Risk Factors for Manipulation Under Anesthesia and/or Lysis of Adhesions After Anterior Cruciate Ligament Reconstruction
Background: In the currently published literature, a higher risk for developing arthrofibrosis after anterior cruciate ligament (ACL) reconstruction has been reported for female patients, adolescents, early surgery or concomitant procedures, and the use of a patellar tendon autograft. There is a lac...
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| Veröffentlicht in: | Orthopaedic journal of sports medicine 2018-09, Vol.6 (9), p.2325967118794490-2325967118794490 |
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| creator | Huleatt, Joel Gottschalk, Michael Fraser, Kelsey Boden, Allison Dalwadi, Poonam Xerogeanes, John Hammond, Kyle |
| description | Background:
In the currently published literature, a higher risk for developing arthrofibrosis after anterior cruciate ligament (ACL) reconstruction has been reported for female patients, adolescents, early surgery or concomitant procedures, and the use of a patellar tendon autograft. There is a lack of evidence regarding other graft choices or factors.
Hypothesis:
Multiple risk factors will play a significant role in the development of arthrofibrosis after ACL reconstruction. Specifically, we hypothesized that the risk of manipulation under anesthesia (MUA) and/or lysis of adhesions (LOA) would be affected by graft choice and patient demographic factors.
Study Design:
Case-control study; Level of evidence, 3.
Methods:
The charts of all patients who underwent ACL reconstruction over a 10-year period at a single academic institution were queried from an electronic medical record database and reviewed at a minimum of 6 months after ACL reconstruction, with the collection of demographic and surgical data. The relative risk for undergoing MUA and/or LOA was calculated for each analyzed risk factor.
Results:
A total of 2424 ACL reconstructions were included, with a chart review at a mean of 56.7 months after surgery (range, 7.6-124.0 months). The rate of MUA and/or LOA for arthrofibrosis was 4.5%. A statistically significantly increased relative risk was found for infection (5.45), hematoma requiring evacuation (3.55), ACL reconstruction with meniscal repair (2.83), use of a quadriceps tendon autograft (2.68), age 25 years (0.34), and use of a tibialis anterior allograft (0.36). In the multivariate regression model, the use of a quadriceps tendon autograft (P = .00007), infection (P = .00126), and concomitant meniscal repair (P = .00194) were independent risk factors, whereas revision ACL reconstruction (P = .0024) was an independent protective factor.
Conclusion:
Graft type, infection, concomitant meniscal repair, and primary reconstruction are significant risk factors for undergoing MUA or LOA after ACL reconstruction. |
| doi_str_mv | 10.1177/2325967118794490 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6131313</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_2325967118794490</sage_id><sourcerecordid>2103681009</sourcerecordid><originalsourceid>FETCH-LOGICAL-c528t-bcfa23f60e0db48ea510ffbe82b0aa91144669251b57809b211ab24230c95aaf3</originalsourceid><addsrcrecordid>eNp1kctrJCEQxiVkScLs3PcUhFxy6cRHv7wEhiEvmLAQds5SbevEpEcn2h02__3ambxhFSz5_NWnZSH0i5ITSqvqlHFWiLKitK5Enguygw5GKRu13U_7fTSN8Z6kURdU8GoP7XPCKGV5eYD-3tr4gC9A9T5EbHzAN-DsZuigt97hpWt1wDOnY3-nowUMrj1N0OI52oi9wbN21L2LeGb6FzStNhHzMCgLvcYLu4K1dj2-1SpxfdJH65_oh4Eu6ulrnKDlxfmf-VW2-H15PZ8tMlWwus8aZYBxUxJN2iavNRSUGNPomjUEQFCa52UpWEGboqqJaFJd0LCccaJEAWD4BJ1tfTdDs9atSi8J0MlNsGsIz9KDlV9PnL2TK_8kS8rHmQyOXw2CfxzSR8i1jUp3HTjthygZJbysKSEioUff0Hs_BJfKkyxZVTWvUpggsqVU8DEGbd4fQ4kcOyu_dzalHH4u4j3hrY8JyLZAhJX-uPW_hv8Ab3qscg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2313783731</pqid></control><display><type>article</type><title>Risk Factors for Manipulation Under Anesthesia and/or Lysis of Adhesions After Anterior Cruciate Ligament Reconstruction</title><source>DOAJ Directory of Open Access Journals</source><source>Sage Journals GOLD Open Access 2024</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Huleatt, Joel ; Gottschalk, Michael ; Fraser, Kelsey ; Boden, Allison ; Dalwadi, Poonam ; Xerogeanes, John ; Hammond, Kyle</creator><creatorcontrib>Huleatt, Joel ; Gottschalk, Michael ; Fraser, Kelsey ; Boden, Allison ; Dalwadi, Poonam ; Xerogeanes, John ; Hammond, Kyle</creatorcontrib><description>Background:
In the currently published literature, a higher risk for developing arthrofibrosis after anterior cruciate ligament (ACL) reconstruction has been reported for female patients, adolescents, early surgery or concomitant procedures, and the use of a patellar tendon autograft. There is a lack of evidence regarding other graft choices or factors.
