Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep;24(9):2936-2942.
doi: 10.1007/s00167-015-3568-x. Epub 2015 Mar 19.

Risk factors for knee instability after anterior cruciate ligament reconstruction

Ji Hyun Ahn  1 , Sung Hyun Lee  2
Affiliations

Risk factors for knee instability after anterior cruciate ligament reconstruction

Ji Hyun Ahn et al. Knee Surg Sports Traumatol Arthrosc. 2016 Sep.

Abstract

Purpose: The objective of this study was to estimate risk factors that influence postoperative instability after anterior cruciate ligament (ACL) reconstruction using multivariate logistic regression analysis.

Methods: A total of 152 consecutive patients with symptomatic ACL insufficiency underwent arthroscopic ACL reconstruction between 2005 and 2011. Loss to follow-up and previous ligament reconstruction were exclusion criteria, resulting in 131 patients remaining for this retrospective study. The median follow-up was 55 months (range 25-100 months). Patients were sorted into two groups by anterior translation on stress radiograph and pivot shift test grade and were analysed for the statistical significance of various risk factors including age at surgery, gender, body mass index, preoperative instability, time from injury to surgery, single-bundle reconstruction with preserved abundant remnant versus double-bundle reconstruction with scanty remnant, and concomitant ligament, meniscus, and articular cartilage injury with use of multivariate logistic regression analysis.

Results: Time from injury to surgery over 12 weeks was found to be a significant risk factor for postoperative instability [p < 0.001, adjusted odds ratio (OR) 6.22; 95 % confidence interval (CI) 2.14-18.06)]. Grade 2 injury of medial collateral ligament (MCL) was also a risk factor (p = 0.02, adjusted OR 13.60; 95 % CI 1.24-148.25). The other variables were not found to be a significant risk factor.

Conclusions: Among the risk factor variables, concomitant grade 2 MCL injury and surgical delay of more than 12 weeks from injury were significant risk factors for postoperative knee instability after ACL reconstruction. The overall results suggest that surgery <12 weeks from injury and meticulous attention to concomitant MCL injury should be considered.

Level of evidence: Retrospective case-control study, Level III.

Keywords: Anterior cruciate ligament reconstruction; Multivariate logistic regression; Postoperative instability; Risk factors.

PubMed Disclaimer

References

    1. Andernord D, Desai N, Björnsson H, Ylander M, Karlsson J, Samuelsson K (2015) Patient predictors of early revision surgery after anterior cruciate ligament reconstruction: a cohort study of 16,930 patients with 2-year follow-up. Am J Sports Med 43(1):121–127 - DOI - PubMed
    1. Beldame J, Mouchel S, Bertiaux S, Adam JM, Mouilhade F, Roussignol X, Dujardin F (2012) Anterior knee laxity measurement: comparison of passive stress radiographs Telos® and “Lerat”, and GNRB® arthrometer. Orthop Traumatol Surg Res 98(7):744–750 - DOI - PubMed
    1. Bernstein J (2011) Early versus delayed reconstruction of the anterior cruciate ligament. A decision analysis approach. J Bone Joint Surg Am 93(9):e48 - DOI - PubMed
    1. Biau DJ, Tournoux C, Katsahian S, Schranz P, Nizard R (2007) ACL reconstruction: a meta-analysis of functional scores. Clin Orthop Relat Res 458:180–187 - PubMed
    1. Biau DJ, Tournoux C, Katsahian S, Schranz PJ, Nizard RS (2006) Bone-patellar tendon-bone autografts versus hamstring autografts for reconstruction of anterior cruciate ligament: meta-analysis. BMJ 332(7548):995–1001 - DOI - PubMed - PMC

LinkOut - more resources