Document Detail


Descriptive epidemiology of the Multicenter ACL Revision Study (MARS) cohort.
MedLine Citation:
PMID:  20889962     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
; Rick W Wright; Laura J Huston; Kurt P Spindler; Warren R Dunn; Amanda K Haas; Christina R Allen; Daniel E Cooper; Thomas M DeBerardino; Brett Brick A Lantz; Barton J Mann; Michael J Stuart
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of sports medicine     Volume:  38     ISSN:  1552-3365     ISO Abbreviation:  Am J Sports Med     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2011-02-18     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1979-86     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anterior Cruciate Ligament / injuries*,  surgery
Canada / epidemiology
Child
Cohort Studies
Cross-Sectional Studies
Female
Humans
Knee Injuries / epidemiology,  surgery*
Male
Middle Aged
Multivariate Analysis
Orthopedic Procedures / methods*
Outcome Assessment (Health Care)
Prospective Studies
Questionnaires
Reoperation
Sports Medicine
Treatment Failure
United States / epidemiology
Young Adult
Grant Support
ID/Acronym/Agency:
5 K23 AR052392-04/AR/NIAMS NIH HHS; K23 AR052392/AR/NIAMS NIH HHS; R01 AR060846/AR/NIAMS NIH HHS
Investigator
Investigator/Affiliation:
Rick W Wright / ; Laura J Huston / ; Kurt P Spindler / ; Warren R Dunn / ; Amanda K Haas / ; Christina R Allen / ; Daniel E Cooper / ; Thomas M DeBerardino / ; Brett Brick A Lantz / ; Barton J Mann / ; Michael J Stuart / ; John P Albright / ; Annunziato Ned Amendola / ; Allen F Anderson / ; Jack T Andrish / ; Christopher C Annunziata / ; Robert A Arciero / ; Bernard R Bach / ; Champ L Baker / ; Arthur R Bartolozzi / ; Keith M Baumgarten / ; Jeffery R Bechler / ; Jeffrey H Berg / ; Geoffrey A Bernas / ; Stephen F Brockmeier / ; Robert H Brophy / ; Charles A Bush-Joseph / ; J Brad Butler / ; John D Campbell / ; James L Carey / ; James E Carpenter / ; Brian J Cole / ; Jonathan M Cooper / ; Charles L Cox / ; R Alexander Creighton / ; Diane L Dahm / ; Tal S David / ; David C Flanigan / ; Robert W Frederick / ; Charles J Gatt / ; Steven R Gecha / ; James Robert Giffin / ; Donald B Goodfellow / ; Sharon L Hame / ; Jo A Hannafin / ; Christopher D Harner / ; Norman Lindsay Harris / ; Keith S Hechtman / ; Elliott B Hershman / ; Rudolf G Hoellrich / ; Timothy M Hosea / ; David C Johnson / ; Timothy S Johnson / ; Morgan H Jones / ; Christopher C Kaeding / ; Thomas E Klootwyk / ; Bruce A Levy / ; C Benjamin Ma / ; G Peter Maiers / ; Robert G Marx / ; Matthew J Matava / ; Gregory M Mathien / ; David R McAllister / ; Eric C McCarty / ; Robert G McCormack / ; Bruce S Miller / ; Ali R Motamedi / ; Carl W Nissen / ; Daniel F O'Neil / ; Richard D Parker / ; Mark L Purnell / ; Arun J Ramappa / ; Michael A Rauh / ; Arthur Rettig / ; Jon K Sekiya / ; Kevin G Shea / ; Orrin H Sherman / ; James R Slauterbeck / ; Matthew V Smith / ; Steven J Svoboda / ; Timothy N Taft / ; Joachim J Tenuta / ; Edwin M Tingstad / ; Armando F Vidal / ; Darius G Viskontas / ; Richard A White / ; James S Williams / ; Michelle L Wolcott / ; Brian R Wolf / ; James J York /
Comments/Corrections

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