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Joint effusion at 6 months is a significant predictor of joint effusion 1 year after anterior cruciate ligament reconstruction

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to assess the risk factors for prolonged joint effusion in patients undergoing double-bundle anterior cruciate ligament reconstruction (ACLR).

Methods

In total, 160 patients who underwent primary ACLR using autograft hamstring between 2015 and 2018 were retrospectively reviewed. Joint effusion was defined as any grade ≥ 2 (range, 0–3) according to the MRI Osteoarthritis Knee Score (MOAKS). Univariate and multivariate logistic regression analyses were performed.

Results

The median age of the patients was 25 years (range 14–68 years) at the time of the surgery; there were 89 women and 71 men. At 1 year, 46 (28.8%) patients experienced knee joint effusion, as defined by the MOAKS. Univariate analysis revealed that age, preoperative Kellgren–Lawrence (K–L) grade, and joint effusion at 6 months were significantly associated with joint effusion at 1 year. In the multivariate analysis, joint effusion at 6 months was significantly associated with joint effusion at 1 year (odds ratio, 68.0; 95% confidence interval, 22.1–209.4). No significant difference in the Lysholm scores was observed between patients with and without joint effusion at 1 year (n.s.).

Conclusions

Joint effusion at 6 months was significantly associated with joint effusion 1 year after ACLR.

Level of evidence

III.

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References

  1. Barenius B, Ponzer S, Shalabi A, Bujak R, Norlen L, Eriksson K (2014) Increased risk of osteoarthritis after anterior cruciate ligament reconstruction: a 14-year follow-up study of a randomized controlled trial. Am J Sports Med 42:1049–1057

    Article  Google Scholar 

  2. Cattano NM, Driban JB, Balasubramanian E, Barbe MF, Amin M, Sitler MR (2011) Biochemical comparison of osteoarthritic knees with and without effusion. BMC Musculoskelet Disord 12:273

    Article  CAS  Google Scholar 

  3. Catterall JB, Stabler TV, Flannery CR, Kraus VB (2010) Changes in serum and synovial fluid biomarkers after acute injury (NCT00332254). Arthritis Res Ther 12:R229

    Article  Google Scholar 

  4. Cinque ME, Chahla J, Moatshe G, DePhillipo NN, Kennedy NI, Godin JA et al (2017) Outcomes and complication rates after primary anterior cruciate ligament reconstruction are similar in younger and older patients. Orthop J Sports Med 5:2325967117729659

    PubMed  PubMed Central  Google Scholar 

  5. Cinque ME, Dornan GJ, Chahla J, Moatshe G, LaPrade RF (2018) High rates of osteoarthritis develop after anterior cruciate ligament surgery: an analysis of 4108 patients. Am J Sports Med 46:2011–2019

    Article  Google Scholar 

  6. Culvenor AG, Collins NJ, Guermazi A, Cook JL, Vicenzino B, Khan KM et al (2015) Early knee osteoarthritis is evident one year following anterior cruciate ligament reconstruction: a magnetic resonance imaging evaluation. Arthritis Rheumatol 67:946–955

    Article  CAS  Google Scholar 

  7. Filardo G, Andriolo L, di Laura FG, Napoli F, Zaffagnini S, Candrian C (2019) Bone bruise in anterior cruciate ligament rupture entails a more severe joint damage affecting joint degenerative progression. Knee Surg Sports Traumatol Arthrosc 27:44–59

    Article  Google Scholar 

  8. Frobell RB, Le Graverand MP, Buck R, Roos EM, Roos HP, Tamez-Pena J et al (2009) The acutely ACL injured knee assessed by MRI: changes in joint fluid, bone marrow lesions, and cartilage during the first year. Osteoarthritis Cartilage 17:161–167

    Article  CAS  Google Scholar 

  9. Gallelli L, Galasso O, Falcone D, Southworth S, Greco M, Ventura V et al (2013) The effects of nonsteroidal anti-inflammatory drugs on clinical outcomes, synovial fluid cytokine concentration and signal transduction pathways in knee osteoarthritis. A randomized open label trial. Osteoarthritis Cartilage 21:1400–1408

