Ayato Miyamoto

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.

Purpose: To investigate factors that influence the prevalence of articular cartilage injury in patients with anterior cruciate ligament (ACL) injury.Methods: This multicentre study included patients with ACL injury. Logistic regression analysis was conducted to identify factors that influence the prevalence of cartilage injury during ACL reconstruction.Results: A total of 811 patients were enrolled. The factors that significantly influenced the prevalence of cartilage injury were age (odds ratio [OR], 1.04; P = 0.000), a positive pivot shift test result (OR, 1.43; P = 0.021), medial meniscal injury (OR, 2.55; P = 0.000), and delayed surgery (≥ 12 months) (OR, 2.52; P = 0.028) in the medial compartment of the knee; age (OR, 1.05; P = 0.000), subjective grades of apprehension during the pivot shift test (OR, 1.46; P = 0.010), lateral meniscal injury (OR, 1.98; P = 0.003), femoro‐tibial angle (FTA) (OR, 0.92; P = 0.006), and delayed surgery (≥ 12 months) (OR, 2.63; P = 0.001) in the lateral compartment; and age (OR, 1.06; P = 0.000), body mass index (OR, 1.07; P = 0.028), a positive pivot shift test result (OR, 1.60; P = 0.018), FTA (OR, 0.90; P = 0.006), and delayed surgery (≥ 12 months) (OR, 3.17; P = 0.008) in the patellofemoral compartment.Conclusion: An older age, a longer duration between injury and surgery, and a positive pivot shift test result were positively associated with the prevalence of cartilage injury in three compartments in patients with ACL injuries. Early ACL reconstruction is recommended to prevent cartilage injury.Level of Evidence: Level III.