Evidence map›Paper›PMID 39555321›Full record

ArticleOrthopaedic journal of sports medicine2024

A Novel Machine Learning Model to Predict Revision ACL Reconstruction Failure in the MARS Cohort.

MARS Group, Kinjal Vasavada, Vrinda Vasavada, Jay Moran, Sai Devana, Changhee Lee, Sharon L Hame, Laith M Jazrawi, Orrin H Sherman, Laura J Huston and 79 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Orthopaedic journal of sports medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00625885 (Multicenter ACL Revision Study), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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.

NCT00625885 active not recruitingnot on this map

Multicenter ACL Revision Study (MARS)

TypeobservationalSponsorVanderbilt University Medical CenterRan2006 to 2030Enrolled1,234ConditionsRupture of Anterior Cruciate Ligament
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Machine learning model identifies tibial anatomical variables as potential risk factors for anterior cruciate ligament injury.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026
    Article
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

89 authors.

MARS Group
Kinjal VasavadaYale University, New Haven, Connecticut, USA.
Vrinda VasavadaNYU Hospital for Joint Diseases, New York, New York, USA.
Jay MoranYale University, New Haven, Connecticut, USA.
Sai DevanaDavid Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California, USA.
Changhee LeeKorea University, Seoul, Republic of Korea.
Sharon L HameDavid Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California, USA.
Laith M JazrawiNYU Hospital for Joint Diseases, New York, New York, USA.
Orrin H ShermanNYU Hospital for Joint Diseases, New York, New York, USA.
Laura J HustonVanderbilt University, Nashville, Tennessee, USA.
Amanda K HaasWashington University in St Louis, St Louis, Missouri, USA.
Christina R AllenYale University, New Haven, Connecticut, USA.
Daniel E CooperW.B. Carrell Memorial Clinic, Dallas, Texas, USA.
Thomas M DeBerardinoUT Health, San Antonio, Texas, USA.
Kurt P SpindlerCleveland Clinic, Cleveland, Ohio, USA.
Michael J StuartMayo Clinic, Rochester, Minnesota, USA.
Annunziato Ned AmendolaDuke University, Durham, North Carolina, USA.
Christopher C AnnunziataCommonwealth Orthopaedics & Rehabilitation, Arlington, Virginia, USA.
Robert A ArcieroUniversity of Connecticut Health Center, Farmington, Connecticut, USA.
Bernard R BachRush University Medical Center, Chicago, Illinois, USA.
Champ L BakerThe Hughston Clinic, Columbus, Georgia, USA.
Arthur R Bartolozzi3B Orthopaedics, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
Keith M BaumgartenOrthopedic Institute, Sioux Falls, South Dakota, USA.
Jeffrey H BergTown Center Orthopaedic Associates, Reston, Virginia, USA.
Geoffrey A BernasState University of New York at Buffalo, Buffalo, New York, USA.
Stephen F BrockmeierUniversity of Virginia, Charlottesville, Virginia, USA.
Robert H BrophyWashington University in St Louis, St Louis, Missouri, USA.
Charles A Bush-JosephRush University Medical Center, Chicago, Illinois, USA.
J Brad Butler VOrthopedic and Fracture Clinic, Portland, Oregon, USA.
James L CareyUniversity of Pennsylvania, Philadelphia, Pennsylvania, USA.
James E CarpenterUniversity of Michigan, Ann Arbor, Michigan, USA.
Brian J ColeRush University Medical Center, Chicago, Illinois, USA.
Jonathan M CooperHealthPartners Specialty Center, St Paul, Minnesota, USA.
Charles L CoxVanderbilt University, Nashville, Tennessee, USA.
R Alexander CreightonUniversity of North Carolina Medical Center, Chapel Hill, North Carolina, USA.
Tal S DavidSynergy Specialists Medical Group, San Diego, California, USA.
Warren R DunnFondren Orthopedic Group, Houston, Texas, USA.
David C FlaniganThe Ohio State University, Columbus, Ohio, USA.
Robert W FrederickThe Rothman Institute/Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Theodore J GanleyChildren's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Charles J GattUniversity Orthopaedic Associates LLC, Princeton, New Jersey, USA.
Steven R GechaPrinceton Orthopaedic Associates, Princeton, New Jersey, USA.
James Robert GiffinFowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.
Jo A HannafinHospital for Special Surgery, New York, New York, USA.
Norman Lindsay HarrisGrand River Health, Rifle, Colorado, USA.
Keith S HechtmanMiami Orthopedics and Sports Medicine Institute, Coral Gables, Florida, USA.
Elliott B HershmanLenox Hill Hospital, New York, New York, USA.
Rudolf G HoellrichSlocum Research and Education Foundation, Eugene, Oregon, USA.
David C JohnsonNational Sports Medicine Institute, Leesburg, Virginia, USA.
Timothy S JohnsonNational Sports Medicine Institute, Leesburg, Virginia, USA.
Morgan H JonesBrigham and Women's Hospital, Boston, Massachusetts, USA.
Christopher C KaedingThe Ohio State University, Columbus, Ohio, USA.
Ganesh V KamathUniversity of North Carolina Medical Center, Chapel Hill, North Carolina, USA.
Thomas E KlootwykForte Sports Medicine and Orthopedics, Indianapolis, Indiana, USA.
Bruce A LevyOrlando Health, Orlando, Florida, USA.
C Benjamin MaUniversity of California at San Francisco, San Francisco, California, USA.
G Peter MaiersForte Sports Medicine and Orthopedics, Indianapolis, Indiana, USA.
Robert G MarxHospital for Special Surgery, New York, New York, USA.
Matthew J MatavaWashington University in St Louis, St Louis, Missouri, USA.
Gregory M MathienKnoxville Orthopedic Clinic, Knoxville, Tennessee, USA.
David R McAllisterUniversity of California at Los Angeles, Los Angeles, California, USA.
Eric C McCartyUniversity of Colorado-Denver School of Medicine, Denver, Colorado, USA.
Robert G McCormackUniversity of British Columbia/Fraser Health Authority, New Westinster, British Columbia, Canada.
Bruce S MillerUniversity of Michigan, Ann Arbor, Michigan, USA.
Carl W NissenConnecticut Children's Medical Center, Hartford, Connecticut, USA.
Daniel F O'NeillThe Alpine Clinic, Plymouth, New Hampshire, USA.
Brett D OwensWarren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
Richard D ParkerCleveland Clinic, Cleveland, Ohio, USA.
Mark L PurnellValley Ortho, Aspen, Colorado, USA.
Arun J RamappaBeth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Michael A RauhState University of New York at Buffalo, Buffalo, New York, USA.
Arthur C RettigForte Sports Medicine and Orthopedics, Indianapolis, Indiana, USA.
Jon K SekiyaUniversity of Michigan, Ann Arbor, Michigan, USA.
Kevin G SheaStanford University, Palo Alto, California, USA.
James R SlauterbeckUNC Health Southeastern, Lumberton, North Carolina, USA.
Matthew V SmithWashington University in St Louis, St Louis, Missouri, USA.
Jeffrey T SpangUniversity of North Carolina Medical Center, Chapel Hill, North Carolina, USA.
Steven J SvobodaMedStar Orthopaedic and Sports Center, Washington, DC, USA.
Timothy N TaftUniversity of North Carolina Medical Center, Chapel Hill, North Carolina, USA.
Joachim J TenutaAlbany Medical Center, Albany, New York, USA.
Edwin M TingstadInland Orthopaedic Surgery and Sports Medicine Clinic, Pullman, Washington, USA.
Armando F VidalThe Steadman Clinic, Vail, Colorado, USA.
Darius G ViskontasFraser Orthopaedic Institute, New Westminster, British Columbia, Canada.
Richard A WhiteFitzgibbon's Hospital, Marshall, Missouri, USA.
James S WilliamsCleveland Clinic, Euclid, Ohio, USA.
Michelle L WolcottUniversity of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA.
Brian R WolfUniversity of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Rick W WrightVanderbilt University, Nashville, Tennessee, USA.
James J YorkLuminis Health Orthopedics, Pasadena, Maryland, USA.

