Descriptive Epidemiology of the Multicenter ACL Revision Study (MARS) Cohort

被引：293

作者：

Wright, Rick W. ^{[1
]}

Huston, Laura J. ^{[1
]}

Spindler, Kurt P. ^{[1
]}

Dunn, Warren R. ^{[1
]}

Haas, Amanda K. ^{[1
]}

Allen, Christina R. ^{[1
]}

Cooper, Daniel E. ^{[1
]}

DeBerardino, Thomas M. ^{[1
]}

Lantz, Brett A. ^{[1
]}

Mann, Barton J. ^{[1
]}

Stuart, Michael J. ^{[1
]}

Albright, John P. ^{[1
]}

Amendola, Annunziato ^{[1
]}

Anderson, Allen F. ^{[1
]}

Andrish, Jack T. ^{[1
]}

Annunziata, Christopher C. ^{[1
]}

Arciero, Robert A. ^{[1
]}

Bach, Bernard R., Jr. ^{[1
]}

Baker, Champ L., III ^{[1
]}

Bartolozzi, Arthur R. ^{[1
]}

Baumgarten, Keith M. ^{[1
]}

Bechler, Jeffery R. ^{[1
]}

Berg, Jeffrey H. ^{[1
]}

Bernas, Geoffrey A. ^{[1
]}

Brockmeier, Stephen F. ^{[1
]}

Brophy, Robert H. ^{[1
]}

Bush-Joseph, Charles A. ^{[1
]}

Butler, J. Brad ^{[1
]}

Campbell, John D. ^{[1
]}

Carey, James L. ^{[1
]}

Carpenter, James E. ^{[1
]}

Cole, Brian J. ^{[1
]}

Cooper, Jonathan M. ^{[1
]}

Cox, Charles L. ^{[1
]}

Creighton, R. Alexander ^{[1
]}

Dahm, Diane L. ^{[1
]}

David, Tal S. ^{[1
]}

Flanigan, David C. ^{[1
]}

Frederick, Robert W. ^{[1
]}

Gatt, Charles J., Jr. ^{[1
]}

Gecha, Steven R. ^{[1
]}

Giffin, James Robert ^{[1
]}

Goodfellow, Donald B. ^{[1
]}

Hame, Sharon L. ^{[1
]}

Hannafin, Jo A. ^{[1
]}

Harner, Christopher D. ^{[1
]}

Harris, Norman Lindsay, Jr. ^{[1
]}

Hechtman, Keith S. ^{[1
]}

Hershman, Elliott B. ^{[1
]}

Hoellrich, Rudolf G. ^{[1
]}

机构：

[1] Washington Univ, Sch Med, Dept Orthopaed Surg, St Louis, MO 63110 USA

来源：

AMERICAN JOURNAL OF SPORTS MEDICINE | 2010年 / 38卷 / 10期

关键词：

revision; anterior cruciate ligament (ACL); reconstruction; epidemiology; ANTERIOR CRUCIATE LIGAMENT; CONTRALATERAL PATELLAR TENDON; SHELBOURNE EXPERIENCE; MULTIRATER AGREEMENT; RECONSTRUCTION; BONE; KNEE; AUTOGRAFT; SURGERY; FAILURE;