    Article  CAS  Google Scholar 

  10. Hunter DJ, Guermazi A, Lo GH, Grainger AJ, Conaghan PG, Boudreau RM et al (2011) Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score). Osteoarthritis Cartilage 19:990–1002

    Article  CAS  Google Scholar 

  11. Kellgren JH, Lawrence JS (1957) Radiological assessment of rheumatoid arthritis. Ann Rheum Dis 16:485–493

    Article  CAS  Google Scholar 

  12. Kraus VB, Birmingham J, Stabler TV, Feng S, Taylor DC, Moorman CT 3rd et al (2012) Effects of intraarticular IL1-Ra for acute anterior cruciate ligament knee injury: a randomized controlled pilot trial (NCT00332254). Osteoarthritis Cartilage 20:271–278

    Article  CAS  Google Scholar 

  13. Kumahashi N, Sward P, Larsson S, Lohmander LS, Frobell R, Struglics A (2015) Type II collagen C2C epitope in human synovial fluid and serum after knee injury–associations with molecular and structural markers of injury. Osteoarthritis Cartilage 23:1506–1512

    Article  CAS  Google Scholar 

  14. Larsson S, Struglics A, Lohmander LS, Frobell R (2017) Surgical reconstruction of ruptured anterior cruciate ligament prolongs trauma-induced increase of inflammatory cytokines in synovial fluid: an exploratory analysis in the KANON trial. Osteoarthritis Cartilage 25:1443–1451

    Article  CAS  Google Scholar 

  15. Lattermann C, Jacobs CA, Proffitt Bunnell M, Huston LJ, Gammon LG, Johnson DL et al (2017) A multicenter study of early anti-inflammatory treatment in patients with acute anterior cruciate ligament tear. Am J Sports Med 45:325–333

    Article  Google Scholar 

  16. Li RT, Lorenz S, Xu Y, Harner CD, Fu FH, Irrgang JJ (2011) Predictors of radiographic knee osteoarthritis after anterior cruciate ligament reconstruction. Am J Sports Med 39:2595–2603

    Article  Google Scholar 

  17. Lie MM, Risberg MA, Storheim K, Engebretsen L, Øiestad BE (2019) What’s the rate of knee osteoarthritis 10 years after anterior cruciate ligament injury? An updated systematic review. Br J Sports Med 53:1162–1167

    Article  Google Scholar 

  18. Lohmander LS, Ostenberg A, Englund M, Roos H (2004) High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 50:3145–3152

    Article  CAS  Google Scholar 

  19. Luc B, Gribble PA, Pietrosimone BG (2014) Osteoarthritis prevalence following anterior cruciate ligament reconstruction: a systematic review and numbers-needed-to-treat analysis. J Athl Train 49:806–819

    Article  Google Scholar 

  20. McCurry SM, Von Korff M, Vitiello MV, Saunders K, Balderson BH, Moore AL et al (2011) Frequency of comorbid insomnia, pain, and depression in older adults with osteoarthritis: predictors of enrollment in a randomized treatment trial. J Psychosom Res 71:296–299

    Article  Google Scholar 

  21. McDonough CM, Jette AM (2010) The contribution of osteoarthritis to functional limitations and disability. Clin Geriatr Med 26:387–399

    Article  Google Scholar 

  22. Muneta T, Sekiya I, Yagishita K, Ogiuchi T, Yamamoto H, Shinomiya K (1999) Two-bundle reconstruction of the anterior cruciate ligament using semitendinosus tendon with endobuttons: operative technique and preliminary results. Arthroscopy 15:618–624

    Article  CAS  Google Scholar 

  23. Ramski DE, Kanj WW, Franklin CC, Baldwin KD, Ganley TJ (2014) Anterior cruciate ligament tears in children and adolescents: a meta-analysis of nonoperative versus operative treatment. Am J Sports Med 42:2769–2776

    Article  Google Scholar 

  24. Roemer FW, Guermazi A, Felson DT, Niu J, Nevitt MC, Crema MD et al (2011) Presence of MRI-detected joint effusion and synovitis increases the risk of cartilage loss in knees without osteoarthritis at 30-month follow-up: the MOST study. Ann Rheum Dis 70:1804–1809

