Prognosis and Predictors of ACL Reconstruction: A Multicenter Cohort Study

ACL 重建的预后和预测因素：多中心队列研究

• 批准号: 9763447
• 负责人: Kurt Paul Spindler
• 金额: $ 58.99万
• 依托单位: CLEVELAND CLINIC LERNER COM-CWRU
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9763447
• 关键词: Age; Allografting; Anterior Cruciate Ligament; Arthroscopic Surgical Procedures; Basic Science; Caring; Cartilage; Cartilage injury; Characteristics; Clinical; Clinical Research; Clinical assessments; Cohort Studies; Contralateral; Data; Decision Making; Degenerative polyarthritis; Documentation; Enrollment; Evaluation; Excision; Failure; Funding; Future; Gender; Grant; Health; Image; Incidence; Individual; Infection; Inferior; Injury; International; Joints; Knee; Knee Injuries; Knee Osteoarthritis; Knowledge; Longitudinal Studies; Measurement; Measures; Meniscus structure of joint; Modeling; Operative Surgical Procedures; Orthopedics; Outcome; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Physical activity; Physicians; Policy Maker; Population; Prevention; Procedures; Prospective Studies; Quality of life; Questionnaires; Radiology Specialty; Reporting; Research; Risk; Risk Factors; Sample Size; Schedule; Severities; Signs and Symptoms; Smoking Status; Source; Sports; Surgeon; Symptoms; Techniques; Telephone; Testing; Time; Work; active lifestyle; anterior cruciate ligament injury; anterior cruciate ligament reconstruction; anterior cruciate ligament rupture; articular cartilage; clinical predictors; cohort; design; disability; follow-up; graft failure; improved; improved outcome; individual patient; instrument; meniscus injury; modifiable risk; outcome forecast; pain score; patient population; predictive modeling; prospective; public health relevance; return to sport; sex; standard of care

 DESCRIPTION (provided by applicant): Injury to the anterior cruciate ligament (ACL) results in a threat to an active lifestyle and exposes the patient to risk of early osteoarthritis. ACL reconstruction is typically chosen by individuals to allow a return to their previous work and sports activities. The results of primary ACL reconstruction have in general been good at restoring functional stability, but patients' long-term outcome remains unknown. The Multicenter Orthopaedic Outcomes Network (MOON) is an established consortium designed to enroll and longitudinally follow a multicenter cohort of ACL reconstructed patients to determine the modifiable predictors (or risk factors) of long-term outcomes of ACL reconstruction in order to establish patient-specific predictive models of clinically important outcomes. The objective of this prospective multicenter cohort of ACL reconstructions is to identify both the long-term prognosis and the potentially modifiable predictors of symptoms of osteoarthritis (OA), sports function, activity and general health through validated patient- reported outcomes, and incidence of ACL reconstruction graft and/or contralateral ACL failures. Our previous grants (R01 AR053684) have allowed us to enroll 3,547 patients and obtain both 2 and 6 year follow-up on this cohort. At both time points, we have been able to obtain a minimum of 84% follow-up using validated patient-reported outcome questionnaires and 93% via phone follow-up. In addition, a nested cohort or 317 ACL reconstructed patients returned onsite after 2 years for a comprehensive clinical assessment, specialized radiologic measurements, along with completing their patient-reported outcomes. The objective of this grant is to longitudinally follow these two cohorts at 10 years utilizing the same validated outcome measurements as well as following incidence of clinical graft and/or contralateral ACL failure. Further, nested cohort will help determine the predictors of and the correlates from clinical assessment with both the symptoms and signs of OA and validated outcomes (in terms of sports function, activity, and general health). This grant focuses on the predictors for ACL reconstruction outcome at 10 year follow-up, and will be accomplished by three Specific Aims. Aim 1 will identify the risk factors or predictors of return to sports function, physical activity level, and patient-reported quality of lfe. Specific Aim 2 will identify those risk factors or predictors measured at the time of the ACL reconstruction associated with symptoms of early osteoarthritis at 10 years post-surgery. Specific Aim 3 will identify incidence of additional surgery and graft failure performed on patient following ACL reconstruction. Once the risk factors or predictors for worse outcomes are identified, surgeons can be educated in potential modifiable variables to improve the outcome.

