Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears
Purpose To assess the reliability and predictive value of quantifying anterior cruciate ligament (ACL) tear location on magnetic resonance imaging (MRI) and assess the predictive value of tear location on the eligibility for arthroscopic primary repair of proximal ACL tears. Methods In this case–con...
Ausführliche Beschreibung
Autor*in: |
Vermeijden, Harmen D. [verfasserIn] Cerniglia, Brett [verfasserIn] Mintz, Douglas N. [verfasserIn] Rademakers, Maarten V. [verfasserIn] Kerkhoffs, Gino M. M. J. [verfasserIn] van der List, Jelle P. [verfasserIn] DiFelice, Gregory S. [verfasserIn] |
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Format: |
E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2020 |
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Schlagwörter: |
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Anmerkung: |
© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020 |
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Übergeordnetes Werk: |
Enthalten in: Knee surgery, sports traumatology, arthroscopy - Berlin : Springer, 1993, 29(2020), 9 vom: 15. Okt., Seite 2967-2975 |
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Übergeordnetes Werk: |
volume:29 ; year:2020 ; number:9 ; day:15 ; month:10 ; pages:2967-2975 |
Links: |
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DOI / URN: |
10.1007/s00167-020-06312-x |
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Katalog-ID: |
SPR044904649 |
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245 | 1 | 0 | |a Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears |
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520 | |a Purpose To assess the reliability and predictive value of quantifying anterior cruciate ligament (ACL) tear location on magnetic resonance imaging (MRI) and assess the predictive value of tear location on the eligibility for arthroscopic primary repair of proximal ACL tears. Methods In this case–control study, all adult patients undergoing acute ACL surgery between 2008 and 2020 were retrospectively reviewed. All patients were treated with the treatment algorithm of undergoing primary repair when proximal tears with sufficient tissue quality were present intraoperatively, and otherwise underwent single-bundle ACL reconstruction. Sagittal MRI images were reviewed to measure proximal and distal remnant lengths along the anterior aspect of the torn ligament, and tear location was calculated as distal remnant divided by total remnant length. Interobserver and intraobserver reliability for remnant measurements were calculated. Then, receiver operating curve analysis (ROC) was performed to calculate the optimal cut-off for the possibility of primary repair with the different measurements. Results Two hundred and forty-eight patients were included, of which 151 underwent repair (61%). Inter- and intraobserver reliability ranged between 0.92 and 0.96 [95% confidence interval (CI) 0.55–0.98] and 0.91–0.97 (95% CI 0.78–0.98, respectively). All patients with a tear location of ≥ 80% on MRI could undergo repair, whereas all patients with tear location of < 60% required reconstruction. The positive predictive value of a proximal quarter tear (≥ 75%) on primary repair was 94%. Older age was correlated with more proximal tear location (p < 0.001), but there was no correlation between tear location and gender, BMI, or timing of surgery (all n.s). Conclusion This study showed that tear location could reliably be quantified on MRI by assessing distal and proximal remnant lengths. Tear location in the proximal quarter of the ACL was found to have a positive predictive value for repairability of 94%. These findings may assist orthopaedic surgeons in evaluating which patients are eligible for primary ACL repair preoperatively. Level of evidence III. | ||
650 | 4 | |a Anterior cruciate ligament |7 (dpeaa)DE-He213 | |
650 | 4 | |a Primary repair |7 (dpeaa)DE-He213 | |
650 | 4 | |a Magnetic resonance imaging |7 (dpeaa)DE-He213 | |
650 | 4 | |a Preoperative assessment |7 (dpeaa)DE-He213 | |
650 | 4 | |a ACL preservation |7 (dpeaa)DE-He213 | |
700 | 1 | |a Cerniglia, Brett |e verfasserin |4 aut | |
700 | 1 | |a Mintz, Douglas N. |e verfasserin |4 aut | |
700 | 1 | |a Rademakers, Maarten V. |e verfasserin |4 aut | |
700 | 1 | |a Kerkhoffs, Gino M. M. J. |e verfasserin |4 aut | |
700 | 1 | |a van der List, Jelle P. |e verfasserin |4 aut | |
700 | 1 | |a DiFelice, Gregory S. |e verfasserin |4 aut | |
