Neither Residual Anterior Knee Laxity Up to 6 mm nor a Pivot Glide Predict Patient-Reported Outcome Scores or Subsequent Knee Surgery Between 2 and 6 Years After ACL Reconstruction
Background: A primary goal of anterior cruciate ligament reconstruction (ACLR) is to reduce pathologically increased anterior and rotational laxity of the knee, but the effects of residual laxity on patient-reported outcomes (PROs) after ACLR remain unclear. Hypothesis: Increased residual laxity at...
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| Veröffentlicht in: | The American journal of sports medicine 2021-08, Vol.49 (10), p.2631-2637 |
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| container_title | The American journal of sports medicine |
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| creator | Magnussen, Robert A. Reinke, Emily K. Huston, Laura J. Briskin, Isaac Cox, Charles L. Dunn, Warren R. Flanigan, David C. Jones, Morgan H. Kaeding, Christopher C. Matava, Matthew J. Parker, Richard D. Smith, Matthew V. Wright, Rick W. Spindler, Kurt P. |
| description | Background:
A primary goal of anterior cruciate ligament reconstruction (ACLR) is to reduce pathologically increased anterior and rotational laxity of the knee, but the effects of residual laxity on patient-reported outcomes (PROs) after ACLR remain unclear.
Hypothesis:
Increased residual laxity at 2 years postoperatively is predictive of a higher risk of subsequent ipsilateral knee surgery and decreases in PRO scores from 2 to 6 years after surgery.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
From a prospective multicenter cohort, 433 patients aged 6 mm in side-to-side anterior laxity at 2 years postoperatively were noted to have a larger decrease in PROs from 2 to 6 years postoperatively (P < .05). No significant differences in any PROs were noted among patients with a difference |
| doi_str_mv | 10.1177/03635465211025003 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2552993293</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_03635465211025003</sage_id><sourcerecordid>2560030318</sourcerecordid><originalsourceid>FETCH-LOGICAL-c454t-de02e6fc869840c1d98c52a497be1660db700b3733f26a03731968d625e5c0693</originalsourceid><addsrcrecordid>eNp1kc1uEzEUhS0EEqHtA7C7Ehs2U_wz9swsQwQFEdGoaResRo59p7iasYPtAfJePCCOgoRExepaut8598iHkJeMXjLWNG-oUELWSnLGKJeUiidkwaTklRBKPiWL4746As_Ji5QeKKWsUe2C_PqMLn_FCDeYnJ31CEufMboQ4ZNHhLX-6fIB7vaQAyiYJvBlpWHjvocMV6OzCJuI1pkMG50d-lzd4D7EjBau52zChLA1IWKCItzOu4Tf5kKd7LdzvMd4gLeYfyB64KC9LXe-oI4JlkOJAsvVuqQzwaccZ5Nd8Ofk2aDHhBd_5hm5e__udvWhWl9ffVwt15WpZZ0ri5SjGkyruramhtmuNZLrumt2yJSidtdQuhONEANXmpYH61RrFZcoDVWdOCOvT777GErolPvJJYPjqD2GOfW8fHDXCd6Jgr76B30Ic_QlXaFU6YMK1haKnSgTQ0oRh34f3aTjoWe0P_bYP-qxaC5PmqTv8a_r_wW_AZcJnBo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2560030318</pqid></control><display><type>article</type><title>Neither Residual Anterior Knee Laxity Up to 6 mm nor a Pivot Glide Predict Patient-Reported Outcome Scores or Subsequent Knee Surgery Between 2 and 6 Years After ACL Reconstruction</title><source>SAGE Complete A-Z List</source><source>Alma/SFX Local Collection</source><creator>Magnussen, Robert A. ; Reinke, Emily K. ; Huston, Laura J. ; Briskin, Isaac ; Cox, Charles L. ; Dunn, Warren R. ; Flanigan, David C. ; Jones, Morgan H. ; Kaeding, Christopher C. ; Matava, Matthew J. ; Parker, Richard D. ; Smith, Matthew V. ; Wright, Rick W. ; Spindler, Kurt P.</creator><creatorcontrib>Magnussen, Robert A. ; Reinke, Emily K. ; Huston, Laura J. ; Briskin, Isaac ; Cox, Charles L. ; Dunn, Warren R. ; Flanigan, David C. ; Jones, Morgan H. ; Kaeding, Christopher C. ; Matava, Matthew J. ; Parker, Richard D. ; Smith, Matthew V. ; Wright, Rick W. ; Spindler, Kurt P. ; MOON Knee Group</creatorcontrib><description>Background:
A primary goal of anterior cruciate ligament reconstruction (ACLR) is to reduce pathologically increased anterior and rotational laxity of the knee, but the effects of residual laxity on patient-reported outcomes (PROs) after ACLR remain unclear.
