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3. Descriptive Characteristics and Outcomes of Patients Undergoing Revision Anterior Cruciate Ligament Reconstruction With and Without Tunnel Bone Grafting

Author

Group, MARS, DeFroda, Steven F, Owens, Brett D, Wright, Rick W, Huston, Laura J, Pennings, Jacquelyn S, Haas, Amanda K, Allen, Christina R, Cooper, Daniel E, DeBerardino, Thomas M, Dunn, Warren R, Lantz, Brett Brick A, Spindler, Kurt P, Stuart, Michael J, Albright, John P, Amendola, Annunziato, Annunziata, Christopher C, Arciero, Robert A, Bach, Bernard R, Baker, Champ L, Bartolozzi, Arthur R, Baumgarten, Keith M, Bechler, Jeffery R, Berg, Jeffrey H, Bernas, Geoffrey A, Brockmeier, Stephen F, Brophy, Robert H, Bush-Joseph, Charles A, Butler, J Brad, Carey, James L, Carpenter, James E, Cole, Brian J, Cooper, Jonathan M, Cox, Charles L, Creighton, R Alexander, David, Tal S, Flanigan, David C, Frederick, Robert W, Ganley, Theodore J, Garofoli, Elizabeth A, Gatt, Charles J, Gecha, Steven R, Giffin, James Robert, Hame, Sharon L, Hannafin, Jo A, Harner, Christopher D, Harris, Norman Lindsay, Hechtman, Keith S, Hershman, Elliott B, Hoellrich, Rudolf G, Johnson, David C, Johnson, Timothy S, Jones, Morgan H, Kaeding, Christopher C, Kamath, Ganesh V, Klootwyk, Thomas E, Levy, Bruce A, Benjamin, C, Maiers, G Peter, Marx, Robert G, Matava, Matthew J, Mathien, Gregory M, McAllister, David R, McCarty, Eric C, McCormack, Robert G, Miller, Bruce S, Nissen, Carl W, O’Neill, Daniel F, Parker, Richard D, Purnell, Mark L, Ramappa, Arun J, Rauh, Michael A, Rettig, Arthur C, Sekiya, Jon K, Shea, Kevin G, Sherman, Orrin H, Slauterbeck, James R, Smith, Matthew V, Spang, Jeffrey T, Svoboda, Steven J, Taft, Timothy N, Tenuta, Joachim J, Tingstad, Edwin M, Vidal, Armando F, Viskontas, Darius G, White, Richard A, Williams, James S, Wolcott, Michelle L, Wolf, Brian R, and York, James J

Subjects
Transplantation, Clinical Research, Musculoskeletal, Anterior Cruciate Ligament Injuries, Anterior Cruciate Ligament Reconstruction, Cohort Studies, Humans, Osteoarthritis, Quality of Life, Reoperation, bone graft, outcomes, revision anterior cruciate ligament reconstruction, tunnel lysis, MARS Group, Biomedical Engineering, Mechanical Engineering, Human Movement and Sports Sciences, Orthopedics
Abstract

BackgroundLytic or malpositioned tunnels may require bone grafting during revision anterior cruciate ligament reconstruction (rACLR) surgery. Patient characteristics and effects of grafting on outcomes after rACLR are not well described.PurposeTo describe preoperative characteristics, intraoperative findings, and 2-year outcomes for patients with rACLR undergoing bone grafting procedures compared with patients with rACLR without grafting.Study designCohort study; Level of evidence, 3.MethodsA total of 1234 patients who underwent rACLR were prospectively enrolled between 2006 and 2011. Baseline revision and 2-year characteristics, surgical technique, pathology, treatment, and patient-reported outcome instruments (International Knee Documentation Committee [IKDC], Knee injury and Osteoarthritis Outcome Score [KOOS], Western Ontario and McMaster Universities Osteoarthritis Index, and Marx Activity Rating Scale [Marx]) were collected, as well as subsequent surgery information, if applicable. The chi-square and analysis of variance tests were used to compare group characteristics.ResultsA total of 159 patients (13%) underwent tunnel grafting-64 (5%) patients underwent 1-stage and 95 (8%) underwent 2-stage grafting. Grafting was isolated to the femur in 31 (2.5%) patients, the tibia in 40 (3%) patients, and combined in 88 patients (7%). Baseline KOOS Quality of Life (QoL) and Marx activity scores were significantly lower in the 2-stage group compared with the no bone grafting group (P≤ .001). Patients who required 2-stage grafting had more previous ACLRs (P < .001) and were less likely to have received a bone-patellar tendon-bone or a soft tissue autograft at primary ACLR procedure (P≤ .021) compared with the no bone grafting group. For current rACLR, patients undergoing either 1-stage or 2-stage bone grafting were more likely to receive a bone-patellar tendon-bone allograft (P≤ .008) and less likely to receive a soft tissue autograft (P≤ .003) compared with the no bone grafting group. At 2-year follow-up of 1052 (85%) patients, we found inferior outcomes in the 2-stage bone grafting group (IKDC score = 68; KOOS QoL score = 44; KOOS Sport/Recreation score = 65; and Marx activity score = 3) compared with the no bone grafting group (IKDC score = 77; KOOS QoL score = 63; KOOS Sport/Recreation score = 75; and Marx activity score = 7) (P≤ .01). The 1-stage bone graft group did not significantly differ compared with the no bone grafting group.ConclusionTunnel bone grafting was performed in 13% of our rACLR cohort, with 8% undergoing 2-stage surgery. Patients treated with 2-stage grafting had inferior baseline and 2-year patient-reported outcomes and activity levels compared with patients not undergoing bone grafting. Patients treated with 1-stage grafting had similar baseline and 2-year patient-reported outcomes and activity levels compared with patients not undergoing bone grafting.

