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An older age, a longer duration between injury and surgery, and positive pivot shift test results increase the prevalence of articular cartilage injury during ACL reconstruction in all three compartments of the knee in patients with ACL injuries

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To investigate factors that influence the prevalence of articular cartilage injury in patients with anterior cruciate ligament (ACL) injury.

Methods

This multicentre study included patients with ACL injury. Logistic regression analysis was conducted to identify factors that influence the prevalence of cartilage injury during ACL reconstruction.

Results

A total of 811 patients were enrolled. The factors that significantly influenced the prevalence of cartilage injury were age (odds ratio [OR], 1.04; P = 0.000), a positive pivot shift test result (OR, 1.43; P = 0.021), medial meniscal injury (OR, 2.55; P = 0.000), and delayed surgery (≥ 12 months) (OR, 2.52; P = 0.028) in the medial compartment of the knee; age (OR, 1.05; P = 0.000), subjective grades of apprehension during the pivot shift test (OR, 1.46; P = 0.010), lateral meniscal injury (OR, 1.98; P = 0.003), femoro-tibial angle (FTA) (OR, 0.92; P = 0.006), and delayed surgery (≥ 12 months) (OR, 2.63; P = 0.001) in the lateral compartment; and age (OR, 1.06; P = 0.000), body mass index (OR, 1.07; P = 0.028), a positive pivot shift test result (OR, 1.60; P = 0.018), FTA (OR, 0.90; P = 0.006), and delayed surgery (≥ 12 months) (OR, 3.17; P = 0.008) in the patellofemoral compartment.

Conclusion

An older age, a longer duration between injury and surgery, and a positive pivot shift test result were positively associated with the prevalence of cartilage injury in three compartments in patients with ACL injuries. Early ACL reconstruction is recommended to prevent cartilage injury.

Level of Evidence

Level III.

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Availability of data and materials

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Acknowledgments

This work was supported by JSPS KAKENHI (Grants-in-Aid for Scientific Research of Japan Society for the Promotion of Science) Grant Number JP18K10672. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. The authors thank the following additional members of our multicenter study group, whose efforts related to data collection and manuscript preparation: Yoshio Sumen, MD (JA Onomichi General Hospital), Kazuhiro Tsukisaka, MD, Atsushi Okuhara, MD, Seiju Hayashi, MD and Yusuke Tsuyuguchi, MD (Mazda Hospital), Masataka Deie, MD (Aichi Medical University), Eisaku Fujimoto, MD and Yoshikazu Sumida, MD (Chugoku Rosai Hospital), Yoshinori Soda, MD and Shingo Ohkawa, MD (Hiroshima Citizens Hospital), Yasunori Izuta, MD and Tsuyoshi Takada, MD (Kure Medical Center).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Atsuo Nakamae, Goki Kamei, Masakazu Ishikawa & Nobuo Adachi

  2. Department of Orthopaedic Surgery, Matsuyama Shimin Hospital, 2-6-5 Otemachi, Matsuyama, 790-0067, Japan

    Ayato Miyamoto

  3. Department of Orthopaedic Surgery, Matsuyama Red Cross Hospital, 1 Bunkyocho, Matsuyama, 790-8524, Japan

    Akio Eguchi

  4. Department of Orthopaedic Surgery, JA Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, Hiroshima, 722-8508, Japan

    Ryo Shimizu

  5. Department of Orthopaedic Surgery, Aichi Medical University, 21 Karimata, Yazako, Nagakute, Aichi, 480-1195, Japan

    Machiko Akao

Authors
  1. Atsuo Nakamae
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  2. Ayato Miyamoto
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Correspondence to Atsuo Nakamae.

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The current study was reviewed and approved by each participating site’s respective institutional review board (Code; E-1178).

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Nakamae, A., Miyamoto, A., Kamei, G. et al. An older age, a longer duration between injury and surgery, and positive pivot shift test results increase the prevalence of articular cartilage injury during ACL reconstruction in all three compartments of the knee in patients with ACL injuries. Knee Surg Sports Traumatol Arthrosc 30, 219–230 (2022). https://doi.org/10.1007/s00167-021-06461-7

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