Evidence map›Paper›PMID 31598765›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020

Cartilage damage at the time of anterior cruciate ligament reconstruction is associated with weaker quadriceps function and lower risk of future ACL injury.

Joshua S Everhart, Alex C DiBartola, Katherine Swank, Robert Pettit, Langston Hughes, Caroline Lewis, David C Flanigan

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Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Joshua S EverhartDepartment of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Alex C DiBartolaDepartment of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Katherine SwankDepartment of Orthopaedic Surgery, Beaumont Hospital, Royal Oak, MI, USA.
Robert PettitDepartment of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Langston HughesCollege of Medicine, The Ohio State University, Columbus, OH, USA.
Caroline LewisDepartment of Physical Therapy and Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
David C FlaniganDepartment of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA. david.flanigan@osumc.edu.ORCID http://orcid.org/0000-0001-8876-7043

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo determine whether articular cartilage damage noted at the time of primary anterior cruciate ligament reconstruction (ACLR) affects the likelihood of achieving ≥ 90% symmetry for isokinetic extension strength at 6 months after surgery or risk of recurrent ACL injury.

methodsFive hundred and eight patients underwent primary ACLR and diagnostic arthroscopy. All identified cartilage lesions were graded using the Outerbridge system. All patients underwent isokinetic strength testing. The association between cartilage Outerbridge grade and a ≥ 90% Limb Symmetry Index (LSI) and recurrent ACL injury risk at mean 38.7 month follow-up (SD 31.8) was evaluated via multivariate regression analysis.

resultsGrade 2 or higher damage was present in 394 (77.5%) of patients, grade 3 or higher in 143 (28.1%) and grade 4 in 83 (16.4%) at time of ACLR. Ipsilateral ACLR graft rupture occurred in 31 (6.1%) of patients. Contralateral ACL injury occurred in 19 (3.7%). Patients with grade 2 or higher damage were significantly less likely to meet an LSI goal of ≥ 90% for fast (300°/s) isokinetic extension. There was no association with slow isokinetic extension. Cartilage lesion severity at or beyond grade 2 had a similar effect on isokinetic testing results regardless of compartment involvement or performance of microfracture. Patients with grade 2-4 cartilage damage were less likely to sustain a second ipsilateral ACL injury or a contralateral native ACL injury.

conclusionsCartilage damage seen at time of ACL reconstruction is common and associated with lower likelihood of achieving ≥ 90% symmetry for isokinetic extension strength at 6 months after surgery. However, lower recurrent ACL injury rates are seen in patients with concurrent cartilage damage. These data may inform future clinical decisions regarding operative managment of recurrent ACL injuries. LEVEL OF EVIDENCE: III.

Indexed as

AdolescentAdultAnterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionArthroscopyCartilage, ArticularCartilage DiseasesFemaleHumansMaleMiddle AgedQuadriceps MuscleRecurrenceRisk FactorsACL injuryIsokinetic strength testingKnee cartilage defectsQuadriceps atrophyReturn to sport

Identifiers

PMID31598765

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.