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10.1007/s00167-020-06312-x doi (DE-627)SPR044904649 (SPR)s00167-020-06312-x-e DE-627 ger DE-627 rakwb eng 610 796 ASE 44.83 bkl 44.70 bkl Vermeijden, Harmen D. verfasserin aut Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020 Purpose To assess the reliability and predictive value of quantifying anterior cruciate ligament (ACL) tear location on magnetic resonance imaging (MRI) and assess the predictive value of tear location on the eligibility for arthroscopic primary repair of proximal ACL tears. Methods In this case–control study, all adult patients undergoing acute ACL surgery between 2008 and 2020 were retrospectively reviewed. All patients were treated with the treatment algorithm of undergoing primary repair when proximal tears with sufficient tissue quality were present intraoperatively, and otherwise underwent single-bundle ACL reconstruction. Sagittal MRI images were reviewed to measure proximal and distal remnant lengths along the anterior aspect of the torn ligament, and tear location was calculated as distal remnant divided by total remnant length. Interobserver and intraobserver reliability for remnant measurements were calculated. Then, receiver operating curve analysis (ROC) was performed to calculate the optimal cut-off for the possibility of primary repair with the different measurements. Results Two hundred and forty-eight patients were included, of which 151 underwent repair (61%). Inter- and intraobserver reliability ranged between 0.92 and 0.96 [95% confidence interval (CI) 0.55–0.98] and 0.91–0.97 (95% CI 0.78–0.98, respectively). All patients with a tear location of ≥ 80% on MRI could undergo repair, whereas all patients with tear location of < 60% required reconstruction. The positive predictive value of a proximal quarter tear (≥ 75%) on primary repair was 94%. Older age was correlated with more proximal tear location (p < 0.001), but there was no correlation between tear location and gender, BMI, or timing of surgery (all n.s). Conclusion This study showed that tear location could reliably be quantified on MRI by assessing distal and proximal remnant lengths. Tear location in the proximal quarter of the ACL was found to have a positive predictive value for repairability of 94%. These findings may assist orthopaedic surgeons in evaluating which patients are eligible for primary ACL repair preoperatively. Level of evidence III. Anterior cruciate ligament (dpeaa)DE-He213 Primary repair (dpeaa)DE-He213 Magnetic resonance imaging (dpeaa)DE-He213 Preoperative assessment (dpeaa)DE-He213 ACL preservation (dpeaa)DE-He213 Cerniglia, Brett verfasserin aut Mintz, Douglas N. verfasserin aut Rademakers, Maarten V. verfasserin aut Kerkhoffs, Gino M. M. J. verfasserin aut van der List, Jelle P. verfasserin aut DiFelice, Gregory S. verfasserin aut Enthalten in Knee surgery, sports traumatology, arthroscopy Berlin : Springer, 1993 29(2020), 9 vom: 15. Okt., Seite 2967-2975 (DE-627)268761787 (DE-600)1473170-8 1433-7347 nnns volume:29 year:2020 number:9 day:15 month:10 pages:2967-2975 https://dx.doi.org/10.1007/s00167-020-06312-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.83 ASE 44.70 ASE AR 29 2020 9 15 10 2967-2975 |
spelling |
10.1007/s00167-020-06312-x doi (DE-627)SPR044904649 (SPR)s00167-020-06312-x-e DE-627 ger DE-627 rakwb eng 610 796 ASE 44.83 bkl 44.70 bkl Vermeijden, Harmen D. verfasserin aut Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020 Purpose To assess the reliability and predictive value of quantifying anterior cruciate ligament (ACL) tear location on magnetic resonance imaging (MRI) and assess the predictive value of tear location on the eligibility for arthroscopic primary repair of proximal ACL tears. Methods In this case–control study, all adult patients undergoing acute ACL surgery between 2008 and 2020 were retrospectively reviewed. All patients were treated with the treatment algorithm of undergoing primary repair when proximal tears with sufficient tissue quality were present intraoperatively, and otherwise underwent single-bundle ACL reconstruction. Sagittal MRI images were reviewed to measure proximal and distal remnant lengths along the anterior aspect of the torn ligament, and tear location was calculated as distal remnant divided by total remnant length. Interobserver and intraobserver reliability for remnant measurements were calculated. Then, receiver operating curve analysis (ROC) was performed to calculate the optimal cut-off for the possibility of primary repair with the different measurements. Results Two hundred and forty-eight patients were included, of which 151 underwent repair (61%). Inter- and intraobserver reliability ranged between 0.92 and 0.96 [95% confidence interval (CI) 0.55–0.98] and 0.91–0.97 (95% CI 0.78–0.98, respectively). All patients with a tear location of ≥ 80% on MRI could undergo repair, whereas all patients with tear location of < 60% required reconstruction. The positive predictive value