Effect of Gender and Sports on the Risk of Full-Thickness Articular Cartilage Lesions in Anterior Cruciate Ligament–Injured Knees: A Nationwide Cohort Study From Sweden and Norway of 15 783 Patients
Background: The presence of an articular cartilage lesion in anterior cruciate ligament–injured knees is considered a predictor of osteoarthritis. Purpose: This study was undertaken to evaluate risk factors for full-thickness articular cartilage lesions in anterior cruciate ligament–injured knees, i...
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| Veröffentlicht in: | The American journal of sports medicine 2011-07, Vol.39 (7), p.1387-1394 |
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| creator | Røtterud, Jan Harald Sivertsen, Einar A. Forssblad, Magnus Engebretsen, Lars Årøen, Asbjørn |
| description | Background: The presence of an articular cartilage lesion in anterior cruciate ligament–injured knees is considered a predictor of osteoarthritis.
Purpose: This study was undertaken to evaluate risk factors for full-thickness articular cartilage lesions in anterior cruciate ligament–injured knees, in particular the role of gender and the sport causing the initial injury.
Study Design: Cohort study (prognosis); Level of evidence, 2.
Methods: Primary unilateral anterior cruciate ligament reconstructions prospectively registered in the Swedish and the Norwegian National Knee Ligament Registry during 2005 through 2008 were included (N = 15 783). Logistic regression analyses were used to evaluate risk factors for cartilage lesions.
Results: A total of 1012 patients (6.4%) had full-thickness cartilage lesions. The median time from injury to surgery was 9 months (range, 0 days-521 months). Male patients had an increased odds of full-thickness cartilage lesions compared with females (odds ratio = 1.22; 95% confidence interval, 1.04-1.42). In males, team handball had an increase in the odds of full-thickness cartilage lesions compared with soccer (odds ratio = 2.36; 95% confidence interval, 1.33-4.19). Among female patients, no sport investigated showed a significant decrease or increase in the odds of full-thickness cartilage lesions. The odds of a full-thickness cartilage lesion increased by 1.006 (95% confidence interval, 1.005-1.008) for each month elapsed from time of injury until anterior cruciate ligament reconstruction when all patients were considered, while time from injury to surgery did not affect the odds significantly in those patients reconstructed within 1 year of injury (odds ratio = 0.98; 95% confidence interval, 0.95-1.02). Previous surgery increased the odds of having a full-thickness cartilage lesion (odds ratio = 1.40; 95% confidence interval, 1.21-1.63). One year of increasing patient age also increased the odds (odds ratio = 1.05; 95% confidence interval, 1.05-1.06).
Conclusion: Male gender is associated with an increased risk of full-thickness articular cartilage lesions in anterior cruciate ligament–injured knees. Male team handball players had an increased risk of full-thickness lesions. No other sports investigated were found to have significant effect on the risk in either gender. Furthermore, age, previous surgery, and time from injury to surgery exceeding 12 months are risk factors for full-thickness cartilage lesions. |
| doi_str_mv | 10.1177/0363546510397813 |
| format | Article |
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Purpose: This study was undertaken to evaluate risk factors for full-thickness articular cartilage lesions in anterior cruciate ligament–injured knees, in particular the role of gender and the sport causing the initial injury.
Study Design: Cohort study (prognosis); Level of evidence, 2.
Methods: Primary unilateral anterior cruciate ligament reconstructions prospectively registered in the Swedish and the Norwegian National Knee Ligament Registry during 2005 through 2008 were included (N = 15 783). Logistic regression analyses were used to evaluate risk factors for cartilage lesions.
Results: A total of 1012 patients (6.4%) had full-thickness cartilage lesions. The median time from injury to surgery was 9 months (range, 0 days-521 months). Male patients had an increased odds of full-thickness cartilage lesions compared with females (odds ratio = 1.22; 95% confidence interval, 1.04-1.42). In males, team handball had an increase in the odds of full-thickness cartilage lesions compared with soccer (odds ratio = 2.36; 95% confidence interval, 1.33-4.19). Among female patients, no sport investigated showed a significant decrease or increase in the odds of full-thickness cartilage lesions. The odds of a full-thickness cartilage lesion increased by 1.006 (95% confidence interval, 1.005-1.008) for each month elapsed from time of injury until anterior cruciate ligament reconstruction when all patients were considered, while time from injury to surgery did not affect the odds significantly in those patients reconstructed within 1 year of injury (odds ratio = 0.98; 95% confidence interval, 0.95-1.02). Previous surgery increased the odds of having a full-thickness cartilage lesion (odds ratio = 1.40; 95% confidence interval, 1.21-1.63). One year of increasing patient age also increased the odds (odds ratio = 1.05; 95% confidence interval, 1.05-1.06).