Published
2022

6. The Sagittal Tibial Tubercle–Trochlear Groove Distance as a Measurement of Sagittal Imbalance in Patients with Symptomatic Patellofemoral Chondral Lesions

Author

Lansdown, Drew A, Christian, David, Madden, Brett, Redondo, Michael, Farr, Jack, Cole, Brian J, and Yanke, Adam B

Subjects
Clinical Research, Biomedical Imaging, Musculoskeletal, Humans, Magnetic Resonance Imaging, Patella, Patellofemoral Joint, Retrospective Studies, Tibia, patellofemoral joint, cartilage, tibial tubercle osteotomy, knee imaging, Biomedical Engineering, Medical Biotechnology, Clinical Sciences
Abstract

Objective. To measure the sagittal alignment of the tibial tubercle through the sagittal tibial tubercle-trochlear groove (sTTTG) distance in patients with and without patellar chondral lesions. Design. Patients treated with patellofemoral cartilage restoration or repair procedures were retrospectively reviewed (group 1; N = 17). A control group of patients (group 2; N = 20) undergoing partial meniscectomy with normal patellar cartilage was included. An asymptomatic patellar chondrosis group (group 3; N = 15) was identified as patients undergoing partial meniscectomy with patellar cartilage wear. The sTTTG was measured on the preoperative axial T2 magnetic resonance imaging (MRI) sequence. The first point was the nadir of the anterior trochlear cartilage, and the second point was the anterior tibial tubercle. A line was drawn between these points, perpendicular to the posterior condylar axis. Comparisons were made between the 3 groups using analysis of variance testing with Bonferroni corrections. Significance was defined as P < 0.05. Results. The mean sTTTG was significantly more posterior in group 1 (5.9 ± 5.5 mm posterior to the trochlear groove) relative to group 2 (0.8 ± 5.3 mm posterior; P = 0.018). The mean value for group 3 (2.7 ± 5.3 mm posterior) fell between group 1 and 3 but was not significantly different from group 1 (P = 0.31) or group 2 (P = 0.89). There were no significant differences with regards to sulcus angle, Caton-Deschamps Index, TTTG, or knee flexion angle on the MRI scan. Conclusions. A more posteriorly positioned tibial tubercle was observed in patients with patellar cartilage lesions relative to those with intact patellar cartilage. Intermediate positioning was observed in patients with asymptomatic patellar chondral wear. Level of Evidence. Level 3 diagnostic study.

Published
2021

12. After Chondroplasty, Patient Election to Proceed With Cartilage Transplantation Is Closely and Additively Associated With Preoperative AMADEUS (Area Measurement And DEpth Underlying Structure) Grade, Condylar Involvement, Knee Injury and Osteoarthritis Outcome Score Pain Score, and Veterans Rand 12-Item Health Survey Physical Score

Author

Yanke, Adam B., Hevesi, Mario, Dandu, Navya, Trasolini, Nicholas A., Darwish, Reem Y., Zavras, Athan G., and Cole, Brian J.

