دورية أكاديمية
Prevalence and Predictors of Concomitant Meniscal and Ligamentous Injuries Associated With ACL Surgery: An Analysis of 20 Years of ACL Reconstruction at a Tertiary Care Children's Hospital.
| العنوان: | Prevalence and Predictors of Concomitant Meniscal and Ligamentous Injuries Associated With ACL Surgery: An Analysis of 20 Years of ACL Reconstruction at a Tertiary Care Children's Hospital. |
|---|---|
| المؤلفون: | Pruneski JA; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Heyworth BE; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Kocher MS; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Tavabi N; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Milewski MD; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Kramer DE; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Christino MA; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Yen YM; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Micheli LJ; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Murray MM; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Gilreath L; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Kim A; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Murray J; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Kiapour AM; Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Investigation performed at Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA. |
| المصدر: | The American journal of sports medicine [Am J Sports Med] 2024 Jan; Vol. 52 (1), pp. 77-86. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Publications Country of Publication: United States NLM ID: 7609541 Publication Model: Print Cited Medium: Internet ISSN: 1552-3365 (Electronic) Linking ISSN: 03635465 NLM ISO Abbreviation: Am J Sports Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2004- : Thousand Oaks, CA : Sage Publications Original Publication: Baltimore, Williams & Wilkins. |
| مواضيع طبية MeSH: | Knee Injuries*/epidemiology , Knee Injuries*/surgery , Anterior Cruciate Ligament Injuries*/epidemiology , Anterior Cruciate Ligament Injuries*/surgery, Adolescent ; Young Adult ; Humans ; Female ; Child ; Adult ; Male ; Anterior Cruciate Ligament/surgery ; Prevalence ; Cross-Sectional Studies ; Tertiary Healthcare ; Retrospective Studies ; Menisci, Tibial/surgery ; Hospitals |
| مستخلص: | Background: There is an increasing rate of procedures being performed for concomitant injuries during anterior cruciate ligament (ACL) surgery. Few studies have examined risk factors for these associated injuries in young patients. Hypothesis: There are patient-related factors predictive of concomitant knee pathology that differ between age-based cohorts. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Natural language processing was used to extract clinical variables from available notes of patients undergoing ACL surgery between 2000 and 2020 at a single institution (5174 ACL surgeries; mean age, 17 ± 4 years; 53.1% female; accuracy, >98%). Patients were stratified to pediatric (5-13 years), adolescent (14-19 years), and young adult (20-35 years) cohorts. Logistic regression was used to determine predictors of concomitant injury to the menisci, medial collateral ligament (MCL), posterolateral corner (PLC), and posterior cruciate ligament (PCL). Results: Between 2000 and 2020, 54% of pediatric, 71% of adolescent, and 70% of adult patients had ≥1 concomitant soft tissue injury. In children and adolescents, increased age was consistently predictive of sustaining a concomitant injury ( P < .02). Female children had increased odds of concomitant medial meniscal injury, while female adults had decreased odds ( P ≤ .046). Adolescent and adult female patients had decreased odds of concomitant lateral meniscal injury ( P ≤ .027). Female children had increased odds of injury to the MCL ( P = .015), whereas female children and adolescents had decreased odds of PCL injury ( P ≤ .044). Adolescents undergoing revision ACL surgery had increased odds of meniscal injury ( P ≤ .001) and decreased odds of concomitant MCL injury ( P = .028). Increased body mass index (BMI) was associated with increased odds of concomitant medial meniscal injury in all cohorts ( P ≤ .041), lateral meniscal injury in adults ( P = .045), and PLC injury in children ( P = .016). Contact injuries were associated with increased odds of MCL injury in adolescents ( P = .017) and PLC injury in adolescents and adults ( P < .014). Conclusion: These findings support the hypothesis, as there were multiple factors that significantly affected the risk of concomitant injuries that differed between cohorts. Increased age, BMI, and contact injury history were generally associated with increased odds of sustaining a concomitant injury, whereas female sex and revision ACL surgery had mixed effects. Further studies are essential to investigate the sex-based differences in risk for concomitant injuries and to develop tailored treatment plans that minimize the risk of secondary ACL injury. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: This study received funding support from the Children's Hospital Orthopedic Surgery Foundation and Boston Children's Hospital Faculty Council. B.E.H. has received education payments from Arthrex, Kairos Surgical, and Pylant and is a consultant and stock owner for Imagen Technologies. M.S.K. has received consulting fees and royalties from OrthoPediatrics and Ossur; royalties from Elsevier and Wolters Kluwer; speaking fees from Smith & Nephew; and support for education from Kairos Surgical Inc. D.E.K. is a paid consultant for Miach Orthopaedics and DePuy Synthes and receives education support from Kairos Surgical. M.D.M. has received royalties from Saunders/Mosby-Elsevier. Y.-M.Y. has received consulting fees from OrthoPediatrics and Smith & Nephew. L.M. is an unpaid consultant for Carticel. M.M.M. owns stock and has received consulting fees from Miach Orthopaedics and has received royalties from Springer. A.M.K. is a paid consultant of Miach Orthopaedics. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. |
| فهرسة مساهمة: | Keywords: anterior cruciate ligament; collateral ligament; knee; meniscus; posterior cruciate ligament |
| تواريخ الأحداث: | Date Created: 20240102 Date Completed: 20240103 Latest Revision: 20240213 |
| رمز التحديث: | 20240213 |
| DOI: | 10.1177/03635465231205556 |
| PMID: | 38164668 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1552-3365 |
|---|---|
| DOI: | 10.1177/03635465231205556 |