Conclusion: Male gender is associated with an increased risk of full-thickness articular cartilage lesions in anterior cruciate ligament–injured knees. Male team handball players had an increased risk of full-thickness lesions. No other sports investigated were found to have significant effect on the risk in either gender. Furthermore, age, previous surgery, and time from injury to surgery exceeding 12 months are risk factors for full-thickness cartilage lesions.</description><identifier>ISSN: 0363-5465</identifier><identifier>ISSN: 1552-3365</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546510397813</identifier><identifier>PMID: 21730206</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Adult ; Age ; Aged ; anterior cruciate ligament ; Anterior Cruciate Ligament - surgery ; Anterior Cruciate Ligament Injuries ; Athletic Injuries - epidemiology ; Biological and medical sciences ; Cartilage ; Cartilage (articular) ; Cartilage diseases ; Cartilage, Articular - injuries ; Cartilage, Articular - pathology ; Child ; Cohort Studies ; Diseases of the osteoarticular system ; Female ; Gender ; Humans ; Injuries ; Knee ; Knee Injuries - epidemiology ; Knees ; Lesions ; Ligaments ; Logistic Models ; Male ; Medical sciences ; Medicin och hälsovetenskap ; Middle Aged ; Norway - epidemiology ; Patients ; Prognosis ; Reconstruction ; Regression analysis ; Risk Factors ; Sex Factors ; Skin & tissue grafts ; Sports ; Sports medicine ; sports related injuries ; Surgery ; Sweden - epidemiology ; Team handball ; Time Factors ; Young Adult</subject><ispartof>The American journal of sports medicine, 2011-07, Vol.39 (7), p.1387-1394</ispartof><rights>2011 The Author(s)</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c467t-4d95a7e0e8d678fe1415bd6a9a05f9a9fa45c4c32b6e0daa1cfc712f1f6a41a33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546510397813$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546510397813$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,314,780,784,885,21818,27923,27924,43620,43621</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24396647$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21730206$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:122882113$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Røtterud, Jan Harald</creatorcontrib><creatorcontrib>Sivertsen, Einar A.</creatorcontrib><creatorcontrib>Forssblad, Magnus</creatorcontrib><creatorcontrib>Engebretsen, Lars</creatorcontrib><creatorcontrib>Årøen, Asbjørn</creatorcontrib><title>Effect of Gender and Sports on the Risk of Full-Thickness Articular Cartilage Lesions in Anterior Cruciate Ligament–Injured Knees: A Nationwide Cohort Study From Sweden and Norway of 15 783 Patients</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background: The presence of an articular cartilage lesion in anterior cruciate ligament–injured knees is considered a predictor of osteoarthritis.
Purpose: This study was undertaken to evaluate risk factors for full-thickness articular cartilage lesions in anterior cruciate ligament–injured knees, in particular the role of gender and the sport causing the initial injury.
Study Design: Cohort study (prognosis); Level of evidence, 2.
Methods: Primary unilateral anterior cruciate ligament reconstructions prospectively registered in the Swedish and the Norwegian National Knee Ligament Registry during 2005 through 2008 were included (N = 15 783). Logistic regression analyses were used to evaluate risk factors for cartilage lesions.
Results: A total of 1012 patients (6.4%) had full-thickness cartilage lesions. The median time from injury to surgery was 9 months (range, 0 days-521 months). Male patients had an increased odds of full-thickness cartilage lesions compared with females (odds ratio = 1.22; 95% confidence interval, 1.04-1.42). In males, team handball had an increase in the odds of full-thickness cartilage lesions compared with soccer (odds ratio = 2.36; 95% confidence interval, 1.33-4.19). Among female patients, no sport investigated showed a significant decrease or increase in the odds of full-thickness cartilage lesions. The odds of a full-thickness cartilage lesion increased by 1.006 (95% confidence interval, 1.005-1.008) for each month elapsed from time of injury until anterior cruciate ligament reconstruction when all patients were considered, while time from injury to surgery did not affect the odds significantly in those patients reconstructed within 1 year of injury (odds ratio = 0.98; 95% confidence interval, 0.95-1.02). Previous surgery increased the odds of having a full-thickness cartilage lesion (odds ratio = 1.40; 95% confidence interval, 1.21-1.63). One year of increasing patient age also increased the odds (odds ratio = 1.05; 95% confidence interval, 1.05-1.06).
