Purpose: To conduct 2 separate stratum-specific likelihood ratio analyses in patients younger than 40 year of age (<40 years) and those aged 40 and older (40+ years) at time of anterior cruciate ligament (ACL) reconstruction to define data-driven strata between ACL tear and primary isolated ACL reconstruction in which the risk of arthrofibrosis, using manipulation under anesthesia and arthroscopic lysis of adhesions as surrogates, is significantly different.
Methods: A retrospective cohort analysis was conducted using the PearlDiver Database. Patients who underwent ACL reconstruction were identified using the Current Procedure Terminology code 29888. Patients were stratified to those aged younger than 40 (<40) and those 40 and older (40+) at time of ACL reconstruction. The incidence of 2-year arthrofibrosis was calculated for weekly intervals from initial ACL injury to reconstruction. Stratum specific likelihood ratio analysis was conducted to determine data-driven intervals from initial ACL tear to reconstruction that optimize differences in 2-year arthrofibrosis. Following the identification of these intervals for both those <40 and 40+, multivariable analysis was conducted.
Results: For those <40, stratum-specific likelihood ratio analysis identified only 2 data-driven timing strata: 0-5 and 6-26 weeks. For those 40+, stratum-specific likelihood ratio analysis also only identified 2 data-driven strata: 0-9 and 10-26 weeks. A delay in ACL reconstruction from initial injury by at least 6 weeks in patients younger than 40 and at least 10 weeks in patients older than 40 years is associated with a 65% and 35% reduction of 2-year manipulation under anesthesia and arthroscopic lysis of adhesions, respectively.
Conclusions: Our analysis showed a delay in ACLR of at least 6 weeks in patients younger than 40 years to be associated with a 65% reduction in the risk of surgical intervention for arthrofibrosis and a delay of at least 10 weeks in patients 40 years and older to be associated with only a 35% reduction in the risk of surgical intervention for arthrofibrosis. The authors propose this difference in reduction to be multifactorial and potentially associated with mechanism of injury, activity level, and preoperative factors such as amount of physical therapy, rather than solely timing.
Level Of Evidence: Level III, retrospective comparative prognostic study.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.arthro.2023.01.102 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Individual variability in the phenology of an asynchronous penguin species induces consequences on breeding and carry-over effects.
Oecologia
January 2025
Institut Pluridisciplinaire Hubert Curien (IPHC), UMR 7178, Université de Strasbourg, CNRS, 23 Rue Becquerel, 67000, Strasbourg, France.
Phenology is a major component of animals' breeding, as they need to adjust their breeding timing to match optimal environmental conditions. While the effects of shifting phenology are well-studied on populations, few studies emphasise its ecological causes and consequences at the inter-individual level. Using a 20-year monitoring of more than 2500 breeding events from ~ 500 breeding little penguins (Eudyptula minor), a very asynchronously breeding seabird, we investigated the consequences of late breeding on present and next breeding events.
View Article and Find Full Text PDFParents' Early Concerns about Their Child with Autism: Relation to Age of Diagnosis.
J Autism Dev Disord
January 2025
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
There is a substantial time gap between when parents develop concerns about their child (ages 1-2) and when they receive a diagnosis of autism (ages 3-5), delaying the onset of critical interventions. Few studies have examined how the timing, type, and quantity of early parental concerns are associated with age of diagnosis. The aims of this study were to describe characteristics of parents' concerns in a large community-based sample and explore how characteristics of concerns relate to age of diagnosis.
View Article and Find Full Text PDFAcute severe ulcerative colitis: defining the precise moment for colectomy.
Expert Rev Gastroenterol Hepatol
January 2025
INFINY Institute, Department of Gastroenterology, CHRU Nancy, INSERM NGERE, Université de Lorraine, Vandœuvre-lès-Nancy, France.
Introduction: Acute severe ulcerative colitis (ASUC) is a critical manifestation of ulcerative colitis (UC), often necessitating colectomy when medical management fails. Despite advancements in therapeutic interventions such as corticosteroids, biologics, and JAK inhibitors, a significant proportion of patients require surgery, with colectomy rates ranging from 10% to 15%.
Areas Covered: This paper reviews the factors influencing the timing and necessity of colectomy in ASUC management, emphasizing the importance of multidisciplinary decision-making involving gastroenterologists and surgeons.
Compromising tyrosine hydroxylase function extends and blunts the temporal profile of reinforcement by dopamine neurons in .
J Neurosci
January 2025
Leibniz Institute for Neurobiology (LIN), Department of Genetics of Learning and Memory, Magdeburg, 39118 Germany
For a proper representation of the causal structure of the world, it is adaptive to consider both evidence for and evidence against causality. To take punishment as an example, the causality of a stimulus is unlikely if there is a temporal gap before punishment is received, but causality is credible if the stimulus immediately precedes punishment. In contrast, causality can be ruled out if the punishment occurred first.
View Article and Find Full Text PDFDisparities in time to treatment initiation of invasive lung cancer among Black and White patients in Tennessee.
PLoS One
January 2025
Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States of America.
Article Synopsis
- The study investigates disparities in treatment initiation times for lung cancer between Black and White patients in Tennessee, revealing that Black patients generally face delays.
- The analysis of 42,970 lung cancer cases identified that younger Black patients and married White patients had the highest risks for late treatment initiation.
- The findings suggest a need for further research to better understand the factors contributing to these disparities in treatment timing between racial groups.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!