Hypothesis:
Increased residual laxity at 2 years postoperatively is predictive of a higher risk of subsequent ipsilateral knee surgery and decreases in PRO scores from 2 to 6 years after surgery.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
From a prospective multicenter cohort, 433 patients aged <36 years were identified at a minimum 2 years after primary ACLR. These patients underwent a KT-1000 arthrometer assessment and pivot-shift test and completed PRO assessments with the Knee injury and Osteoarthritis Outcome Score and International Knee Documentation Committee (IKDC) scores. Patients completed the same PROs at 6 years postoperatively, and any subsequent ipsilateral knee procedures during this period were recorded. Subsequent surgery risk and change in PROs from 2 to 6 years postoperatively were compared based on residual side-to-side KT-1000 arthrometer differences (<−1 mm, −1 to 2 mm, 2 to 6 mm, and >6 mm) in laxity at 2 years postoperatively. Multiple linear regression models were built to determine the relationship between 2-year postoperative knee laxity and 2- to 6-year change in PROs while controlling for age, sex, body mass index, smoking status, meniscal and cartilage status, and graft type.
Results:
A total of 381 patients (87.9%) were available for follow-up 6 years postoperatively. There were no significant differences in risk of subsequent knee surgery based on residual knee laxity. Patients with a difference >6 mm in side-to-side anterior laxity at 2 years postoperatively were noted to have a larger decrease in PROs from 2 to 6 years postoperatively (P < .05). No significant differences in any PROs were noted among patients with a difference <6 mm in side-to-side anterior laxity or those with pivot glide (IKDC B) versus no pivot shift (IKDC A).
Conclusion:
The presence of a residual side-to-side KT-1000 arthrometer difference <6 mm or pivot glide at 2 years after ACLR is not associated with an increased risk of subsequent ipsilateral knee surgery or decreased PROs up to 6 years after ACLR. Conversely, patients exhibiting a difference >6 mm in side-to-side anterior laxity were noted to have significantly decreased PROs at 6 years after ACLR.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/03635465211025003</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Knee ; Ligaments ; Patients ; Sports medicine ; Surgery</subject><ispartof>The American journal of sports medicine, 2021-08, Vol.49 (10), p.2631-2637</ispartof><rights>2021 The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c454t-de02e6fc869840c1d98c52a497be1660db700b3733f26a03731968d625e5c0693</citedby><cites>FETCH-LOGICAL-c454t-de02e6fc869840c1d98c52a497be1660db700b3733f26a03731968d625e5c0693</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/03635465211025003$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/03635465211025003$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids></links><search><creatorcontrib>Magnussen, Robert A.</creatorcontrib><creatorcontrib>Reinke, Emily K.</creatorcontrib><creatorcontrib>Huston, Laura J.</creatorcontrib><creatorcontrib>Briskin, Isaac</creatorcontrib><creatorcontrib>Cox, Charles L.</creatorcontrib><creatorcontrib>Dunn, Warren R.</creatorcontrib><creatorcontrib>Flanigan, David C.</creatorcontrib><creatorcontrib>Jones, Morgan H.</creatorcontrib><creatorcontrib>Kaeding, Christopher C.</creatorcontrib><creatorcontrib>Matava, Matthew J.</creatorcontrib><creatorcontrib>Parker, Richard D.</creatorcontrib><creatorcontrib>Smith, Matthew V.</creatorcontrib><creatorcontrib>Wright, Rick W.</creatorcontrib><creatorcontrib>Spindler, Kurt P.</creatorcontrib><creatorcontrib>MOON Knee Group</creatorcontrib><title>Neither Residual Anterior Knee Laxity Up to 6 mm nor a Pivot Glide Predict Patient-Reported Outcome Scores or Subsequent Knee Surgery Between 2 and 6 Years After ACL Reconstruction</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
A primary goal of anterior cruciate ligament reconstruction (ACLR) is to reduce pathologically increased anterior and rotational laxity of the knee, but the effects of residual laxity on patient-reported outcomes (PROs) after ACLR remain unclear.
