Objective: To identify demographic and anthropometric risk factors for intra-articular (IA) injuries observed during ACL reconstruction. We hypothesize that significant associations exist among height, weight, and body mass index (BMI) with IA injuries when ACL tear occurs.
Design: This observational study of a prospective multi-investigator ACL database used logistic and Poisson regression analysis to assess independent predictors of IA injuries.
Setting: Vanderbilt Sports Medicine and affiliated tertiary care center.
Patients: Patients undergoing unilateral ACL reconstruction without prior injury to either knee were identified from a detailed prospective ACL reconstruction database. Four hundred fifty-six patients met inclusion/exclusion criteria.
Interventions: Per inclusion criteria, all patients underwent unilateral ACL reconstruction after assessment of injury profile.
Main Outcome Measurements: The ACL database was initiated in 1990 to identify demographic, anthropometric, and mechanistic variables associated with intra-articular injury.
Results: Height best predicted tibial and patellar damage. BMI better predicted medial femoral condyle lesions, whereas weight better predicted lateral and patellofemoral injury. BMI and weight equally predicted injury to menisci and medial tibial plateau. Through different outcomes, age (odd ratio [OR], 1.49; 95% CI, 1.02-2.16), height (OR, 2.66; 95% CI, 1.52-4.65), weight (OR, 1.02; 95% CI, 1.01-1.04), and BMI (OR, 1.24; 95% CI, 1.004-1.53) were all significant predictors of intra-articular injury.
Conclusions: This is the first report using multivariable analysis of age, height, weight, and BMI to evaluate associations with IA injuries after ACL rupture observed during ACL reconstruction. We hypothesize that athletes possibly could reduce risk of certain IA pathologies with maintenance of lower body weight and BMI and thus potentially improve long-term functional outcomes after ACL reconstruction.
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http://dx.doi.org/10.1097/00042752-200501000-00003 | DOI Listing |
BMC Musculoskelet Disord
January 2025
Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Background: To summarize the statistical performance of machine learning in predicting revision, secondary knee injury, or reoperations following anterior cruciate ligament reconstruction (ACLR), and to provide a general overview of the statistical performance of these models.
Methods: Three online databases (PubMed, MEDLINE, EMBASE) were searched from database inception to February 6, 2024, to identify literature on the use of machine learning to predict revision, secondary knee injury (e.g.
Am J Sports Med
January 2025
Campbell Clinic Orthopedics, Germantown, Tennessee, USA.
Background: While allografts are commonly used for anterior cruciate ligament reconstruction (ACLR), evidence to guide specific allograft selection is lacking.
Purpose: To compare clinical and graft failure rates after ACLR using soft tissue-only allografts and bone-soft tissue allografts in adults.
Study Design: Systematic review and meta-analysis; Level of evidence, 4.
Am J Sports Med
January 2025
Department of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy.
Background: Failure, persistent knee instability, and reinjury rates after anterior cruciate ligament (ACL) reconstruction are still concerns. Biomechanical investigations have highlighted the role of the anterolateral ligament (ALL) as a crucial knee stabilizer, and clinical outcomes after combined ACL and ALL reconstruction appear to indicate the success of the procedure.
Purpose: To compare the functional outcomes, return-to-sport (RTS) rate, and complications between combined ACL and ALL reconstruction and isolated ACL reconstruction.
Am J Sports Med
January 2025
Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, Arizona, USA.
Background: Tobacco use is a known modifiable risk factor for postoperative complications and revision surgery after anterior cruciate ligament reconstruction (ACLR). Previous studies focus on tobacco as a broad categorization of traditional smoking, smokeless tobacco, and other forms of nicotine use. It is unclear if differences in the type of nicotine used lead to similar adverse outcomes after ACLR.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Medical University of Graz, Graz, Austria.
Background: The role of local infiltration anesthesia (LIA) in knee surgery is significant. LIA can be more potent than a nerve block, but without the downsides. A wide range of agents are used for LIA, including some off-label medications such as dexmedetomidine and ropivacaine.
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