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J Knee Surg 2024; 37(14): 925-932
DOI: 10.1055/a-2368-3739
Original Article

Articular Cartilage Damage in the Patellofemoral Compartment at ACL Reconstruction Predicts Poor Postoperative Subjective Outcomes in Patients Age 40 and Older

Ayato Miyamoto
1   Department of Orthopaedic Surgery, Matsuyama Shimin Hospital, Matsuyama, Japan
,
Atsuo Nakamae
2   Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
,
Kazuhiro Tsukisaka
3   Department of Orthopaedic Surgery, Mazda Hospital, Hiroshima, Japan
,
Masataka Deie
4   Department of Orthopaedic Surgery, Hiroshima City Hospital, Hiroshima, Japan
,
Eisaku Fujimoto
5   Department of Orthopaedic Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
,
Yoshinori Soda
4   Department of Orthopaedic Surgery, Hiroshima City Hospital, Hiroshima, Japan
,
Ryo Shimizu
6   Department of Orthopaedic Surgery, JA Onomichi General Hospital, Hiroshima, Japan
,
Nobuo Adachi
2   Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
› Author Affiliations Funding None.
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Abstract

The purpose of this study was to investigate factors that influence clinical outcomes after anterior cruciate ligament (ACL) reconstruction in patients aged ≥40 years. We studied 264 patients aged ≥40 and 154 patients aged ≤20 years who underwent ACL reconstruction at several surgical centers. A logistic regression analysis was conducted to identify factors that influenced the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 1 year post-ACL reconstruction. In the older patient group, cartilage damage in the patellofemoral compartment at surgery was a significant risk factor for poor postoperative KOOS subscores (pain, activities of daily living [ADL], sports, and quality of life [QOL]). Articular cartilage damage in the lateral compartment also significantly influenced one of the postoperative KOOS subscores (symptoms). In the younger patient group, articular cartilage damage in any compartments did not influence the postoperative KOOS subscores; only two preoperative KOOS subscores (symptoms and QOL) significantly influenced their postoperative KOOS subscores. We concluded that the articular cartilage damage in the patellofemoral compartment at ACL reconstruction predicts poor KOOS subscores at the 1-year follow-up in patients aged ≥40 years.

Study Design Cohort study (Prevalence); Level of evidence, 2.

Keywords

anterior cruciate ligament reconstruction - patients aged ≥40 year - articular cartilage damage - patellofemoral compartment

Ethics Approval

The current study was reviewed and approved by each participating site's respective institutional review board (code: E-1178).


Availability of Data and Material

The data used in the study are available from the corresponding author upon request.




Publication History

Received: 04 July 2023

Accepted: 16 July 2024

Accepted Manuscript online:
17 July 2024

Article published online:
02 August 2024

© 2024. Thieme. All rights reserved.

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