Published
2022
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26. Association Between Baseline Meniscal Symptoms and Outcomes of Operative and Nonoperative Treatment of Meniscal Tear in Patients With Osteoarthritis

Author

MacFarlane, Lindsey A., Yang, Heidi, Collins, Jamie E., Brophy, Robert H., Cole, Brian J., Spindler, Kurt P., Guermazi, Ali, Jones, Morgan H., Mandl, Lisa A., Martin, Scott, Marx, Robert G., Levy, Bruce A., Stuart, Michael, Safran‐Norton, Clare, Wright, John, Wright, Rick W., Losina, Elena, and Katz, Jeffrey N.

Published
2022
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32. Radiographic Changes Five Years After Treatment of Meniscal Tear and Osteoarthritic Changes

Author

Katz, Jeffrey N., primary, Collins, Jamie E., additional, Brophy, Robert H., additional, Cole, Brian J., additional, Cox, Charles L., additional, Guermazi, Ali, additional, Jones, Morgan H., additional, Levy, Bruce A., additional, MacFarlane, Lindsey A., additional, Mandl, Lisa A., additional, Marx, Robert G., additional, Selzer, Faith, additional, Spindler, Kurt P., additional, Wright, Rick W., additional, Losina, Elena, additional, and Chang, Yuchiao, additional

Published
2023
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38. Determining the Time Required to Achieve Clinically Significant Outcomes on the PROMIS Upper Extremity Questionnaire After Arthroscopic Rotator Cuff Repair

Author

Polce, Evan M., primary, Vadhera, Amar S., additional, Fu, Michael C., additional, Singh, Harsh, additional, Haunschild, Eric D., additional, Garrigues, Grant E., additional, Yanke, Adam B., additional, Forsythe, Brian, additional, Cole, Brian J., additional, and Verma, Nikhil N., additional

Published
2023
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40. Patient-reported outcomes measurement information system depression psychometrically underperforms compared to legacy measures and is poorly associated with postoperative functional outcomes in shoulder arthroplasty patients

Author

Huddleston, Hailey P, primary, Mehta, Nabil, additional, Lavoie-Gagne, Ophelie Z, additional, Maheshwer, Bhargavi, additional, Fu, Michael C, additional, Cole, Brian J, additional, Verma, Nikhil N, additional, Forsythe, Brian, additional, and Yanke, Adam B, additional

Published
2022
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45. Descriptive Characteristics and Outcomes of Patients Undergoing Revision Anterior Cruciate Ligament Reconstruction With and Without Tunnel Bone Grafting.