of a proximal quarter tear (≥ 75%) on primary repair was 94%. Older age was correlated with more proximal tear location (p < 0.001), but there was no correlation between tear location and gender, BMI, or timing of surgery (all n.s). Conclusion This study showed that tear location could reliably be quantified on MRI by assessing distal and proximal remnant lengths. Tear location in the proximal quarter of the ACL was found to have a positive predictive value for repairability of 94%. These findings may assist orthopaedic surgeons in evaluating which patients are eligible for primary ACL repair preoperatively. Level of evidence III. Anterior cruciate ligament (dpeaa)DE-He213 Primary repair (dpeaa)DE-He213 Magnetic resonance imaging (dpeaa)DE-He213 Preoperative assessment (dpeaa)DE-He213 ACL preservation (dpeaa)DE-He213 Cerniglia, Brett verfasserin aut Mintz, Douglas N. verfasserin aut Rademakers, Maarten V. verfasserin aut Kerkhoffs, Gino M. M. J. verfasserin aut van der List, Jelle P. verfasserin aut DiFelice, Gregory S. verfasserin aut Enthalten in Knee surgery, sports traumatology, arthroscopy Berlin : Springer, 1993 29(2020), 9 vom: 15. Okt., Seite 2967-2975 (DE-627)268761787 (DE-600)1473170-8 1433-7347 nnns volume:29 year:2020 number:9 day:15 month:10 pages:2967-2975 https://dx.doi.org/10.1007/s00167-020-06312-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.83 ASE 44.70 ASE AR 29 2020 9 15 10 2967-2975 |
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10.1007/s00167-020-06312-x doi (DE-627)SPR044904649 (SPR)s00167-020-06312-x-e DE-627 ger DE-627 rakwb eng 610 796 ASE 44.83 bkl 44.70 bkl Vermeijden, Harmen D. verfasserin aut Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020 Purpose To assess the reliability and predictive value of quantifying anterior cruciate ligament (ACL) tear location on magnetic resonance imaging (MRI) and assess the predictive value of tear location on the eligibility for arthroscopic primary repair of proximal ACL tears. Methods In this case–control study, all adult patients undergoing acute ACL surgery between 2008 and 2020 were retrospectively reviewed. All patients were treated with the treatment algorithm of undergoing primary repair when proximal tears with sufficient tissue quality were present intraoperatively, and otherwise underwent single-bundle ACL reconstruction. Sagittal MRI images were reviewed to measure proximal and distal remnant lengths along the anterior aspect of the torn ligament, and tear location was calculated as distal remnant divided by total remnant length. Interobserver and intraobserver reliability for remnant measurements were calculated. Then, receiver operating curve analysis (ROC) was performed to calculate the optimal cut-off for the possibility of primary repair with the different measurements. Results Two hundred and forty-eight patients were included, of which 151 underwent repair (61%). Inter- and intraobserver reliability ranged between 0.92 and 0.96 [95% confidence interval (CI) 0.55–0.98] and 0.91–0.97 (95% CI 0.78–0.98, respectively). All patients with a tear location of ≥ 80% on MRI could undergo repair, whereas all patients with tear location of < 60% required reconstruction. The positive predictive value of a proximal quarter tear (≥ 75%) on primary repair was 94%. Older age was correlated with more proximal tear location (p < 0.001), but there was no correlation between tear location and gender, BMI, or timing of surgery (all n.s). Conclusion This study showed that tear location could reliably be quantified on MRI by assessing distal and proximal remnant lengths. Tear location in the proximal quarter of the ACL was found to have a positive predictive value for repairability of 94%. These findings may assist orthopaedic surgeons in evaluating which patients are eligible for primary ACL repair preoperatively. Level of evidence III. Anterior cruciate ligament (dpeaa)DE-He213 Primary repair (dpeaa)DE-He213 Magnetic resonance imaging (dpeaa)DE-He213 Preoperative assessment (dpeaa)DE-He213 ACL preservation (dpeaa)DE-He213 Cerniglia, Brett verfasserin aut Mintz, Douglas N. verfasserin aut Rademakers, Maarten V. verfasserin aut Kerkhoffs, Gino M. M. J. verfasserin aut van der List, Jelle P. verfasserin aut DiFelice, Gregory S. verfasserin aut Enthalten in Knee surgery, sports traumatology, arthroscopy Berlin : Springer, 1993 29(2020), 9 vom: 15. Okt., Seite 2967-2975 (DE-627)268761787 (DE-600)1473170-8 1433-7347 nnns volume:29 year:2020 number:9 day:15 month:10 pages:2967-2975 https://dx.doi.org/10.1007/s00167-020-06312-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.83 ASE 44.70 ASE AR 29 2020 9 15 10 2967-2975 |
