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Joint effusion at 3 months after anterior cruciate ligament reconstruction is associated with reinjury

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate whether joint effusion at 3 months after anterior cruciate ligament (ACL) reconstruction is associated with ACL reinjury.

Methods

The medical records of 227 consecutive patients who underwent single-bundle ACL reconstruction between 2015 and 2018 were reviewed in this retrospective single-center study. Demographic data such as sex and age at surgery, as well as data on preinjury Tegner activity scale score, time from injury to surgery, presence of meniscus and cartilage injuries, and the occurrence of ACL reinjury within 2 years, were collected. Joint effusion was defined as grade 3 (range 0–3) according to the ACL Osteoarthritis Score by magnetic resonance imaging at 3 months postoperatively. Multivariate logistic regression analysis was performed to control for potential confounders.

Results

A total of 176 patients (mean age 22.5 ± 9.9 years) were included. Among these patients, 18 (10.2%) had ACL reinjury. At the multivariate logistic regression analysis, higher Tegner activity scale (odds ratio [OR] 3.12; 95% confidence interval [CI] 1.61–6.04; p < 0.001) and presence of joint effusion (OR 34.5; 95% CI 6.63–179.7; p < 0.001) increased the odds of ACL reinjury, and older age (OR 0.68; 95% CI 0.51–0.92; p = 0.012) decreased the odds of ACL reinjury.

Conclusions

Joint effusion with a larger fluid volume at 3 months postoperatively was one of the risk factors for ACL reinjury independent of confounders, such as age and activity level. This result suggests the possibility of postoperative intervention for ACL reinjury.

Level of evidence

III.

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Abbreviations

ACL:

Anterior cruciate ligament

ACLR:

Anterior cruciate ligament reconstruction

MRI:

Magnetic resonance imaging

CT:

Computed tomography

ACLOAS:

Anterior Cruciate Ligament Osteoarthritis Score

KOOS:

Knee Injury and Osteoarthritis Outcome Score

OR:

Odds ratio

CI:

Confidence interval

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Acknowledgements

The authors would like to thank Editage for English language editing.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Naoya Kikuchi, Akihiro Kanamori, Kosuke Okuno, Norihtio Arai, Kojiro Hyodo & Masashi Yamazaki

  2. Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan

    Tomokazu Yoshioka

Authors
  1. Naoya Kikuchi
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Contributions

NK conceived and designed the study, analyzed and interpreted the data, drafted the manuscript, approved the final version of the manuscript to be published, and agrees to be accountable for all aspects of the work if questions arise related to its accuracy or integrity. AK conceived and designed the study, contributed on interpreted the data, revised the manuscript critically for important intellectual content, approved the final version of the manuscript to be published, and agrees to be accountable for all aspects of the work if questions arise related to its accuracy or integrity. KO contributed to the acquisition of the data, revised the manuscript critically for important intellectual content, approved the final version of the manuscript to be published, and agrees to be accountable for all aspects of the work if questions arise related to its accuracy or integrity. NA contributed to the interpretation of the data, revised the manuscript critically for important intellectual content, approved the final version of the manuscript to be published, and agrees to be accountable for all aspects of the work if questions arise related to its accuracy or integrity. KH contributed to the interpretation of the data, revised the manuscript critically for important intellectual content, approved the final version of the manuscript to be published, and agrees to be accountable for all aspects of the work if questions arise related to its accuracy or integrity. TY contributed to the interpretation of the data, revised the manuscript critically for important intellectual content, approved the final version of the manuscript to be published, and agree to be accountable for all aspects of the work if questions arise related to its accuracy or integrity. MY contributed to the interpretation of the data, revised the manuscript critically for important intellectual content, approved the final version of the manuscript to be published, and agrees to be accountable for all aspects of the work if questions arise related to its accuracy or integrity.

Corresponding author

Correspondence to Naoya Kikuchi.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

This study was approved by the Medical Ethical Committee of the University of Tsukuba (No. R03-257).

Informed consent

The need for informed consent was waived by the Medical Ethical Committee of the University of Tsukuba (no. R03-257) because of the retrospective nature of the study.

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Kikuchi, N., Kanamori, A., Okuno, K. et al. Joint effusion at 3 months after anterior cruciate ligament reconstruction is associated with reinjury. Knee Surg Sports Traumatol Arthrosc 31, 1798–1804 (2023). https://doi.org/10.1007/s00167-022-07081-5

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  • DOI: https://doi.org/10.1007/s00167-022-07081-5

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