Hypothesis:
Multiple risk factors will play a significant role in the development of arthrofibrosis after ACL reconstruction. Specifically, we hypothesized that the risk of manipulation under anesthesia (MUA) and/or lysis of adhesions (LOA) would be affected by graft choice and patient demographic factors.
Study Design:
Case-control study; Level of evidence, 3.
Methods:
The charts of all patients who underwent ACL reconstruction over a 10-year period at a single academic institution were queried from an electronic medical record database and reviewed at a minimum of 6 months after ACL reconstruction, with the collection of demographic and surgical data. The relative risk for undergoing MUA and/or LOA was calculated for each analyzed risk factor.
Results:
A total of 2424 ACL reconstructions were included, with a chart review at a mean of 56.7 months after surgery (range, 7.6-124.0 months). The rate of MUA and/or LOA for arthrofibrosis was 4.5%. A statistically significantly increased relative risk was found for infection (5.45), hematoma requiring evacuation (3.55), ACL reconstruction with meniscal repair (2.83), use of a quadriceps tendon autograft (2.68), age <18 years (2.39), multiple concomitant procedures (1.69), contact injury (1.62), female sex (1.60), and surgery within 28 days of injury (1.53), and a statistically significantly decreased relative risk was found for revision ACL reconstruction (0.30), age >25 years (0.34), and use of a tibialis anterior allograft (0.36). In the multivariate regression model, the use of a quadriceps tendon autograft (P = .00007), infection (P = .00126), and concomitant meniscal repair (P = .00194) were independent risk factors, whereas revision ACL reconstruction (P = .0024) was an independent protective factor.
Conclusion:
Graft type, infection, concomitant meniscal repair, and primary reconstruction are significant risk factors for undergoing MUA or LOA after ACL reconstruction.</description><identifier>ISSN: 2325-9671</identifier><identifier>EISSN: 2325-9671</identifier><identifier>DOI: 10.1177/2325967118794490</identifier><identifier>PMID: 30211246</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Infections ; Knee ; Orthopedics ; Risk factors ; Sports medicine ; Surgery</subject><ispartof>Orthopaedic journal of sports medicine, 2018-09, Vol.6 (9), p.2325967118794490-2325967118794490</ispartof><rights>The Author(s) 2018</rights><rights>The Author(s) 2018. This work is licensed under the Creative Commons Attribution – Non-Commercial – No Derivatives License http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2018 2018 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-bcfa23f60e0db48ea510ffbe82b0aa91144669251b57809b211ab24230c95aaf3</citedby><cites>FETCH-LOGICAL-c528t-bcfa23f60e0db48ea510ffbe82b0aa91144669251b57809b211ab24230c95aaf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131313/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131313/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,21947,27834,27905,27906,44926,45314,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30211246$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huleatt, Joel</creatorcontrib><creatorcontrib>Gottschalk, Michael</creatorcontrib><creatorcontrib>Fraser, Kelsey</creatorcontrib><creatorcontrib>Boden, Allison</creatorcontrib><creatorcontrib>Dalwadi, Poonam</creatorcontrib><creatorcontrib>Xerogeanes, John</creatorcontrib><creatorcontrib>Hammond, Kyle</creatorcontrib><title>Risk Factors for Manipulation Under Anesthesia and/or Lysis of Adhesions After Anterior Cruciate Ligament Reconstruction</title><title>Orthopaedic journal of sports medicine</title><addtitle>Orthop J Sports Med</addtitle><description>Background:
In the currently published literature, a higher risk for developing arthrofibrosis after anterior cruciate ligament (ACL) reconstruction has been reported for female patients, adolescents, early surgery or concomitant procedures, and the use of a patellar tendon autograft. There is a lack of evidence regarding other graft choices or factors.