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10.1007/s00167-020-06312-x doi (DE-627)SPR044904649 (SPR)s00167-020-06312-x-e DE-627 ger DE-627 rakwb eng 610 796 ASE 44.83 bkl 44.70 bkl Vermeijden, Harmen D. verfasserin aut Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020 Purpose To assess the reliability and predictive value of quantifying anterior cruciate ligament (ACL) tear location on magnetic resonance imaging (MRI) and assess the predictive value of tear location on the eligibility for arthroscopic primary repair of proximal ACL tears. Methods In this case–control study, all adult patients undergoing acute ACL surgery between 2008 and 2020 were retrospectively reviewed. All patients were treated with the treatment algorithm of undergoing primary repair when proximal tears with sufficient tissue quality were present intraoperatively, and otherwise underwent single-bundle ACL reconstruction. Sagittal MRI images were reviewed to measure proximal and distal remnant lengths along the anterior aspect of the torn ligament, and tear location was calculated as distal remnant divided by total remnant length. Interobserver and intraobserver reliability for remnant measurements were calculated. Then, receiver operating curve analysis (ROC) was performed to calculate the optimal cut-off for the possibility of primary repair with the different measurements. Results Two hundred and forty-eight patients were included, of which 151 underwent repair (61%). Inter- and intraobserver reliability ranged between 0.92 and 0.96 [95% confidence interval (CI) 0.55–0.98] and 0.91–0.97 (95% CI 0.78–0.98, respectively). All patients with a tear location of ≥ 80% on MRI could undergo repair, whereas all patients with tear location of < 60% required reconstruction. The positive predictive value of a proximal quarter tear (≥ 75%) on primary repair was 94%. Older age was correlated with more proximal tear location (p < 0.001), but there was no correlation between tear location and gender, BMI, or timing of surgery (all n.s). Conclusion This study showed that tear location could reliably be quantified on MRI by assessing distal and proximal remnant lengths. Tear location in the proximal quarter of the ACL was found to have a positive predictive value for repairability of 94%. These findings may assist orthopaedic surgeons in evaluating which patients are eligible for primary ACL repair preoperatively. Level of evidence III. Anterior cruciate ligament (dpeaa)DE-He213 Primary repair (dpeaa)DE-He213 Magnetic resonance imaging (dpeaa)DE-He213 Preoperative assessment (dpeaa)DE-He213 ACL preservation (dpeaa)DE-He213 Cerniglia, Brett verfasserin aut Mintz, Douglas N. verfasserin aut Rademakers, Maarten V. verfasserin aut Kerkhoffs, Gino M. M. J. verfasserin aut van der List, Jelle P. verfasserin aut DiFelice, Gregory S. verfasserin aut Enthalten in Knee surgery, sports traumatology, arthroscopy Berlin : Springer, 1993 29(2020), 9 vom: 15. Okt., Seite 2967-2975 (DE-627)268761787 (DE-600)1473170-8 1433-7347 nnns volume:29 year:2020 number:9 day:15 month:10 pages:2967-2975 https://dx.doi.org/10.1007/s00167-020-06312-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.83 ASE 44.70 ASE AR 29 2020 9 15 10 2967-2975 |
allfieldsSound |
10.1007/s00167-020-06312-x doi (DE-627)SPR044904649 (SPR)s00167-020-06312-x-e DE-627 ger DE-627 rakwb eng 610 796 ASE 44.83 bkl 44.70 bkl Vermeijden, Harmen D. verfasserin aut Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020 Purpose To assess the reliability and predictive value of quantifying anterior cruciate ligament (ACL) tear location on magnetic resonance imaging (MRI) and assess the predictive value of tear location on the eligibility for arthroscopic primary repair of proximal ACL tears. Methods In this case–control study, all adult patients undergoing acute ACL surgery between 2008 and 2020 were retrospectively reviewed. All patients were treated with the treatment algorithm of undergoing primary repair when proximal tears with sufficient tissue quality were present intraoperatively, and otherwise underwent single-bundle ACL reconstruction. Sagittal MRI images were reviewed to measure proximal and distal remnant lengths along the anterior aspect of the torn ligament, and tear location was calculated as distal remnant divided by total remnant length. Interobserver and intraobserver reliability for remnant measurements were calculated. Then, receiver operating curve analysis (ROC) was performed to calculate the optimal cut-off for the possibility of primary repair with the different measurements. Results Two hundred and forty-eight patients were included, of which 151 underwent repair (61%). Inter- and intraobserver reliability ranged between 0.92 and 0.96 [95% confidence interval (CI) 0.55–0.98] and 0.91–0.97 (95% CI 0.78–0.98, respectively). All