Which Preoperative Factors, Including Bone Bruise, Are Associated With Knee Pain/Symptoms at Index Anterior Cruciate Ligament Reconstruction (ACLR)? A Multicenter Orthopaedic Outcomes Network (MOON) ACLR Cohort Study

被引:74
作者
Dunn, Warren R. [1 ]
Spindler, Kurt P.
Amendola, Annunziato [2 ]
Andrish, Jack T. [3 ]
Kaeding, Christopher C. [4 ,5 ]
Marx, Robert G.
McCarty, Eric C. [6 ]
Parker, Richard D. [3 ]
Harrell, Frank E., Jr.
An, Angel Q.
Wright, Rick W. [7 ]
Brophy, Robert H.
Matava, Matthew J. [7 ]
Flanigan, David C. [4 ,5 ]
Huston, Laura J.
Jones, Morgan H. [3 ]
Wolcott, Michelle L. [6 ]
Vidal, Armando F. [6 ]
Wolf, Brian R. [2 ]
机构
[1] Vanderbilt Univ, Sch Med, Dept Orthopaed Surg & Rehabil, Nashville, TN 37232 USA
[2] Univ Iowa, Sch Med, Iowa City, IA 52242 USA
[3] Cleveland Clin, Cleveland, OH 44106 USA
[4] Ohio State Univ, Sch Med, Columbus, OH 43210 USA
[5] Hosp Special Surg, New York, NY 10021 USA
[6] Univ Colorado, Sch Med, Denver, CO USA
[7] Washington Univ, Sch Med, Barnes Jewish Hosp, St Louis, MO USA
关键词
bone bruise; ACL reconstruction; KOOS; MOON; knee pain/symptoms; FOLLOW-UP; OSTEOCHONDRAL LESIONS; MULTIRATER AGREEMENT; INJURIES; OSTEOARTHRITIS; MENISCECTOMY; TEARS;
D O I
10.1177/0363546510370279
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
100224 [整形外科学];
摘要
Background: Increased knee pain at the time of anterior cruciate ligament reconstruction may potentially predict more difficult rehabilitation, prolonged recovery, and/or be predictive of increased knee pain at 2 years. Hypothesis: A bone bruise and/or other preoperative factors are associated with more knee pain/symptoms at the time of index anterior cruciate ligament reconstruction, and the presence of a bone bruise would be associated with specific demographic and injury-related factors. Study Design: Cohort study (prevalence); Level of evidence, 2. Methods: In 2007, the Multicenter Orthopaedic Outcomes Network (MOON) database began to prospectively collect surgeon-reported magnetic resonance imaging bone bruise status. A multivariable analysis was performed to (1) determine if a bone bruise, among other preoperative factors, is associated with more knee symptoms/pain and (2) examine the association of factors related to bone bruise. To evaluate the association of a bone bruise with knee pain/symptoms, linear multiple regression models were fit using the continuous scores of the Knee injury and Osteoarthritis Outcome Score (KOOS) symptoms and pain subscales and the Short Form 36 (SF-36) bodily pain subscale as dependent variables. To examine the association between a bone bruise and risk factors, a logistic regression model was used, in which the dependent variable was the presence or absence of a bone bruise. Results: Baseline data for 525 patients were used for analysis, and a bone bruise was present in 419 (80%). The cohort comprises 58% male patients, with a median age of 23 years. The median Marx activity level was 13. Factors associated with more pain were higher body mass index (P<.0001), female sex (P=.001), lateral collateral ligament injury (P=.012), and older age (P=.038). Factors associated with more symptoms were a concomitant lateral collateral ligament injury (P=.014), higher body mass index (P<.0001), and female sex (P<.0001). Bone bruise is not associated with symptoms/pain at the time of index anterior cruciate ligament reconstruction. None of the factors included in the SF-36 bodily pain model were found to be significant. After controlling for other baseline factors, the following factors were associated with a bone bruise: younger age (P=.034) and not jumping at the time of injury (P=.006). Conclusion: After anterior cruciate ligament injury, risk factors associated with a bone bruise are younger age and not jumping at the time of injury. Bone bruise is not associated with symptoms/pain at the time of index anterior cruciate ligament reconstruction.
引用
收藏
页码:1778 / 1787
页数:10
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