Hypothesis:
Increased residual laxity at 2 years postoperatively is predictive of a higher risk of subsequent ipsilateral knee surgery and decreases in PRO scores from 2 to 6 years after surgery.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
From a prospective multicenter cohort, 433 patients aged <36 years were identified at a minimum 2 years after primary ACLR. These patients underwent a KT-1000 arthrometer assessment and pivot-shift test and completed PRO assessments with the Knee injury and Osteoarthritis Outcome Score and International Knee Documentation Committee (IKDC) scores. Patients completed the same PROs at 6 years postoperatively, and any subsequent ipsilateral knee procedures during this period were recorded. Subsequent surgery risk and change in PROs from 2 to 6 years postoperatively were compared based on residual side-to-side KT-1000 arthrometer differences (<−1 mm, −1 to 2 mm, 2 to 6 mm, and >6 mm) in laxity at 2 years postoperatively. Multiple linear regression models were built to determine the relationship between 2-year postoperative knee laxity and 2- to 6-year change in PROs while controlling for age, sex, body mass index, smoking status, meniscal and cartilage status, and graft type.
Results:
A total of 381 patients (87.9%) were available for follow-up 6 years postoperatively. There were no significant differences in risk of subsequent knee surgery based on residual knee laxity. Patients with a difference >6 mm in side-to-side anterior laxity at 2 years postoperatively were noted to have a larger decrease in PROs from 2 to 6 years postoperatively (P < .05). No significant differences in any PROs were noted among patients with a difference <6 mm in side-to-side anterior laxity or those with pivot glide (IKDC B) versus no pivot shift (IKDC A).
Conclusion:
The presence of a residual side-to-side KT-1000 arthrometer difference <6 mm or pivot glide at 2 years after ACLR is not associated with an increased risk of subsequent ipsilateral knee surgery or decreased PROs up to 6 years after ACLR. Conversely, patients exhibiting a difference >6 mm in side-to-side anterior laxity were noted to have significantly decreased PROs at 6 years after ACLR.</description><subject>Knee</subject><subject>Ligaments</subject><subject>Patients</subject><subject>Sports medicine</subject><subject>Surgery</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kc1uEzEUhS0EEqHtA7C7Ehs2U_wz9swsQwQFEdGoaResRo59p7iasYPtAfJePCCOgoRExepaut8598iHkJeMXjLWNG-oUELWSnLGKJeUiidkwaTklRBKPiWL4746As_Ji5QeKKWsUe2C_PqMLn_FCDeYnJ31CEufMboQ4ZNHhLX-6fIB7vaQAyiYJvBlpWHjvocMV6OzCJuI1pkMG50d-lzd4D7EjBau52zChLA1IWKCItzOu4Tf5kKd7LdzvMd4gLeYfyB64KC9LXe-oI4JlkOJAsvVuqQzwaccZ5Nd8Ofk2aDHhBd_5hm5e__udvWhWl9ffVwt15WpZZ0ri5SjGkyruramhtmuNZLrumt2yJSidtdQuhONEANXmpYH61RrFZcoDVWdOCOvT777GErolPvJJYPjqD2GOfW8fHDXCd6Jgr76B30Ic_QlXaFU6YMK1haKnSgTQ0oRh34f3aTjoWe0P_bYP-qxaC5PmqTv8a_r_wW_AZcJnBo</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Magnussen, Robert A.</creator><creator>Reinke, Emily K.</creator><creator>Huston, Laura J.</creator><creator>Briskin, Isaac</creator><creator>Cox, Charles L.</creator><creator>Dunn, Warren R.</creator><creator>Flanigan, David C.</creator><creator>Jones, Morgan H.</creator><creator>Kaeding, Christopher C.</creator><creator>Matava, Matthew J.</creator><creator>Parker, Richard D.</creator><creator>Smith, Matthew V.</creator><creator>Wright, Rick W.</creator><creator>Spindler, Kurt P.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20210801</creationdate><title>Neither Residual Anterior Knee Laxity Up to 6 mm nor a Pivot Glide Predict Patient-Reported Outcome Scores or Subsequent Knee Surgery Between 2 and 6 Years After ACL Reconstruction</title><author>Magnussen, Robert A. ; Reinke, Emily K. ; Huston, Laura J. ; Briskin, Isaac ; Cox, Charles L. ; Dunn, Warren R. ; Flanigan, David C. ; Jones, Morgan H. ; Kaeding, Christopher C. ; Matava, Matthew J. ; Parker, Richard D. ; Smith, Matthew V. ; Wright, Rick W. ; Spindler, Kurt P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c454t-de02e6fc869840c1d98c52a497be1660db700b3733f26a03731968d625e5c0693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Knee</topic><topic>Ligaments</topic><topic>Patients</topic><topic>Sports medicine</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Magnussen, Robert A.</creatorcontrib><creatorcontrib>Reinke, Emily K.</creatorcontrib><creatorcontrib>Huston, Laura J.</creatorcontrib><creatorcontrib>Briskin, Isaac</creatorcontrib><creatorcontrib>Cox, Charles L.