patients with a tear location of ≥ 80% on MRI could undergo repair, whereas all patients with tear location of < 60% required reconstruction. The positive predictive value of a proximal quarter tear (≥ 75%) on primary repair was 94%. Older age was correlated with more proximal tear location (p < 0.001), but there was no correlation between tear location and gender, BMI, or timing of surgery (all n.s). Conclusion This study showed that tear location could reliably be quantified on MRI by assessing distal and proximal remnant lengths. Tear location in the proximal quarter of the ACL was found to have a positive predictive value for repairability of 94%. These findings may assist orthopaedic surgeons in evaluating which patients are eligible for primary ACL repair preoperatively. Level of evidence III. Anterior cruciate ligament (dpeaa)DE-He213 Primary repair (dpeaa)DE-He213 Magnetic resonance imaging (dpeaa)DE-He213 Preoperative assessment (dpeaa)DE-He213 ACL preservation (dpeaa)DE-He213 Cerniglia, Brett verfasserin aut Mintz, Douglas N. verfasserin aut Rademakers, Maarten V. verfasserin aut Kerkhoffs, Gino M. M. J. verfasserin aut van der List, Jelle P. verfasserin aut DiFelice, Gregory S. verfasserin aut Enthalten in Knee surgery, sports traumatology, arthroscopy Berlin : Springer, 1993 29(2020), 9 vom: 15. Okt., Seite 2967-2975 (DE-627)268761787 (DE-600)1473170-8 1433-7347 nnns volume:29 year:2020 number:9 day:15 month:10 pages:2967-2975 https://dx.doi.org/10.1007/s00167-020-06312-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.83 ASE 44.70 ASE AR 29 2020 9 15 10 2967-2975 |
language |
English |
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Enthalten in Knee surgery, sports traumatology, arthroscopy 29(2020), 9 vom: 15. Okt., Seite 2967-2975 volume:29 year:2020 number:9 day:15 month:10 pages:2967-2975 |
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Enthalten in Knee surgery, sports traumatology, arthroscopy 29(2020), 9 vom: 15. Okt., Seite 2967-2975 volume:29 year:2020 number:9 day:15 month:10 pages:2967-2975 |
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Anterior cruciate ligament Primary repair Magnetic resonance imaging Preoperative assessment ACL preservation |
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Knee surgery, sports traumatology, arthroscopy |
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Vermeijden, Harmen D. @@aut@@ Cerniglia, Brett @@aut@@ Mintz, Douglas N. @@aut@@ Rademakers, Maarten V. @@aut@@ Kerkhoffs, Gino M. M. J. @@aut@@ van der List, Jelle P. @@aut@@ DiFelice, Gregory S. @@aut@@ |
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Methods In this case–control study, all adult patients undergoing acute ACL surgery between 2008 and 2020 were retrospectively reviewed. All patients were treated with the treatment algorithm of undergoing primary repair when proximal tears with sufficient tissue quality were present intraoperatively, and otherwise underwent single-bundle ACL reconstruction. Sagittal MRI images were reviewed to measure proximal and distal remnant lengths along the anterior aspect of the torn ligament, and tear location was calculated as distal remnant divided by total remnant length. Interobserver and intraobserver reliability for remnant measurements were calculated. Then, receiver operating curve analysis (ROC) was performed to calculate the optimal cut-off for the possibility of primary repair with the different measurements. Results Two hundred and forty-eight patients were included, of which 151 underwent repair (61%). Inter- and intraobserver reliability ranged between 0.92 and 0.96 [95% confidence interval (CI) 0.55–0.98] and 0.91–0.97 (95% CI 0.78–0.98, respectively). All patients with a tear location of ≥ 80% on MRI could undergo repair, whereas all patients with tear location of < 60% required reconstruction. The positive predictive value of a proximal quarter tear (≥ 75%) on primary repair was 94%. Older age was correlated with more proximal tear location (p < 0.001), but there was no correlation between tear location and gender, BMI, or timing of surgery (all n.s). Conclusion This study showed that tear location could reliably be quantified on MRI by assessing distal and proximal remnant lengths. Tear location in the proximal quarter of the ACL was found to have a positive predictive value for repairability of 94%. These findings may assist orthopaedic surgeons in evaluating which patients are eligible for primary ACL repair preoperatively. 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author |
Vermeijden, Harmen D. |
spellingShingle |
Vermeijden, Harmen D. ddc 610 bkl 44.83 bkl 44.70 misc Anterior cruciate ligament misc Primary repair misc Magnetic resonance imaging misc Preoperative assessment misc ACL preservation Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears |
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610 796 ASE 44.83 bkl 44.70 bkl Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears Anterior cruciate ligament (dpeaa)DE-He213 Primary repair (dpeaa)DE-He213 Magnetic resonance imaging (dpeaa)DE-He213 Preoperative assessment (dpeaa)DE-He213 ACL preservation (dpeaa)DE-He213 |
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ddc 610 bkl 44.83 bkl 44.70 misc Anterior cruciate ligament misc Primary repair misc Magnetic resonance imaging misc Preoperative assessment misc ACL preservation |
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ddc 610 bkl 44.83 bkl 44.70 misc Anterior cruciate ligament misc Primary repair misc Magnetic resonance imaging misc Preoperative assessment misc ACL preservation |
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Knee surgery, sports traumatology, arthroscopy |
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Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears |
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Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears |
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Vermeijden, Harmen D. |
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Knee surgery, sports traumatology, arthroscopy |
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Knee surgery, sports traumatology, arthroscopy |
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Vermeijden, Harmen D. Cerniglia, Brett Mintz, Douglas N. Rademakers, Maarten V. Kerkhoffs, Gino M. M. J. van der List, Jelle P. DiFelice, Gregory S. |
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10.1007/s00167-020-06312-x |
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distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears |
title_auth |
Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears |
abstract |
Purpose To assess the reliability and predictive value of quantifying anterior cruciate ligament (ACL) tear location on magnetic resonance imaging (MRI) and assess the predictive value of tear location on the eligibility for arthroscopic primary repair of proximal ACL tears. Methods In this case–control study, all adult patients undergoing acute ACL surgery between 2008 and 2020 were retrospectively reviewed. All patients were treated with the treatment algorithm of undergoing primary repair when proximal tears with sufficient tissue quality were present intraoperatively, and otherwise underwent single-bundle ACL reconstruction. Sagittal MRI images were reviewed to measure proximal and distal remnant lengths along the anterior aspect of the torn ligament, and tear location was calculated as distal remnant divided by total remnant length. Interobserver and intraobserver reliability for remnant measurements were calculated. Then, receiver operating curve analysis (ROC) was performed to calculate the optimal cut-off for the possibility of primary repair with the different measurements. Results Two hundred and forty-eight patients were included, of which 151 underwent repair (61%). Inter- and intraobserver reliability ranged between 0.92 and 0.96 [95% confidence interval (CI) 0.55–0.98] and 0.91–0.97 (95% CI 0.78–0.98, respectively). All patients with a tear location of ≥ 80% on MRI could undergo repair, whereas all patients with tear location of < 60% required reconstruction. The positive predictive value of a proximal quarter tear (≥ 75%) on primary repair was 94%. Older age was correlated with more proximal tear location (p < 0.001), but there was no correlation between tear location and gender, BMI, or timing of surgery (all n.s). Conclusion This study showed that tear location could reliably be quantified on MRI by assessing distal and proximal remnant lengths. Tear location in the proximal quarter of the ACL was found to have a positive predictive value for repairability of 94%. These findings may assist orthopaedic surgeons in evaluating which patients are eligible for primary ACL repair preoperatively. Level of evidence III. © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020 |
abstractGer |