 描述（由申请人提供）：前十字韧带 (ACL) 损伤会对积极的生活方式造成威胁，并使患者面临早期骨关节炎的风险，个人通常会选择进行 ACL 重建，以恢复之前的工作和生活。初级 ACL 重建的结果总体上有助于恢复功能稳定性，但多中心骨科结果网络 (MOON) 仍不清楚患者的长期结果。一个已建立的联盟，旨在招募并纵向追踪 ACL 重建患者的多中心队列，以确定 ACL 重建长期结果的可修改预测因子（或风险因素），以便建立该临床重要结果的患者特异性预测模型。 ACL 重建的前瞻性多中心队列旨在通过经过验证的患者报告结果以及骨关节炎 (OA) 症状、运动功能、活动和一般健康状况以及骨关节炎 (OA) 的发生率来确定长期预后和潜在可修改的预测因子。 ACL 重建移植物和/或对侧 ACL 失败。我们之前的资助 (R01 AR053684) 使我们能够招募 3,547 名患者，并对该队列进行 2 年和 6 年的随访。至少 84% 的患者使用经验证的患者报告结果问卷进行随访，93% 的患者通过电话随访。此外，还返回了一个嵌套队列或 317 名 ACL 重建患者。两年后现场进行全面的临床评估、专门的放射学测量，并完成患者报告的结果。这笔资助的目的是纵向跟踪。 这两个队列在 10 年时使用相同的经过验证的结果测量以及临床移植物和/或对侧 ACL 失败的发生率此外，嵌套队列将。 帮助确定 OA 症状和体征的临床评估的预测因素和相关性以及经过验证的结果（在运动功能、活动和总体健康方面） 该资助重点关注 10 年后 ACL 重建结果的预测因素。 ，并将通过三个具体目标来实现，目标 1 将确定风险因素或。 恢复运动功能、体力活动水平和患者报告的生活质量的预测因素具体目标 2 将确定在 ACL 重建时测量的与术后 10 年早期骨关节炎症状相关的风险因素或预测因素。具体目标 3 将确定 ACL 重建后患者进行额外手术和移植失败的发生率。 一旦确定了导致更差结果的危险因素或预测因素，就可以对外科医生进行潜在可修改变量的教育，以改善结果。

项目成果

A systematic review of anterior cruciate ligament reconstruction rehabilitation: part I: continuous passive motion, early weight bearing, postoperative bracing, and home-based rehabilitation.

• DOI: 10.1055/s-0030-1247822
• 发表时间: 2008-07
• 期刊: The journal of knee surgery
• 作者: Wright RW;Preston E;Fleming BC;Amendola A;Andrish JT;Bergfeld JA;Dunn WR;Kaeding C;Kuhn JE;Marx RG;McCarty EC;Parker RC;Spindler KP;Wolcott M;Wolf BR;Williams GN
• 通讯作者: Williams GN

Predicting the Need for Surgical Intervention Prior to First Encounter for Individuals With Knee Complaints: A Novel Approach.

在首次遇到膝关节不适的患者之前预测是否需要手术干预：一种新颖的方法。

• DOI: 10.1177/2325967119859485
• 发表时间: 2019
• 期刊: Orthopaedic journal of sports medicine
• 影响因子: 2.6
• 作者: Vega,JoséF;Strnad,GregoryJ;Bena,James;Spindler,KurtP
• 通讯作者: Spindler,KurtP

Risk factors for radiographic joint space narrowing and patient reported outcomes of post-traumatic osteoarthritis after ACL reconstruction: Data from the MOON cohort.

• DOI: 10.1002/jor.23557
• 发表时间: 2017-07
• 期刊: Journal of orthopaedic research : official publication of the Orthopaedic Research Society
• 作者: Jones MH;Spindler KP
• 通讯作者: Spindler KP

Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction: Predictors of Failure From a MOON Prospective Longitudinal Cohort.

• DOI: 10.1177/1941738110386185
• 发表时间: 2011-01
• 期刊: Sports health
• 影响因子: 3.3
• 作者: Kaeding CC;Aros B;Pedroza A;Pifel E;Amendola A;Andrish JT;Dunn WR;Marx RG;McCarty EC;Parker RD;Wright RW;Spindler KP
• 通讯作者: Spindler KP

Are Bone Bruise Characteristics and Articular Cartilage Pathology Associated with Inferior Outcomes 2 and 6 Years After Anterior Cruciate Ligament Reconstruction?

• DOI: 10.1177/1947603516653209
• 发表时间: 2017-04-01
• 期刊: CARTILAGE
• 影响因子: 2.8
• 作者: Lattermann, Christian;Jacobs, Cale A.;Spindler, Kurt P.
• 通讯作者: Spindler, Kurt P.