Hypothesis:
Multiple risk factors will play a significant role in the development of arthrofibrosis after ACL reconstruction. Specifically, we hypothesized that the risk of manipulation under anesthesia (MUA) and/or lysis of adhesions (LOA) would be affected by graft choice and patient demographic factors.
Study Design:
Case-control study; Level of evidence, 3.
Methods:
The charts of all patients who underwent ACL reconstruction over a 10-year period at a single academic institution were queried from an electronic medical record database and reviewed at a minimum of 6 months after ACL reconstruction, with the collection of demographic and surgical data. The relative risk for undergoing MUA and/or LOA was calculated for each analyzed risk factor.
Results:
A total of 2424 ACL reconstructions were included, with a chart review at a mean of 56.7 months after surgery (range, 7.6-124.0 months). The rate of MUA and/or LOA for arthrofibrosis was 4.5%. A statistically significantly increased relative risk was found for infection (5.45), hematoma requiring evacuation (3.55), ACL reconstruction with meniscal repair (2.83), use of a quadriceps tendon autograft (2.68), age <18 years (2.39), multiple concomitant procedures (1.69), contact injury (1.62), female sex (1.60), and surgery within 28 days of injury (1.53), and a statistically significantly decreased relative risk was found for revision ACL reconstruction (0.30), age >25 years (0.34), and use of a tibialis anterior allograft (0.36). In the multivariate regression model, the use of a quadriceps tendon autograft (P = .00007), infection (P = .00126), and concomitant meniscal repair (P = .00194) were independent risk factors, whereas revision ACL reconstruction (P = .0024) was an independent protective factor.
Conclusion:
Graft type, infection, concomitant meniscal repair, and primary reconstruction are significant risk factors for undergoing MUA or LOA after ACL reconstruction.</description><subject>Infections</subject><subject>Knee</subject><subject>Orthopedics</subject><subject>Risk factors</subject><subject>Sports medicine</subject><subject>Surgery</subject><issn>2325-9671</issn><issn>2325-9671</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1kctrJCEQxiVkScLs3PcUhFxy6cRHv7wEhiEvmLAQds5SbevEpEcn2h02__3ambxhFSz5_NWnZSH0i5ITSqvqlHFWiLKitK5Enguygw5GKRu13U_7fTSN8Z6kURdU8GoP7XPCKGV5eYD-3tr4gC9A9T5EbHzAN-DsZuigt97hpWt1wDOnY3-nowUMrj1N0OI52oi9wbN21L2LeGb6FzStNhHzMCgLvcYLu4K1dj2-1SpxfdJH65_oh4Eu6ulrnKDlxfmf-VW2-H15PZ8tMlWwus8aZYBxUxJN2iavNRSUGNPomjUEQFCa52UpWEGboqqJaFJd0LCccaJEAWD4BJ1tfTdDs9atSi8J0MlNsGsIz9KDlV9PnL2TK_8kS8rHmQyOXw2CfxzSR8i1jUp3HTjthygZJbysKSEioUff0Hs_BJfKkyxZVTWvUpggsqVU8DEGbd4fQ4kcOyu_dzalHH4u4j3hrY8JyLZAhJX-uPW_hv8Ab3qscg</recordid><startdate>20180901</startdate><enddate>20180901</enddate><creator>Huleatt, Joel</creator><creator>Gottschalk, Michael</creator><creator>Fraser, Kelsey</creator><creator>Boden, Allison</creator><creator>Dalwadi, Poonam</creator><creator>Xerogeanes, John</creator><creator>Hammond, Kyle</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180901</creationdate><title>Risk Factors for Manipulation Under Anesthesia and/or Lysis of Adhesions After Anterior Cruciate Ligament Reconstruction</title><author>Huleatt, Joel ; Gottschalk, Michael ; Fraser, Kelsey ; Boden, Allison ; Dalwadi, Poonam ; Xerogeanes, John ; Hammond, Kyle</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c528t-bcfa23f60e0db48ea510ffbe82b0aa91144669251b57809b211ab24230c95aaf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Infections</topic><topic>Knee</topic><topic>Orthopedics</topic><topic>Risk factors</topic><topic>Sports