Funding

Revision ACL Reconstructions: A Comparative Effectiveness Treatment StudyR01AR060846 · NIAMS · WASHINGTON UNIVERSITY · PI WRIGHT, RICK W · 2011 to 2025
$6.7M
NIAMS NIH HHS R01 AR060846
6 · The paper itself

Abstract

Background: As machine learning becomes increasingly utilized in orthopaedic clinical research, the application of machine learning methodology to cohort data from the Multicenter ACL Revision Study (MARS) presents a valuable opportunity to translate data into patient-specific insights. Purpose: To apply novel machine learning methodology to MARS cohort data to determine a predictive model of revision anterior cruciate ligament reconstruction (rACLR) graft failure and features most predictive of failure. Study Design: Cohort study; Level of evidence, 3. Methods: The authors prospectively recruited patients undergoing rACLR from the MARS cohort and obtained preoperative radiographs, surgeon-reported intraoperative findings, and 2- and 6-year follow-up data on patient-reported outcomes, additional surgeries, and graft failure. Machine learning models including logistic regression (LR), XGBoost, gradient boosting (GB), random forest (RF), and a validated ensemble algorithm (AutoPrognosis) were built to predict graft failure by 6 years postoperatively. Validated performance metrics and feature importance measures were used to evaluate model performance. Results: The cohort included 960 patients who completed 6-year follow-up, with 5.7% (n = 55) experiencing graft failure. AutoPrognosis demonstrated the highest discriminative power (model area under the receiver operating characteristic curve: AutoPrognosis, 0.703; RF, 0.618; GB, 0.660; XGBoost, 0.680; LR, 0.592), with well-calibrated scores (model Brier score: AutoPrognosis, 0.053; RF, 0.054; GB, 0.057; XGBoost, 0.058; LR, 0.111). The most important features for AutoPrognosis model performance were prior compromised femoral and tibial tunnels (placement and size) and allograft graft type used in current rACLR. Conclusion: The present study demonstrated the ability of the novel AutoPrognosis machine learning model to best predict the risk of graft failure in patients undergoing rACLR at 6 years postoperatively with moderate predictive ability. Femoral and tibial tunnel size and position in prior ACLR and allograft use in current rACLR were all risk factors for rACLR failure in the context of the AutoPrognosis model. This study describes a unique model that can be externally validated with larger data sets and contribute toward the creation of a robust rACLR bedside risk calculator in future studies. Registration: NCT00625885 (ClinicalTrials.gov identifier).

Indexed as

ACL revisionfemoral tunnelgraft failuremachine learningtibial tunnel

Identifiers

PMID39555321
PMCPMC11565622

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Registered trials

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