Conclusion: Male gender is associated with an increased risk of full-thickness articular cartilage lesions in anterior cruciate ligament–injured knees. Male team handball players had an increased risk of full-thickness lesions. No other sports investigated were found to have significant effect on the risk in either gender. Furthermore, age, previous surgery, and time from injury to surgery exceeding 12 months are risk factors for full-thickness cartilage lesions.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>anterior cruciate ligament</subject><subject>Anterior Cruciate Ligament - surgery</subject><subject>Anterior Cruciate Ligament Injuries</subject><subject>Athletic Injuries - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Cartilage</subject><subject>Cartilage (articular)</subject><subject>Cartilage diseases</subject><subject>Cartilage, Articular - injuries</subject><subject>Cartilage, Articular - pathology</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Gender</subject><subject>Humans</subject><subject>Injuries</subject><subject>Knee</subject><subject>Knee Injuries - epidemiology</subject><subject>Knees</subject><subject>Lesions</subject><subject>Ligaments</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>Middle Aged</subject><subject>Norway - epidemiology</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Reconstruction</subject><subject>Regression analysis</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Skin & tissue grafts</subject><subject>Sports</subject><subject>Sports medicine</subject><subject>sports related injuries</subject><subject>Surgery</subject><subject>Sweden - epidemiology</subject><subject>Team handball</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>0363-5465</issn><issn>1552-3365</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks2KFDEUhQtRnHZ070oCIq5K85_KsmlmxsEGQcd1kU7dzKS7OmmTKgZ3go_gG_okpuieHwYGFyEh5zv3Xi6nql4T_IEQpT5iJpngUhDMtGoIe1LNiBC0ZkyKp9VskutJP6pe5LzGGBMlm-fVESWKYYrlrPp94hzYAUWHziB0kJAJHfq2i2nIKAY0XAH66vNmAk7Hvq8vrrzdBMgZzdPg7dibhBamPHtzCWgJ2ceQkQ9oHgZIPhY1jdaboYj-0mwhDH9__TkP6zFBhz4HgPyyeuZMn-HV4T6uvp-eXCw-1csvZ-eL-bK2XKqh5p0WRgGGppOqcUA4EatOGm2wcNpoZ7iw3DK6koA7Y4h1VhHqiJOGE8PYcVXv6-Zr2I2rdpf81qSfbTS-PXxtygtawRnVtPD6UX6XYndnujESSpuGEjL1er_3FvDHCHlotz5b6HsTII65bRqGORVY_Z9UgmsssC7k2wfkOo4plJW1ROOGlqMnCu8pm2LOCdzt3AS3U2rah6kpljeHwuNqC92t4SYmBXh3AEy2pnfJBOvzHceZlpKrexsuYbg33WON_wEPQ9jO</recordid><startdate>20110701</startdate><enddate>20110701</enddate><creator>Røtterud, Jan Harald</creator><creator>Sivertsen, Einar A.</creator><creator>Forssblad, Magnus</creator><creator>Engebretsen, Lars</creator><creator>Årøen, Asbjørn</creator><general>SAGE Publications</general><general>Sage Publications</general><general>Sage Publications Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope><scope>7QP</scope><scope>7T2</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>ADTPV</scope><scope>AOWAS</scope></search><sort><creationdate>20110701</creationdate><title>Effect of Gender and Sports on the Risk of Full-Thickness Articular Cartilage Lesions in Anterior Cruciate Ligament–Injured Knees</title><author>Røtterud, Jan Harald ; Sivertsen, Einar A. ; Forssblad, Magnus ; Engebretsen, Lars ; Årøen, Asbjørn</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-4d95a7e0e8d678fe1415bd6a9a05f9a9fa45c4c32b6e0daa1cfc712f1f6a41a33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>anterior cruciate ligament</topic><topic>Anterior Cruciate Ligament - surgery</topic><topic>Anterior Cruciate Ligament Injuries</topic><topic>Athletic Injuries - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Cartilage</topic><topic>Cartilage (articular)</topic><topic>Cartilage diseases</topic><topic>Cartilage, Articular - injuries</topic><topic>Cartilage, Articular - pathology</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Gender</topic><topic>Humans</topic><topic>Injuries</topic><topic>Knee</topic><topic>Knee Injuries - epidemiology</topic><topic>Knees</topic><topic>Lesions</topic><topic>Ligaments</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicin och hälsovetenskap</topic><topic>Middle Aged</topic><topic>Norway - epidemiology</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Reconstruction</topic><topic>Regression analysis</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Skin & tissue grafts</topic><topic>Sports</topic><topic>Sports medicine</topic><topic>sports related injuries</topic><topic>Surgery</topic><topic>Sweden - epidemiology</topic><topic>Team handball</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Røtterud, Jan Harald</creatorcontrib><creatorcontrib>Sivertsen, Einar A.</creatorcontrib><creatorcontrib>Forssblad, Magnus</creatorcontrib><creatorcontrib>Engebretsen, Lars</creatorcontrib><creatorcontrib>Årøen, Asbjørn</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><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><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>SwePub</collection><collection>SwePub Articles</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Røtterud, Jan Harald</au><au>Sivertsen, Einar A.</au><au>Forssblad, Magnus</au><au>Engebretsen, Lars</au><au>Årøen, Asbjørn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Gender and Sports on the Risk of Full-Thickness Articular Cartilage Lesions in Anterior Cruciate Ligament–Injured Knees: A Nationwide Cohort Study From Sweden and Norway of 15 783 Patients</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2011-07-01</date><risdate>2011</risdate><volume>39</volume><issue>7</issue><spage>1387</spage><epage>1394</epage><pages>1387-1394</pages><issn>0363-5465</issn><issn>1552-3365</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background: The presence of an articular cartilage lesion in anterior cruciate ligament–injured knees is considered a predictor of osteoarthritis.