D O I：

10.1177/0363546510378645

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: Revision anterior cruciate ligament (ACL) reconstruction has worse outcomes than primary reconstructions. Predictors for these worse outcomes are not known. The Multicenter ACL Revision Study (MARS) Group was developed to perform a multisurgeon, multicenter prospective longitudinal study to obtain sufficient subjects to allow multivariable analysis to determine predictors of clinical outcome. Purpose: To describe the formation of MARS and provide descriptive analysis of patient demographics and clinical features for the initial 460 enrolled patients to date in this prospective cohort. Study Design: Cross-sectional study; Level of evidence, 2. Methods: After training and institutional review board approval, surgeons began enrolling patients undergoing revision ACL reconstruction, recording patient demographics, previous ACL reconstruction methods, intra-articular injuries, and current revision techniques. Enrolled subjects completed a questionnaire consisting of validated patient-based outcome measures. Results: As of April 1, 2009, 87 surgeons have enrolled a total of 460 patients (57% men; median age, 26 years). For 89%, the reconstruction was the first revision. Mode of failure as deemed by the revising surgeon was traumatic (32%), technical (24%), biologic (7%), combination (37%), infection (<1%), and no response (<1%). Previous graft present at the time of injury was 70% autograft, 27% allograft, 2% combination, and 1% unknown. Sixty-two percent were more than 2 years removed from their last reconstruction. Graft choice for revision ACL reconstruction was 45% autograft, 54% allograft, and more than 1% both allograft and autograft. Meniscus and/or chondral damage was found in 90% of patients. Conclusion: The MARS Group has been able to quickly accumulate the largest revision ACL reconstruction cohort reported to date. Traumatic reinjury is deemed by surgeons to be the most common single mode of failure, but a combination of factors represents the most common mode of failure. Allograft graft choice is more common in the revision setting than autograft. Concomitant knee injury is extremely common in this population.

引用

页码：1979 / 1986

页数：8

共 31 条

[1] Results of revision anterior cruciate ligament surgery [J].

Battaglia, Michael J. ;

Cordasco, Frank A. ;

Hannafin, Jo A. ;

Rodeo, Scott A. ;

O'Brien, Stephen J. ;

Altchek, David W. ;

Cavanaugh, John ;

Wickiewicz, Thomas L. ;

Warren, Russell F. .

AMERICAN JOURNAL OF SPORTS MEDICINE, 2007, 35 (12) :2057-2066

[2]

Carson Eric W, 2004, J Knee Surg, V17, P127

[3] Descriptive epidemiology and prior healthcare utilization of patients in the spine patient outcomes research trial's (SPORT) three observational cohorts - Disc herniation, spinal stenosis, and degenerative spondylolisthesis [J].

Cummins, J ;

Lurie, JD ;

Tosteson, TD ;

Hanscom, B ;

Abdu, WA ;

Birkmeyer, NJO ;

Herkowitz, H ;

Weinstein, J .

SPINE, 2006, 31 (07) :806-814

[4] Cartilage injuries: A review of 31,516 knee arthroscopies [J].

Curl, WW ;

Krome, J ;

Gordon, ES ;

Rushing, J ;

Smith, BP ;

Poehling, GG .

ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 1997, 13 (04) :456-460

[5]

DAWBER TR, 1951, AM J PUBLIC HEALTH, V41, P279

[6] Anterior cruciate ligament revision reconstruction - Results in 107 patients [J].

Diamantopoulos, Andreas P. ;

Lorbach, Olaf ;

Paessler, Hans H. .

AMERICAN JOURNAL OF SPORTS MEDICINE, 2008, 36 (05) :851-860

[7] Multirater agreement of arthroscopic meniscal lesions [J].

Dunn, WR ;

Wolf, BR ;

Amendola, A ;

Andrish, JT ;

Kaeding, C ;

Marx, RG ;

McCarty, EC ;

Parker, RD ;

Wright, RW ;

Spindler, KP .

AMERICAN JOURNAL OF SPORTS MEDICINE, 2004, 32 (08) :1937-1940

[8] Arthroscopic anterior cruciate ligament reconstruction: A metaanalysis comparing patellar tendon and hamstring tendon autografts [J].

Freedman, KB ;

D'Amato, MJ ;

Nedeff, DD ;

Kaz, A ;

Bach, BR .

AMERICAN JOURNAL OF SPORTS MEDICINE, 2003, 31 (01) :2-11

[9] Revision anterior cruciate ligament reconstruction with quadriceps tendon-patellar bone autograft [J].

Garofalo, R ;

Djahangiri, A ;

Siegrist, O .

ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2006, 22 (02) :205-214

[10] Data collection in a multisite project:: Teleform™ [J].

Hardin, JM ;

Woodby, LL ;

Crawford, MA ;

Windsor, RA ;

Miller, TM .

PUBLIC HEALTH NURSING, 2005, 22 (04) :366-370

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