Purpose To assess the reliability and predictive value of quantifying anterior cruciate ligament (ACL) tear location on magnetic resonance imaging (MRI) and assess the predictive value of tear location on the eligibility for arthroscopic primary repair of proximal ACL tears. Methods In this case–control study, all adult patients undergoing acute ACL surgery between 2008 and 2020 were retrospectively reviewed. All patients were treated with the treatment algorithm of undergoing primary repair when proximal tears with sufficient tissue quality were present intraoperatively, and otherwise underwent single-bundle ACL reconstruction. Sagittal MRI images were reviewed to measure proximal and distal remnant lengths along the anterior aspect of the torn ligament, and tear location was calculated as distal remnant divided by total remnant length. Interobserver and intraobserver reliability for remnant measurements were calculated. Then, receiver operating curve analysis (ROC) was performed to calculate the optimal cut-off for the possibility of primary repair with the different measurements. Results Two hundred and forty-eight patients were included, of which 151 underwent repair (61%). Inter- and intraobserver reliability ranged between 0.92 and 0.96 [95% confidence interval (CI) 0.55–0.98] and 0.91–0.97 (95% CI 0.78–0.98, respectively). All patients with a tear location of ≥ 80% on MRI could undergo repair, whereas all patients with tear location of < 60% required reconstruction. The positive predictive value of a proximal quarter tear (≥ 75%) on primary repair was 94%. Older age was correlated with more proximal tear location (p < 0.001), but there was no correlation between tear location and gender, BMI, or timing of surgery (all n.s). Conclusion This study showed that tear location could reliably be quantified on MRI by assessing distal and proximal remnant lengths. Tear location in the proximal quarter of the ACL was found to have a positive predictive value for repairability of 94%. These findings may assist orthopaedic surgeons in evaluating which patients are eligible for primary ACL repair preoperatively. Level of evidence III. © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020 |
abstract_unstemmed |
Purpose To assess the reliability and predictive value of quantifying anterior cruciate ligament (ACL) tear location on magnetic resonance imaging (MRI) and assess the predictive value of tear location on the eligibility for arthroscopic primary repair of proximal ACL tears. Methods In this case–control study, all adult patients undergoing acute ACL surgery between 2008 and 2020 were retrospectively reviewed. All patients were treated with the treatment algorithm of undergoing primary repair when proximal tears with sufficient tissue quality were present intraoperatively, and otherwise underwent single-bundle ACL reconstruction. Sagittal MRI images were reviewed to measure proximal and distal remnant lengths along the anterior aspect of the torn ligament, and tear location was calculated as distal remnant divided by total remnant length. Interobserver and intraobserver reliability for remnant measurements were calculated. Then, receiver operating curve analysis (ROC) was performed to calculate the optimal cut-off for the possibility of primary repair with the different measurements. Results Two hundred and forty-eight patients were included, of which 151 underwent repair (61%). Inter- and intraobserver reliability ranged between 0.92 and 0.96 [95% confidence interval (CI) 0.55–0.98] and 0.91–0.97 (95% CI 0.78–0.98, respectively). All patients with a tear location of ≥ 80% on MRI could undergo repair, whereas all patients with tear location of < 60% required reconstruction. The positive predictive value of a proximal quarter tear (≥ 75%) on primary repair was 94%. Older age was correlated with more proximal tear location (p < 0.001), but there was no correlation between tear location and gender, BMI, or timing of surgery (all n.s). Conclusion This study showed that tear location could reliably be quantified on MRI by assessing distal and proximal remnant lengths. Tear location in the proximal quarter of the ACL was found to have a positive predictive value for repairability of 94%. These findings may assist orthopaedic surgeons in evaluating which patients are eligible for primary ACL repair preoperatively. Level of evidence III. © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020 |
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title_short |
Distal remnant length can be measured reliably and predicts primary repair of proximal anterior cruciate ligament tears |
url |
https://dx.doi.org/10.1007/s00167-020-06312-x |
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Cerniglia, Brett Mintz, Douglas N. Rademakers, Maarten V. Kerkhoffs, Gino M. M. J. van der List, Jelle P. DiFelice, Gregory S. |
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Cerniglia, Brett Mintz, Douglas N. Rademakers, Maarten V. Kerkhoffs, Gino M. M. J. van der List, Jelle P. DiFelice, Gregory S. |
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268761787 |
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doi_str |
10.1007/s00167-020-06312-x |
up_date |
2024-07-04T02:45:35.228Z |
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score |
7.3995256 |