Impact of Biologic Augmentation on Revision Surgery Rates After Meniscus Repair: A Matched-Cohort Analysis of 3420 Patients.

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Abstract

Conflict of interest statement: One or more of the authors has declared the following potential conflict of interest or source of funding: M.E.D. has received hospitality payments from Stryker. E.M.M. has received hospitality payments from Stryker. A.J.K. has received grant support from DJO; consulting fees from Arthrex, JRF Ortho, and Responsive Arthroscopy; nonconsulting fees from Arthrex; royalties from Arthrex; and honoraria from JRF Ortho. B.C.W. has received education payments from Arthrex, Fortis Surgical, and Supreme Orthopedic Systems; consulting fees from Arthrex; nonconsulting fees from Arthrex; and hospitality payments from Integra LifeSciences. C.L.C. has received education payments, consulting fees, and nonconsulting fees from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. 9. Osteoarthritis Cartilage. 2015 Apr;23(4):581-8. doi: 10.1016/j.joca.2014.12.018. Epub 2015 Jan 3. Meniscus treatment and age associated with narrower radiographic joint space width 2-3 years after ACL reconstruction: data from the MOON onsite cohort. Jones MH(1), Spindler KP(2), Fleming BC(3), Duryea J(4), Obuchowski NA(5), Scaramuzza EA(6), Oksendahl HL(7), Winalski CS(8), Duong CL(9), Huston LJ(10), Parker RD(11), Kaeding CC(12), Andrish JT(13), Flanigan DC(14), Dunn WR(15), Reinke EK(16). Author information: (1)Cleveland Clinic, USA. Electronic address: jonesm7@ccf.org. (2)Cleveland Clinic, USA; Vanderbilt University Medical Center, USA. Electronic address: spindlk@ccf.org. (3)Brown University/Rhode Island Hospital, USA. Electronic address: braden_fleming@brown.edu. (4)Brigham and Women's Hospital/Harvard Medical School, USA. Electronic address: duryea@bwh.harvard.edu. (5)Cleveland Clinic, USA. Electronic address: obuchon@ccf.org. (6)Vanderbilt University Medical Center, USA. Electronic address: erica.a.scaramuzza@vanderbilt.edu. (7)Steamboat Physical Therapy, Inc, USA. Electronic address: hoksendahl@yahoo.com. (8)Cleveland Clinic, USA. Electronic address: winalsc@ccf.org. (9)Vanderbilt University Medical Center, USA. Electronic address: carol.l.duong@vanderbilt.edu. (10)Vanderbilt University Medical Center, USA. Electronic address: laura.huston@vanderbilt.edu. (11)Cleveland Clinic, USA. Electronic address: parkerr@ccf.org. (12)The Ohio State University Wexner Medical Center, USA. Electronic address: christopher.kaeding@osumc.edu. (13)Cleveland Clinic, USA. Electronic address: andrisj@ccf.org. (14)The Ohio State University Wexner Medical Center, USA. Electronic address: david.flanigan@osumc.edu. (15)University of Wisconsin School of Medicine and Public Health, USA. Electronic address: dunn@ortho.wisc.edu. (16)Vanderbilt University Medical Center, USA. Electronic address: emily.reinke@vanderbilt.edu. OBJECTIVE: To identify risk factors for radiographic signs of post-traumatic osteoarthritis (OA) 2-3 years after anterior cruciate ligament (ACL) reconstruction through multivariable analysis of minimum joint space width (mJSW) differences in a specially designed nested cohort. METHODS: A nested cohort within the Multicenter Orthopaedic Outcomes Network (MOON) cohort included 262 patients (148 females, average age 20) injured in sport who underwent ACL reconstruction in a previously uninjured knee, were 35 or younger, and did not have ACL revision or contralateral knee surgery. mJSW on semi-flexed radiographs was measured in the medial compartment using a validated computerized method. A multivariable generalized linear model was constructed to assess mJSW difference between the ACL reconstructed and contralateral control knees while adjusting for potential confounding factors. RESULTS: Unexpectedly, we found the mean mJSW was 0.35 mm wider in ACL reconstructed than in control knees (5.06 mm (95% CI 4.96-5.15 mm) vs 4.71 mm (95% CI 4.62-4.80 mm), P < 0.001). However, ACL reconstructed knees with meniscectomy had narrower mJSW compared to contralateral normal knees by 0.64 mm (95% C.I. 0.38-0.90 mm) (P < 0.001). Age (P < 0.001) and meniscus repair (P = 0.001) were also significantly associated with mJSW difference. CONCLUSION: Semi-flexed radiographs can detect differences in mJSW between ACL reconstructed and contralateral normal knees 2-3 years following ACL reconstruction, and the unexpected wider mJSW in ACL reconstructed knees may represent the earliest manifestation of post-traumatic osteoarthritis and warrants further study. Copyright © 2015. Published by Elsevier Ltd. DOI: 10.1016/j.joca.2014.12.018 PMCID: PMC4601556