Author

MARS Group, MARS Group, DeFroda, Steven F, Owens, Brett D, Wright, Rick W, Huston, Laura J, Pennings, Jacquelyn S, Haas, Amanda K, Allen, Christina R, Cooper, Daniel E, DeBerardino, Thomas M, Dunn, Warren R, Lantz, Brett Brick A, Spindler, Kurt P, Stuart, Michael J, Albright, John P, Amendola, Annunziato Ned, Annunziata, Christopher C, Arciero, Robert A, Bach, Bernard R, Baker, Champ L, Bartolozzi, Arthur R, Baumgarten, Keith M, Bechler, Jeffery R, Berg, Jeffrey H, Bernas, Geoffrey A, Brockmeier, Stephen F, Brophy, Robert H, Bush-Joseph, Charles A, Butler, J Brad, Carey, James L, Carpenter, James E, Cole, Brian J, Cooper, Jonathan M, Cox, Charles L, Creighton, R Alexander, David, Tal S, Flanigan, David C, Frederick, Robert W, Ganley, Theodore J, Garofoli, Elizabeth A, Gatt, Charles J, Gecha, Steven R, Giffin, James Robert, Hame, Sharon L, Hannafin, Jo A, Harner, Christopher D, Harris, Norman Lindsay, Hechtman, Keith S, Hershman, Elliott B, Hoellrich, Rudolf G, Johnson, David C, Johnson, Timothy S, Jones, Morgan H, Kaeding, Christopher C, Kamath, Ganesh V, Klootwyk, Thomas E, Levy, Bruce A, Ma, C Benjamin, Maiers, G Peter, Marx, Robert G, Matava, Matthew J, Mathien, Gregory M, McAllister, David R, McCarty, Eric C, McCormack, Robert G, Miller, Bruce S, Nissen, Carl W, O'Neill, Daniel F, Parker, Richard D, Purnell, Mark L, Ramappa, Arun J, Rauh, Michael A, Rettig, Arthur C, Sekiya, Jon K, Shea, Kevin G, Sherman, Orrin H, Slauterbeck, James R, Smith, Matthew V, Spang, Jeffrey T, Svoboda, Steven J, Taft, Timothy N, Tenuta, Joachim J, Tingstad, Edwin M, Vidal, Armando F, Viskontas, Darius G, White, Richard A, Williams, James S, Wolcott, Michelle L, Wolf, Brian R, York, James J, MARS Group, MARS Group, DeFroda, Steven F, Owens, Brett D, Wright, Rick W, Huston, Laura J, Pennings, Jacquelyn S, Haas, Amanda K, Allen, Christina R, Cooper, Daniel E, DeBerardino, Thomas M, Dunn, Warren R, Lantz, Brett Brick A, Spindler, Kurt P, Stuart, Michael J, Albright, John P, Amendola, Annunziato Ned, Annunziata, Christopher C, Arciero, Robert A, Bach, Bernard R, Baker, Champ L, Bartolozzi, Arthur R, Baumgarten, Keith M, Bechler, Jeffery R, Berg, Jeffrey H, Bernas, Geoffrey A, Brockmeier, Stephen F, Brophy, Robert H, Bush-Joseph, Charles A, Butler, J Brad, Carey, James L, Carpenter, James E, Cole, Brian J, Cooper, Jonathan M, Cox, Charles L, Creighton, R Alexander, David, Tal S, Flanigan, David C, Frederick, Robert W, Ganley, Theodore J, Garofoli, Elizabeth A, Gatt, Charles J, Gecha, Steven R, Giffin, James Robert, Hame, Sharon L, Hannafin, Jo A, Harner, Christopher D, Harris, Norman Lindsay, Hechtman, Keith S, Hershman, Elliott B, Hoellrich, Rudolf G, Johnson, David C, Johnson, Timothy S, Jones, Morgan H, Kaeding, Christopher C, Kamath, Ganesh V, Klootwyk, Thomas E, Levy, Bruce A, Ma, C Benjamin, Maiers, G Peter, Marx, Robert G, Matava, Matthew J, Mathien, Gregory M, McAllister, David R, McCarty, Eric C, McCormack, Robert G, Miller, Bruce S, Nissen, Carl W, O'Neill, Daniel F, Parker, Richard D, Purnell, Mark L, Ramappa, Arun J, Rauh, Michael A, Rettig, Arthur C, Sekiya, Jon K, Shea, Kevin G, Sherman, Orrin H, Slauterbeck, James R, Smith, Matthew V, Spang, Jeffrey T, Svoboda, Steven J, Taft, Timothy N, Tenuta, Joachim J, Tingstad, Edwin M, Vidal, Armando F, Viskontas, Darius G, White, Richard A, Williams, James S, Wolcott, Michelle L, Wolf, Brian R, and York, James J

Abstract

BackgroundLytic or malpositioned tunnels may require bone grafting during revision anterior cruciate ligament reconstruction (rACLR) surgery. Patient characteristics and effects of grafting on outcomes after rACLR are not well described.PurposeTo describe preoperative characteristics, intraoperative findings, and 2-year outcomes for patients with rACLR undergoing bone grafting procedures compared with patients with rACLR without grafting.Study designCohort study; Level of evidence, 3.MethodsA total of 1234 patients who underwent rACLR were prospectively enrolled between 2006 and 2011. Baseline revision and 2-year characteristics, surgical technique, pathology, treatment, and patient-reported outcome instruments (International Knee Documentation Committee [IKDC], Knee injury and Osteoarthritis Outcome Score [KOOS], Western Ontario and McMaster Universities Osteoarthritis Index, and Marx Activity Rating Scale [Marx]) were collected, as well as subsequent surgery information, if applicable. The chi-square and analysis of variance tests were used to compare group characteristics.ResultsA total of 159 patients (13%) underwent tunnel grafting-64 (5%) patients underwent 1-stage and 95 (8%) underwent 2-stage grafting. Grafting was isolated to the femur in 31 (2.5%) patients, the tibia in 40 (3%) patients, and combined in 88 patients (7%). Baseline KOOS Quality of Life (QoL) and Marx activity scores were significantly lower in the 2-stage group compared with the no bone grafting group (P≤ .001). Patients who required 2-stage grafting had more previous ACLRs (P < .001) and were less likely to have received a bone-patellar tendon-bone or a soft tissue autograft at primary ACLR procedure (P≤ .021) compared with the no bone grafting group. For current rACLR, patients undergoing either 1-stage or 2-stage bone grafting were more likely to receive a bone-patellar tendon-bone allograft (P≤ .008) and less likely to receive a soft tissue autograft (P≤ .003) compared with the no bon

Published
2022

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