixation and timing of surgery are predictors of early anterior cruciate ligament revision |
| url | http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.19.00037 |
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