Michele Mastio1, Alejandra Duarte2, Jose Raya3, Laith Jazrawi1, and Jenny T. Bencardino4
1NYU Langone Orthopedic Center, NYU Langone Health, New York, NY, United States, 2NYU Center for Biomedical Imaging, New York, NY, United States, 3Radiology, NYU Center for Biomedical Imaging, New York, NY, United States, 4Radiology, NYU School of Medicine, Great Neck, NY, United States
Synopsis
Despite all the attention given to anterolateral ligament injury as potential outcome predictor in the postoperative ACL knee, we found that MM tears perform best at predicting early ACRL failure. Preserving the integrity of the MM during ACLR procedure may be crucial in minimizing the risk for early ACLR failure.
Purpose
To identify markers of early failure of ACL graft reconstruction (ACLR) based on preoperative MRI.Methods and Materials
We identified 26 patients with early ACLR failure (<2Y) who underwent revision between 2011-2015. Exclusion criteria included graft choice other than autografts (n=4) and non available preoperative MRI (n=3). Nineteen patients with early ACLR failure were included. The control group consisted of 38 subjects who underwent ACLR with a minimum of 2 years of clinical FU and no evidence of graft failure matched by age, sex, BMI and graft type. PreoperativeMRI obtained within 8w (range 1-8w) following initial trauma were blindly reviewed by an experienced musculoskeletal radiologist for intra and periarticular lesions including: anterolateral ligament (ALL) injuries (stretch, partial, complete), medial Logistic regression analysis was performed.Results
Mean time to ACLR failure was 14mo (range, 1-24mo). Mean FU of those in the control group was 38mo (range, 25-61). MM tear was the best predictor meniscus tear (MM), lateral meniscus tear (LM) tear, posteromedial corner injury (PMC), posterolateral corner injury (PLC) injury, medial collateral ligament tear (MCL), and lateral collateral ligament tear (LCL). Logistic regression analysis was performed.Results: Mean time to ACLR failure was 14mo (range, 1-24mo). Mean FU of those in the control group was 38mo (range, 25-61). MM tear was the best predictor of early ACLR failure (Accuracy=66.7%, p=0.08) followed by LM (p=0.13). MM was a significant predictor of ACLR failure (p=0.02) with OR 4.2 and 95% CI). All other variables were not associated with ACLR failure (p>0.20).Conclusion
MM tears were the best predictor of early failure of ACLR. Thus, preserving the integrity of the MM during ACLR procedure may be crucial in minimizing the risk for early ACLR failure.Acknowledgements
No acknowledgement found.References
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