medicine</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huleatt, Joel</creatorcontrib><creatorcontrib>Gottschalk, Michael</creatorcontrib><creatorcontrib>Fraser, Kelsey</creatorcontrib><creatorcontrib>Boden, Allison</creatorcontrib><creatorcontrib>Dalwadi, Poonam</creatorcontrib><creatorcontrib>Xerogeanes, John</creatorcontrib><creatorcontrib>Hammond, Kyle</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Orthopaedic journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huleatt, Joel</au><au>Gottschalk, Michael</au><au>Fraser, Kelsey</au><au>Boden, Allison</au><au>Dalwadi, Poonam</au><au>Xerogeanes, John</au><au>Hammond, Kyle</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for Manipulation Under Anesthesia and/or Lysis of Adhesions After Anterior Cruciate Ligament Reconstruction</atitle><jtitle>Orthopaedic journal of sports medicine</jtitle><addtitle>Orthop J Sports Med</addtitle><date>2018-09-01</date><risdate>2018</risdate><volume>6</volume><issue>9</issue><spage>2325967118794490</spage><epage>2325967118794490</epage><pages>2325967118794490-2325967118794490</pages><issn>2325-9671</issn><eissn>2325-9671</eissn><abstract>Background:
In the currently published literature, a higher risk for developing arthrofibrosis after anterior cruciate ligament (ACL) reconstruction has been reported for female patients, adolescents, early surgery or concomitant procedures, and the use of a patellar tendon autograft. There is a lack of evidence regarding other graft choices or factors.
Hypothesis:
Multiple risk factors will play a significant role in the development of arthrofibrosis after ACL reconstruction. Specifically, we hypothesized that the risk of manipulation under anesthesia (MUA) and/or lysis of adhesions (LOA) would be affected by graft choice and patient demographic factors.
Study Design:
Case-control study; Level of evidence, 3.
Methods:
The charts of all patients who underwent ACL reconstruction over a 10-year period at a single academic institution were queried from an electronic medical record database and reviewed at a minimum of 6 months after ACL reconstruction, with the collection of demographic and surgical data. The relative risk for undergoing MUA and/or LOA was calculated for each analyzed risk factor.
Results:
A total of 2424 ACL reconstructions were included, with a chart review at a mean of 56.7 months after surgery (range, 7.6-124.0 months). The rate of MUA and/or LOA for arthrofibrosis was 4.5%. A statistically significantly increased relative risk was found for infection (5.45), hematoma requiring evacuation (3.55), ACL reconstruction with meniscal repair (2.83), use of a quadriceps tendon autograft (2.68), age <18 years (2.39), multiple concomitant procedures (1.69), contact injury (1.62), female sex (1.60), and surgery within 28 days of injury (1.53), and a statistically significantly decreased relative risk was found for revision ACL reconstruction (0.30), age >25 years (0.34), and use of a tibialis anterior allograft (0.36). In the multivariate regression model, the use of a quadriceps tendon autograft (P = .00007), infection (P = .00126), and concomitant meniscal repair (P = .00194) were independent risk factors, whereas revision ACL reconstruction (P = .0024) was an independent protective factor.
Conclusion:
Graft type, infection, concomitant meniscal repair, and primary reconstruction are significant risk factors for undergoing MUA or LOA after ACL reconstruction.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>30211246</pmid><doi>10.1177/2325967118794490</doi><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Sage Journals GOLD Open Access 2024; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Infections Knee Orthopedics Risk factors Sports medicine Surgery |
| title | Risk Factors for Manipulation Under Anesthesia and/or Lysis of Adhesions After Anterior Cruciate Ligament Reconstruction |
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