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Conducting Multicenter Cohort Studies: Lessons from MOON

  • José F. Vega
  • Kurt P. SpindlerEmail author
Chapter

Abstract

One of the most well-known success stories of orthopedic clinical research is the Multicenter Orthopaedic Outcomes Network (MOON), the largest prospective anterior cruciate ligament (ACL) reconstruction cohort in the United States. This chapter aims to chronicle the story of MOON, from its initial vision to its execution and current state.

References

  1. 1.
    Andersson C, Odensten M, Good L, Gillquist J. Surgical or non-surgical treatment of acute rupture of the anterior cruciate ligament. A randomized study with long-term follow-up. J Bone Joint Surg Am. 1989;71(7):965–74.CrossRefGoogle Scholar
  2. 2.
    Bowers AL, Spindler KP, McCarty EC, Arrigain S. Height, weight, and BMI predict intra-articular injuries observed during ACL reconstruction: evaluation of 456 cases from a prospective ACL database. Clin J Sport Med. 2005;15(1):9–13.CrossRefGoogle Scholar
  3. 3.
    Buller LT, Best MJ, Baraga MG, Kaplan LD. Trends in anterior cruciate ligament reconstruction in the United States. Orthop J Sports Med. 2015;3(1):2325967114563664.  https://doi.org/10.1177/2325967114563664.CrossRefPubMedGoogle Scholar
  4. 4.
    Dunn WR, Kuhn JE, Sanders R, et al. 2013 Neer Award: predictors of failure of nonoperative treatment of chronic, symptomatic, full-thickness rotator cuff tears. J Shoulder Elbow Surg. 2016;25(8):1303–11.  https://doi.org/10.1016/j.jse.2016.04.030.CrossRefPubMedGoogle Scholar
  5. 5.
    Dunn WR, Spindler KP, MOON Consortium. Predictors of activity level 2 years after anterior cruciate ligament reconstruction (ACLR): a Multicenter Orthopaedic Outcomes Network (MOON) ACLR cohort study. Am J Sports Med. 2010;38(10):2040–50.  https://doi.org/10.1177/0363546510370280.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Dunn WR, Wolf BR, Amendola A, et al. Multirater agreement of arthroscopic meniscal lesions. Am J Sports Med. 2004;32(8):1937–40.CrossRefGoogle Scholar
  7. 7.
    Engebretsen L, Benum P, Fasting O, Mølster A, Strand T. A prospective, randomized study of three surgical techniques for treatment of acute ruptures of the anterior cruciate ligament. Am J Sports Med. 1990;18(6):585–90.  https://doi.org/10.1177/036354659001800605.CrossRefPubMedGoogle Scholar
  8. 8.
    Feagin JA, Curl WW. Isolated tear of the anterior cruciate ligament: 5-year follow-up study. Am J Sports Med. 1976;4(3):95–100.  https://doi.org/10.1177/036354657600400301.CrossRefPubMedGoogle Scholar
  9. 9.
    Fox JA, Nedeff DD, Bach BR Jr, Spindler KP. Anterior cruciate ligament reconstruction with patellar autograft tendon. Clin Orthop. 2002;402:53–63.CrossRefGoogle Scholar
  10. 10.
    Graham SM, Parker RD. Anterior cruciate ligament reconstruction using hamstring tendon grafts. Clin Orthop. 2002;402:64–75.CrossRefGoogle Scholar
  11. 11.
    Hanypsiak BT, Spindler KP, Rothrock CR, et al. Twelve-year follow-up on anterior cruciate ligament reconstruction: long-term outcomes of prospectively studied osseous and articular injuries. Am J Sports Med. 2008;36(4):671–7.  https://doi.org/10.1177/0363546508315468.CrossRefPubMedGoogle Scholar
  12. 12.
    Heckman JDME-C. Are validated questionnaires valid? [Letter]. J Bone. 2006;88(2):446.Google Scholar
  13. 13.
    Hettrich CM, Dunn WR, Reinke EK, MOON Group, Spindler KP. The rate of subsequent surgery and predictors after anterior cruciate ligament reconstruction: two- and 6-year follow-up results from a multicenter cohort. Am J Sports Med. 2013;41(7):1534–40.  https://doi.org/10.1177/0363546513490277.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Irrgang JJ, Anderson AF, Boland AL, et al. Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med. 2001;29(5):600–13.  https://doi.org/10.1177/03635465010290051301.CrossRefGoogle Scholar
  15. 15.
    Kaeding CC, Pedroza AD, Parker RD, Spindler KP, McCarty EC, Andrish JT. Intra-articular findings in the reconstructed multiligament-injured knee. Arthroscopy. 2005;21(4):424–30.  https://doi.org/10.1016/j.arthro.2004.12.012.CrossRefPubMedGoogle Scholar
  16. 16.
    Kandel B. Peale still positive; Words he lives by. USA Today. 1988:2A.Google Scholar
  17. 17.
    Kannus P, Järvinen M. Conservatively treated tears of the anterior cruciate ligament. Long-term results. J Bone Joint Surg Am. 1987;69(7):1007–12.CrossRefGoogle Scholar
  18. 18.