    Article  Google Scholar 

  25. Roemer FW, Zhang Y, Niu J, Lynch JA, Crema MD, Marra MD et al (2009) Tibiofemoral joint osteoarthritis: risk factors for MR-depicted fast cartilage loss over a 30-month period in the multicenter osteoarthritis study. Radiology 252:772–780

    Article  Google Scholar 

  26. Roos H, Adalberth T, Dahlberg L, Lohmander LS (1995) Osteoarthritis of the knee after injury to the anterior cruciate ligament or meniscus: the influence of time and age. Osteoarthritis Cartilage 3:261–267

    Article  CAS  Google Scholar 

  27. Tan CW, Hsu WH, Yu PA, Chen CL, Kuo LT, Chi CC et al (2020) Anterior cruciate ligament reconstruction in patients older than 50 years: a systematic review and meta-analysis. Orthop J Sports Med 8:2325967120915698

    Article  Google Scholar 

  28. Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49

    Google Scholar 

  29. Törmälehto S, Mononen ME, Aarnio E, Arokoski JPA, Korhonen RK, Martikainen J (2018) Health-related quality of life in relation to symptomatic and radiographic definitions of knee osteoarthritis: data from Osteoarthritis Initiative (OAI) 4-year follow-up study. Health Qual Life Outcomes 16:154

    Article  Google Scholar 

  30. van Meer BL, Oei EH, Meuffels DE, van Arkel ER, Verhaar JA, Bierma-Zeinstra SM et al (2016) Degenerative changes in the knee 2 years after anterior cruciate ligament rupture and related risk factors: a prospective observational follow-up study. Am J Sports Med 44:1524–1533

    Article  Google Scholar 

  31. Wang Y, Teichtahl AJ, Pelletier JP, Abram F, Wluka AE, Hussain SM et al (2019) Knee effusion volume assessed by magnetic resonance imaging and progression of knee osteoarthritis: data from the Osteoarthritis Initiative. Rheumatology 58:246–253

    Article  CAS  Google Scholar 

  32. Yasuda K, Kondo E, Ichiyama H, Tanabe Y, Tohyama H (2006) Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures. Arthroscopy 22:240–251

    Article  Google Scholar 

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Authors and Affiliations

  1. Sports Medicine and Joint Center, Funabashi Orthopaedic Hospital, 1-833 Hasama, Funabashi, Chiba, 274-0822, Japan

    Takahiro Ogura, Shigehiro Asai, Hideaki Fukuda, Ichiro Yamaura, Hiroki Sakai, Yoshinobu Ichino, Tatsuya Takahashi, Toru Omodani, Chikara Saito, Akihiro Tsuchiya & Kenji Takahashi

  2. Musculoskeletal Pain and Disease, Center for Preventive Medical Sciences, School of Medicine, Chiba University, 1-8-1, Inohana, Chiba, 260-8677, Japan

    Takahiro Ogura, Taishi Ninomiya & Takahisa Sasho

  3. Department of Orthopaedic Surgery, School of Medicine, Chiba University, 1-8-1, Inohana, Chiba, 260-8677, Japan

    Ryuichiro Akagi & Takahisa Sasho

  4. Joint Replacement Center, Funabashi Orthopedic Hospital, 1-833 Hasama, Funabashi, Chiba, 274-0822, Japan

    Taishi Ninomiya

  5. Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1, Inohana, Chiba, 260-8677, Japan

    Yuki Shiko & Yohei Kawasaki

Authors
  1. Takahiro Ogura
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  2. Shigehiro Asai
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Correspondence to Takahiro Ogura.

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The authors declare that they have no conflict of interest.

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The authors received no financial support for the research, authorship and/or publication of this article.

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Ethical approval for the study was obtained from the ethics committees for Funabashi Orthopaedic Hospital (ID 2020021).

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Ogura, T., Asai, S., Akagi, R. et al. Joint effusion at 6 months is a significant predictor of joint effusion 1 year after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 29, 3839–3845 (2021). https://doi.org/10.1007/s00167-021-06433-x

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