</creatorcontrib><creatorcontrib>Dunn, Warren R.</creatorcontrib><creatorcontrib>Flanigan, David C.</creatorcontrib><creatorcontrib>Jones, Morgan H.</creatorcontrib><creatorcontrib>Kaeding, Christopher C.</creatorcontrib><creatorcontrib>Matava, Matthew J.</creatorcontrib><creatorcontrib>Parker, Richard D.</creatorcontrib><creatorcontrib>Smith, Matthew V.</creatorcontrib><creatorcontrib>Wright, Rick W.</creatorcontrib><creatorcontrib>Spindler, Kurt P.</creatorcontrib><creatorcontrib>MOON Knee Group</creatorcontrib><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Magnussen, Robert A.</au><au>Reinke, Emily K.</au><au>Huston, Laura J.</au><au>Briskin, Isaac</au><au>Cox, Charles L.</au><au>Dunn, Warren R.</au><au>Flanigan, David C.</au><au>Jones, Morgan H.</au><au>Kaeding, Christopher C.</au><au>Matava, Matthew J.</au><au>Parker, Richard D.</au><au>Smith, Matthew V.</au><au>Wright, Rick W.</au><au>Spindler, Kurt P.</au><aucorp>MOON Knee Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neither Residual Anterior Knee Laxity Up to 6 mm nor a Pivot Glide Predict Patient-Reported Outcome Scores or Subsequent Knee Surgery Between 2 and 6 Years After ACL Reconstruction</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>49</volume><issue>10</issue><spage>2631</spage><epage>2637</epage><pages>2631-2637</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><abstract>Background:
A primary goal of anterior cruciate ligament reconstruction (ACLR) is to reduce pathologically increased anterior and rotational laxity of the knee, but the effects of residual laxity on patient-reported outcomes (PROs) after ACLR remain unclear.
Hypothesis:
Increased residual laxity at 2 years postoperatively is predictive of a higher risk of subsequent ipsilateral knee surgery and decreases in PRO scores from 2 to 6 years after surgery.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
From a prospective multicenter cohort, 433 patients aged <36 years were identified at a minimum 2 years after primary ACLR. These patients underwent a KT-1000 arthrometer assessment and pivot-shift test and completed PRO assessments with the Knee injury and Osteoarthritis Outcome Score and International Knee Documentation Committee (IKDC) scores. Patients completed the same PROs at 6 years postoperatively, and any subsequent ipsilateral knee procedures during this period were recorded. Subsequent surgery risk and change in PROs from 2 to 6 years postoperatively were compared based on residual side-to-side KT-1000 arthrometer differences (<−1 mm, −1 to 2 mm, 2 to 6 mm, and >6 mm) in laxity at 2 years postoperatively. Multiple linear regression models were built to determine the relationship between 2-year postoperative knee laxity and 2- to 6-year change in PROs while controlling for age, sex, body mass index, smoking status, meniscal and cartilage status, and graft type.
Results:
A total of 381 patients (87.9%) were available for follow-up 6 years postoperatively. There were no significant differences in risk of subsequent knee surgery based on residual knee laxity. Patients with a difference >6 mm in side-to-side anterior laxity at 2 years postoperatively were noted to have a larger decrease in PROs from 2 to 6 years postoperatively (P < .05). No significant differences in any PROs were noted among patients with a difference <6 mm in side-to-side anterior laxity or those with pivot glide (IKDC B) versus no pivot shift (IKDC A).
Conclusion:
The presence of a residual side-to-side KT-1000 arthrometer difference <6 mm or pivot glide at 2 years after ACLR is not associated with an increased risk of subsequent ipsilateral knee surgery or decreased PROs up to 6 years after ACLR. Conversely, patients exhibiting a difference >6 mm in side-to-side anterior laxity were noted to have significantly decreased PROs at 6 years after ACLR.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><doi>10.1177/03635465211025003</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0363-5465 |
| ispartof | The American journal of sports medicine, 2021-08, Vol.49 (10), p.2631-2637 |
| issn | 0363-5465 1552-3365 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2552993293 |
| source | SAGE Complete A-Z List; Alma/SFX Local Collection |
| subjects | Knee Ligaments Patients Sports medicine Surgery |
| title | Neither Residual Anterior Knee Laxity Up to 6 mm nor a Pivot Glide Predict Patient-Reported Outcome Scores or Subsequent Knee Surgery Between 2 and 6 Years After ACL Reconstruction |
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