    Katz JN, Brophy RH, Chaisson CE, et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis. N Engl J Med. 2013;368(18):1675–84.  https://doi.org/10.1056/NEJMoa1301408.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Lynch TS, Parker RD, Patel RM, et al. The impact of the Multicenter Orthopaedic Outcomes Network (MOON) research on anterior cruciate ligament reconstruction and orthopaedic practice. J Am Acad Orthop Surg. 2015;23(3):154–63.  https://doi.org/10.5435/JAAOS-D-14-00005.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Marx RG, Connor J, Lyman S, et al. Multirater agreement of arthroscopic grading of knee articular cartilage. Am J Sports Med. 2005;33(11):1654–7.  https://doi.org/10.1177/0363546505275129.CrossRefPubMedGoogle Scholar
  21. 21.
    Odensten M, Lysholm J, Gillquist J. Suture of fresh ruptures of the anterior cruciate ligament. A 5-year follow-up. Acta Orthop Scand. 1984;55(3):270–2.CrossRefGoogle Scholar
  22. 22.
    Paul JJ, Spindler KP, Andrish JT, Parker RD, Secic M, Bergfeld JA. Jumping versus nonjumping anterior cruciate ligament injuries: a comparison of pathology. Clin J Sport Med. 2003;13(1):1–5.CrossRefGoogle Scholar
  23. 23.
    Piasecki DP, Spindler KP, Warren TA, Andrish JT, Parker RD. Intraarticular injuries associated with anterior cruciate ligament tear: findings at ligament reconstruction in high school and recreational athletes. An analysis of sex-based differences. Am J Sports Med. 2003;31(4):601–5.  https://doi.org/10.1177/03635465030310042101.CrossRefPubMedGoogle Scholar
  24. 24.
    Rockey S. What are the chances of getting funded? NIH Extramur Nexus. June 2015. https://nexus.od.nih.gov/all/2015/06/29/what-are-the-chances-of-getting-funded/. Accessed Feb 1 2018.
  25. 25.
    Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998;28(2):88–96.  https://doi.org/10.2519/jospt.1998.28.2.88.CrossRefGoogle Scholar
  26. 26.
    Siljander MP, McQuivey K, Fahs A, Galasso L, Serdahely K, Karadsheh MS. Current trends in patient reported outcome measures in total joint arthroplasty: a study of four major orthopedic journals. J Arthroplasty. 2018.  https://doi.org/10.1016/j.arth.2018.06.034.CrossRefGoogle Scholar
  27. 27.
    Spindler KP, Huston LJ. O’Donoghue sports injury award 10 year outcomes and risk factors after ACL reconstruction: a multicenter cohort study. Orthop J Sports Med. 2017;5(7 Suppl 6):2325967117S00247.  https://doi.org/10.1177/2325967117S00247.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Spindler KP, Kuhn JE, Freedman KB, Matthews CE, Dittus RS, Harrell FE. Anterior cruciate ligament reconstruction autograft choice: bone-tendon-bone versus hamstring: does it really matter? A systematic review. Am J Sports Med. 2004;32(8):1986–95.CrossRefGoogle Scholar
  29. 29.
    Spindler KP, McCarty EC, Warren TA, Devin C, Connor JT. Prospective comparison of arthroscopic medial meniscal repair technique: inside-out suture versus entirely arthroscopic arrows. Am J Sports Med. 2003;31(6):929–34.  https://doi.org/10.1177/03635465030310063101.CrossRefPubMedGoogle Scholar
  30. 30.
    Spindler KP, Schils JP, Bergfeld JA, et al. Prospective study of osseous, articular, and meniscal lesions in recent anterior cruciate ligament tears by magnetic resonance imaging and arthroscopy. Am J Sports Med. 1993;21(4):551–7.  https://doi.org/10.1177/036354659302100412.CrossRefPubMedGoogle Scholar
  31. 31.
    Spindler KP, Warren TA, Callison JC, Secic M, Fleisch SB, Wright RW. Clinical outcome at a minimum of five years after reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am. 2005;87(8):1673–9.  https://doi.org/10.2106/JBJS.D.01842.CrossRefPubMedGoogle Scholar
  32. 32.
    Wolf BR, Ramme AJ, Britton CL, Amendola A, MOON Knee Group. Anterior cruciate ligament tunnel placement. J Knee Surg. 2014;27(4):309–17.  https://doi.org/10.1055/s-0033-1364101.CrossRefPubMedGoogle Scholar
  33. 33.
    Wolf BR, Ramme AJ, Wright RW, et al. Variability in ACL tunnel placement: observational clinical study of surgeon ACL tunnel variability. Am J Sports Med. 2013;41(6):1265–73.  https://doi.org/10.1177/0363546513483271.CrossRefPubMedGoogle Scholar
  34. 34.
    Wright RW, Huston LJ, Haas AK, et al. Effect of graft choice on the outcome of revision anterior cruciate ligament reconstruction in the Multicenter ACL Revision Study (MARS) Cohort. Am J Sports Med. 2014;42(10):2301–10.  https://doi.org/10.1177/0363546514549005.CrossRefPubMedCentralGoogle Scholar
  35. 35.
    Zarins B. Are validated questionnaires valid? J Bone Joint Surg Am. 2005;87(8):1671–2.  https://doi.org/10.2106/JBJS.E.00554.CrossRefPubMedGoogle Scholar

Copyright information

© ISAKOS 2019

Authors and Affiliations

  1. 1.Cleveland Clinic Lerner College of MedicineClevelandUSA
  2. 2.Cleveland Clinic Sports Health CenterGarfield HeightsUSA

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