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J Knee Surg 2011; 24(4): 289-294
DOI: 10.1055/s-0031-1292650
ORIGINAL ARTICLE

© Thieme Medical Publishers

Revision ACL Reconstruction Outcomes: MOON Cohort

Rick Wright1 , Kurt Spindler2 , Laura Huston2 , Annunziato Amendola3 , Jack Andrish4 , Rob Brophy1 , James Carey2 , Charlie Cox2 , David Flanigan5 , Morgan Jones4 , Christopher Kaeding5 , Robert Marx6 , Matthew Matava1 , Eric McCarty7 , Richard Parker4 , Armando Vidal7 , Michelle Wolcott7 , Brian Wolf3 , Warren Dunn2
  • 1Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri
  • 2Department of Orthopaedic Surgery, Vanderbilt Orthopaedic Institute, Nashville, Tennessee
  • 3Department of Orthopaedic Surgery, University of Iowa, Iowa City, Iowa
  • 4Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
  • 5Department of Orthopaedic Surgery, Ohio State University, Medical Center, Columbus, Ohio
  • 6Division of Sports Medicine, Hospital for Special Surgery, New York, New York
  • 7Department of Orthopaedic Surgery, University of Colorado School of Medicine, Denver, Colorado
Further Information

Publication History

Publication Date:
27 October 2011 (online)

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ABSTRACT

Many clinicians believe that the results of revision anterior cruciate ligament (ACL) reconstruction compare unfavorably with primary ACL reconstruction. However, few prospective studies have evaluated revision ACL reconstruction using validated patient-based metrics. This study was performed to evaluate and compare the results of revision ACL reconstruction and primary ACL reconstruction. The Multicenter Orthopaedic Outcomes Network consortium is an NIH-funded, hypothesis-driven, multicenter prospective cohort study of patients undergoing ACL reconstruction. All patients preoperatively complete a series of validated patient-oriented questionnaires. At scheduled 2-year follow-up all patients are given the same series of questionnaires to complete. The study evaluated the results of 2-year follow-up of revision ACL reconstruction performed in 2001. Parameters evaluated included Marx activity level, Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) scores. For this study 446 subjects met inclusion criteria; 2-year follow-up was obtained on 393 (88%). The study group consisted of 55% males with median age of 22 years. There were 33 revision ACL reconstruction cases, for which follow-up was available for 29 (88%). Median baseline Marx (interquartile range) was 12 (8 to 16) and 12 (6 to 16) for the primary ACL reconstruction and revision ACL reconstruction groups, respectively (p = 0.81). At 2 years, median Marx was 9 (4 to 13) and 5 (0 to 10) for the primary ACL reconstruction and revision ACL reconstruction groups, respectively (p = 0.03). Median 2-year IKDC was 75.9 (revision) versus 83.9 (primary) (p = 0.003). Median KOOS subscale Knee Related Quality of Life (KRQOL) at 2 years was 62.5 (revision) versus 75 (primary) (p < 0.001), subscale Sports and Recreation was 75 (revision) and 85 (primary) (p = 0.005), subscale Pain was 83.3 (revision) and 91.7 (primary) (p = 0.002). Marx activity score declined at 2-year follow-up in revision ACL reconstruction compared with primary ACL reconstruction. IKDC and KRQOL were significantly decreased in revision ACL reconstruction compared with primary ACL reconstruction at 2-year follow-up. Revision ACL reconstruction resulted in a significantly worse outcome as measured by these patient-based measures at 2 years.

KEYWORDS

Anterior cruciate ligament - reconstruction - outcomes

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Rick WrightM.D. 

Department of Orthopaedic Surgery, Washington University School of Medicine, 1 Barnes-Jewish Hospital Plaza

Suite 11300, St. Louis, MO 63131

Email: wright@wudosis.wustl.edu