Purpose: This study was undertaken to evaluate risk factors for full-thickness articular cartilage lesions in anterior cruciate ligament–injured knees, in particular the role of gender and the sport causing the initial injury.
Study Design: Cohort study (prognosis); Level of evidence, 2.
Methods: Primary unilateral anterior cruciate ligament reconstructions prospectively registered in the Swedish and the Norwegian National Knee Ligament Registry during 2005 through 2008 were included (N = 15 783). Logistic regression analyses were used to evaluate risk factors for cartilage lesions.
Results: A total of 1012 patients (6.4%) had full-thickness cartilage lesions. The median time from injury to surgery was 9 months (range, 0 days-521 months). Male patients had an increased odds of full-thickness cartilage lesions compared with females (odds ratio = 1.22; 95% confidence interval, 1.04-1.42). In males, team handball had an increase in the odds of full-thickness cartilage lesions compared with soccer (odds ratio = 2.36; 95% confidence interval, 1.33-4.19). Among female patients, no sport investigated showed a significant decrease or increase in the odds of full-thickness cartilage lesions. The odds of a full-thickness cartilage lesion increased by 1.006 (95% confidence interval, 1.005-1.008) for each month elapsed from time of injury until anterior cruciate ligament reconstruction when all patients were considered, while time from injury to surgery did not affect the odds significantly in those patients reconstructed within 1 year of injury (odds ratio = 0.98; 95% confidence interval, 0.95-1.02). Previous surgery increased the odds of having a full-thickness cartilage lesion (odds ratio = 1.40; 95% confidence interval, 1.21-1.63). One year of increasing patient age also increased the odds (odds ratio = 1.05; 95% confidence interval, 1.05-1.06).
Conclusion: Male gender is associated with an increased risk of full-thickness articular cartilage lesions in anterior cruciate ligament–injured knees. Male team handball players had an increased risk of full-thickness lesions. No other sports investigated were found to have significant effect on the risk in either gender. Furthermore, age, previous surgery, and time from injury to surgery exceeding 12 months are risk factors for full-thickness cartilage lesions.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>21730206</pmid><doi>10.1177/0363546510397813</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | The American journal of sports medicine, 2011-07, Vol.39 (7), p.1387-1394 |
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| language | eng |
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| source | MEDLINE; SAGE Complete A-Z List; Alma/SFX Local Collection |
| subjects | Adolescent Adult Age Aged anterior cruciate ligament Anterior Cruciate Ligament - surgery Anterior Cruciate Ligament Injuries Athletic Injuries - epidemiology Biological and medical sciences Cartilage Cartilage (articular) Cartilage diseases Cartilage, Articular - injuries Cartilage, Articular - pathology Child Cohort Studies Diseases of the osteoarticular system Female Gender Humans Injuries Knee Knee Injuries - epidemiology Knees Lesions Ligaments Logistic Models Male Medical sciences Medicin och hälsovetenskap Middle Aged Norway - epidemiology Patients Prognosis Reconstruction Regression analysis Risk Factors Sex Factors Skin & tissue grafts Sports Sports medicine sports related injuries Surgery Sweden - epidemiology Team handball Time Factors Young Adult |
| title | Effect of Gender and Sports on the Risk of Full-Thickness Articular Cartilage Lesions in Anterior Cruciate Ligament–Injured Knees: A Nationwide Cohort Study From Sweden and Norway of 15 783 Patients |
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