Variance in Anterior Cruciate Ligament Reconstruction Graft Selection based on Patient Demographics and Location within the Multicenter Orthopaedic Outcomes Network Cohort

Darby A. Houck; Matthew J. Kraeutler; Armando F. Vidal; Eric C. McCarty; Jonathan T. Bravman; Michelle L. Wolcott; MOON Knee Group

doi:10.1055/s-0037-1604147

The Journal of Knee Surgery, Inhaltsverzeichnis

J Knee Surg 2018; 31(05): 472-478
DOI: 10.1055/s-0037-1604147

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Variance in Anterior Cruciate Ligament Reconstruction Graft Selection based on Patient Demographics and Location within the Multicenter Orthopaedic Outcomes Network Cohort

Darby A. Houck

¹Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado

,

Matthew J. Kraeutler

²Department of Orthopaedics, Seton Hall-Hackensack Meridian School of Medicine, South Orange, New Jersey

,

Armando F. Vidal

¹Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado

,

Eric C. McCarty

¹Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado

,

Jonathan T. Bravman

¹Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado

,

Michelle L. Wolcott

¹Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado

,

MOON Knee Group

(

Annunziato Amendola

³Department of Orthopaedic Surgery, Duke University

,

Jack T. Andrish

⁴Department of Orthopaedics, Cleveland Clinic Foundation, Ohio

,

Robert H. Brophy

⁵Department of Orthopaedic Surgery, Washington University School of Medicine, Chesterfield, Missouri

,

Warren R. Dunn

⁶Department of Orthopaedics, University of Wisconsin Research Park Clinic Sports Medicine Clinic, Madison, Wisconsin

,

David C. Flanigan

⁷Department of Orthopaedics, The Ohio State University, Columbus, Ohio

,

Laura J. Huston

⁸Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee

,

Morgan H. Jones

⁹Department of Orthopaedics, Cleveland Clinic Foundation, Ohio

,

Christopher C. Kaeding

¹⁰Department of Orthopaedics, The Ohio State University, Columbus, Ohio

,

Robert G. Marx

¹¹Department of Orthopaedics, Hospital for Special Surgery, New York, New York

,

Matthew J. Matava

¹²Department of Orthopaedics, Washington University School of Medicine, Chesterfield, Missouri

,

Eric C. McCarty

¹³CU Sports Medicine, Boulder, Colorado

,

Richard D. Parker

¹⁴Department of Orthopaedics, Cleveland Clinic Foundation, Ohio

,

Kurt P. Spindler

¹⁵Department of Orthopaedics, Cleveland Clinic Foundation, Ohio

,

Michelle L. Wolcott

¹⁶CU Sports Medicine Denver, Colorado

,

Brian R. Wolf

¹⁷Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa

,

Rick W. Wright

¹⁸Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri

,

Armando F. Vidal

¹⁹CU Sports Medicine, Denver, Colorado

)› Institutsangaben

Abstract

The purpose of this study is to determine whether any regional or age-related patterns exist in graft choice for patients undergoing primary anterior cruciate ligament reconstruction (ACLR) within a large multicenter consortium. A retrospective cohort study was performed using data collected from the Multicenter Orthopaedic Outcomes Network (MOON) on patients having undergone primary ACLR. Patients were stratified by age group (younger than 20, 20–29, 30–39, 40–49, and 50+ years) and four demographic regions (Midwest, Southeast, Northeast, and West). A total of 2,149 patients (1,288 males, 861 females) were included. At least 70% of the patients were treated by a single surgeon in three of the four demographic regions. There were no clinically significant differences in body mass index (BMI), and no statistically significant differences in Marx activity rating scale (p > 0.05) between regions within any particular age group. There were significant differences in the proportion of autografts versus allografts used for primary ACLR between regions in every age group (p < 0.01). There were also significant differences in autograft (p < 0.001) and allograft (p < 0.001) harvest location based on demographic region. The Southeast and Northeast were more likely to use bone-patellar-tendon-bone autograft while the West and Midwest were likely to use hamstring autograft. Within our consortium, regional patterns exist both in autograft versus allograft use in patients undergoing primary ACLR, as well as harvest location of autografts and allografts. Given the similarities in average patient BMI and activity level between regions, as well as the single surgeon influence in three of the four regions, the regional patterns in graft use are likely due to surgeon preference.

Keywords

anterior cruciate ligament reconstruction - allograft - autograft - demographics

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Referenzen

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