Role of Age on Success of Arthroscopic Primary Repair of Proximal Anterior Cruciate Ligament Tears
Copyright © 2020 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved..
PURPOSE: To assess failure rates and patient-reported outcomes measures following arthroscopic primary anterior cruciate ligament (ACL) repair of proximal tears in different age groups.
METHODS: Between 2008 and 2017, the first 113 consecutive patients treated with repair were retrospectively reviewed at minimum of 2 years. Patients were stratified into 3 age groups: ≤21, 22-35, and >35 years. Primary outcomes were ipsilateral reinjury or reoperation, and contralateral injury rates, and secondary outcomes consisted of Lysholm, modified Cincinnati, Single Assessment Numeric Evaluation, International Knee Documentation Committee subjective, pain, and satisfaction scores. Group differences were compared using χ2 tests and Mann-Whitney U tests.
RESULTS: Follow-up was obtained in 113 patients (100%). Median age was 35 years (interquartile range [IQR] 23-43) and median follow-up was 2.2 years (IQR 2.0-2.8). Overall, ACL reinjury occurred in 13 patients (11.5%), reoperation in 7 patients (6.2%), complications in 2 patients (1.8%) and contralateral ACL injury in 4 patients (3.5%). Overall, median Lysholm was 95 (IQR 89-100) and International Knee Documentation Committee subjective 92 (IQR 84-99). Treatment failure was significantly greater in the youngest age group (37.0%) as compared with the middle and older groups (4.2% and 3.2%, both P < .005). No significant differences were seen in reoperation, complication, or contralateral injury rates between groups (all P > .2), nor in patient-reported outcomes measures between the groups (all P > .1).
CONCLUSIONS: The failure rate of primary repair of proximal ACL tears is high in patients aged 21 or younger (37.0%), and this should be taken into account when discussing repair in this patient group. In patients older than 21, repair may be an excellent treatment with low failure (3.5%) and complication rates (1.2%) and good subjective scores.
LEVEL OF EVIDENCE: Level III, retrospective comparative therapeutic trial.
| Errataetall: |
CommentIn: Arthroscopy. 2021 Apr;37(4):1202-1203. - PMID 33812523 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association - 37(2021), 4 vom: 01. Apr., Seite 1194-1201 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Vermeijden, Harmen D [VerfasserIn] |
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Date Completed 11.06.2021 Date Revised 11.06.2021 published: Print-Electronic CommentIn: Arthroscopy. 2021 Apr;37(4):1202-1203. - PMID 33812523 Citation Status MEDLINE |
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| doi: |
10.1016/j.arthro.2020.11.024 |
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NLM31787487X |
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| 500 | |a CommentIn: Arthroscopy. 2021 Apr;37(4):1202-1203. - PMID 33812523 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: To assess failure rates and patient-reported outcomes measures following arthroscopic primary anterior cruciate ligament (ACL) repair of proximal tears in different age groups | ||
| 520 | |a METHODS: Between 2008 and 2017, the first 113 consecutive patients treated with repair were retrospectively reviewed at minimum of 2 years. Patients were stratified into 3 age groups: ≤21, 22-35, and >35 years. Primary outcomes were ipsilateral reinjury or reoperation, and contralateral injury rates, and secondary outcomes consisted of Lysholm, modified Cincinnati, Single Assessment Numeric Evaluation, International Knee Documentation Committee subjective, pain, and satisfaction scores. Group differences were compared using χ2 tests and Mann-Whitney U tests | ||
| 520 | |a RESULTS: Follow-up was obtained in 113 patients (100%). Median age was 35 years (interquartile range [IQR] 23-43) and median follow-up was 2.2 years (IQR 2.0-2.8). Overall, ACL reinjury occurred in 13 patients (11.5%), reoperation in 7 patients (6.2%), complications in 2 patients (1.8%) and contralateral ACL injury in 4 patients (3.5%). Overall, median Lysholm was 95 (IQR 89-100) and International Knee Documentation Committee subjective 92 (IQR 84-99). Treatment failure was significantly greater in the youngest age group (37.0%) as compared with the middle and older groups (4.2% and 3.2%, both P < .005). No significant differences were seen in reoperation, complication, or contralateral injury rates between groups (all P > .2), nor in patient-reported outcomes measures between the groups (all P > .1) | ||
| 520 | |a CONCLUSIONS: The failure rate of primary repair of proximal ACL tears is high in patients aged 21 or younger (37.0%), and this should be taken into account when discussing repair in this patient group. In patients older than 21, repair may be an excellent treatment with low failure (3.5%) and complication rates (1.2%) and good subjective scores | ||
| 520 | |a LEVEL OF EVIDENCE: Level III, retrospective comparative therapeutic trial | ||
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| 700 | 1 | |a van der List, Jelle P |e verfasserin |4 aut | |
| 700 | 1 | |a DiFelice, Gregory S |e verfasserin |4 aut | |
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