Younger age, increased medial tibial slope may predict revision after ACL repair
Key takeaways:
- Younger age and higher medial tibial slope were predictive of requiring ACL reconstruction after bridge-enhanced ACL repair.
- Sex, IKDC, knee hyperextension and meniscal status were not predictors of revision.
WASHINGTON — Results presented here showed that younger age and increased medial tibial slope were predictive for requiring conversion to an ACL reconstruction within 2 years of a bridge-enhanced ACL repair procedure.
To identify preoperative risk factors for subsequent ACL revision surgery following a bridge-enhanced ACL repair (BEAR) procedure, Dennis E. Kramer, MD, and colleagues evaluated data from 123 patients (median age, 17.6 years; 54% women) included in one of the three prospective BEAR trials who underwent a primary BEAR procedure 30 to 50 days after a complete ACL tear. Kramer and colleagues also collected demographic and intraoperative data, preoperative imaging and patient-reported outcomes, including IKDC and Marx Activity scores.
“The purpose of this report is to look at our data in these three [BEAR] trials and identify patients who underwent ACL repair procedure, failed that and required a reconstruction within 2 years of the repair,” Kramer said in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting.
Researchers found 18 patients (15%) from the cohort required a conversion to an ACL reconstruction within 2 years after a failed BEAR procedure.
Kramer noted that bivariate analysis showed younger age, contact injury and increased medial tibial slope were risk factors for requiring a conversion to ACL reconstruction. Similarly, multivariable logistic regression analysis showed younger age and increased medial tibial slope were predictors for revision.
For every degree increase in medial tibial slope, patients had a 28% increase in odds of undergoing revision with ACL reconstruction, according to Kramer. In addition, he said that for every 1-year increase in age, patients had a 32% increase in odds of undergoing revision. Meanwhile, sex, baseline IKDC score, Marx Activity scores, knee hyperextension and meniscal status had no predictive effect on the odds of requiring a revision.
“In conclusion, younger age and higher medial tibial slope were both independent predictors for requiring ACL reconstruction within 2 years of a BEAR ACL repair procedure,” Kramer said.
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Kramer DE, et al. Paper 27. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 12-16, 2023; Washington, D.C.
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