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Smoking and secondary ACL rupture are detrimental to knee health post ACL injury-a Bayesian analysis

Nicholls, Micah ; Ingvarsson, Thorvaldur LU ; Filbay, Stephanie ; Lohmander, Stefan LU orcid and Briem, Kristin (2023) In Journal of Experimental Orthopaedics 10. p.1-11
Abstract

PURPOSE: To identify potential prognostic factors for patient-reported outcomes in an Icelandic cohort of ACL injured subjects.

METHODS: All knee MRI reports written in Iceland between the years 2001 to 2011 were read to identify individuals with a possible ACL injury. These individuals were contacted and asked to complete an online questionnaire regarding their injury and current knee related health. The questionnaire collected information on years since surgery, injury circumstance, brace use, physiotherapy, ACL surgery, second ACL injury and current smoking status. In addition, the baseline status of their meniscii were assessed from the original MRI report and medical records were used to identify any subsequent, non-ACL... (More)

PURPOSE: To identify potential prognostic factors for patient-reported outcomes in an Icelandic cohort of ACL injured subjects.

METHODS: All knee MRI reports written in Iceland between the years 2001 to 2011 were read to identify individuals with a possible ACL injury. These individuals were contacted and asked to complete an online questionnaire regarding their injury and current knee related health. The questionnaire collected information on years since surgery, injury circumstance, brace use, physiotherapy, ACL surgery, second ACL injury and current smoking status. In addition, the baseline status of their meniscii were assessed from the original MRI report and medical records were used to identify any subsequent, non-ACL surgery. The patient-reported Knee Osteoarthritis and Injury Outcome Score (KOOS) was used assess current knee related health. A Bayesian proportional odds model was used to assess the effect of all potential prognostic factors above as well as age and sex on KOOS outcomes.

RESULTS: A total of 408 subjects completed the questionnaire indicating that they did rupture their ACL. The following variables were associated with worse outcomes across all KOOS subscales: having a subsequent arthroscopy, reinjury to your ACL, and smoking. Having physiotherapy for 9 months was associated with worse KOOS pain scores than having 6 months of physiotherapy. Conversely KOOS pain score tended to be higher if you injured your knee during sports.

CONCLUSION: Reinjuring your ACL, smoking and having subsequent (non-ACLR) surgery predict your knee related health following an ACL injury. Strategies should be implemented to reduce the risk of secondary ACL injury, and patients should be strongly advised not to smoke.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Experimental Orthopaedics
volume
10
article number
79
pages
1 - 11
publisher
Springer
external identifiers
  • scopus:85168278167
  • pmid:37556084
ISSN
2197-1153
DOI
10.1186/s40634-023-00638-4
language
English
LU publication?
yes
additional info
© 2023. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
id
6604a134-cfe3-4fa3-ae53-7688ae53e265
date added to LUP
2023-10-06 20:32:16
date last changed
2024-04-19 02:04:45
@article{6604a134-cfe3-4fa3-ae53-7688ae53e265,
  abstract     = {{<p>PURPOSE: To identify potential prognostic factors for patient-reported outcomes in an Icelandic cohort of ACL injured subjects.</p><p>METHODS: All knee MRI reports written in Iceland between the years 2001 to 2011 were read to identify individuals with a possible ACL injury. These individuals were contacted and asked to complete an online questionnaire regarding their injury and current knee related health. The questionnaire collected information on years since surgery, injury circumstance, brace use, physiotherapy, ACL surgery, second ACL injury and current smoking status. In addition, the baseline status of their meniscii were assessed from the original MRI report and medical records were used to identify any subsequent, non-ACL surgery. The patient-reported Knee Osteoarthritis and Injury Outcome Score (KOOS) was used assess current knee related health. A Bayesian proportional odds model was used to assess the effect of all potential prognostic factors above as well as age and sex on KOOS outcomes.</p><p>RESULTS: A total of 408 subjects completed the questionnaire indicating that they did rupture their ACL. The following variables were associated with worse outcomes across all KOOS subscales: having a subsequent arthroscopy, reinjury to your ACL, and smoking. Having physiotherapy for 9 months was associated with worse KOOS pain scores than having 6 months of physiotherapy. Conversely KOOS pain score tended to be higher if you injured your knee during sports.</p><p>CONCLUSION: Reinjuring your ACL, smoking and having subsequent (non-ACLR) surgery predict your knee related health following an ACL injury. Strategies should be implemented to reduce the risk of secondary ACL injury, and patients should be strongly advised not to smoke.</p>}},
  author       = {{Nicholls, Micah and Ingvarsson, Thorvaldur and Filbay, Stephanie and Lohmander, Stefan and Briem, Kristin}},
  issn         = {{2197-1153}},
  language     = {{eng}},
  month        = {{08}},
  pages        = {{1--11}},
  publisher    = {{Springer}},
  series       = {{Journal of Experimental Orthopaedics}},
  title        = {{Smoking and secondary ACL rupture are detrimental to knee health post ACL injury-a Bayesian analysis}},
  url          = {{http://dx.doi.org/10.1186/s40634-023-00638-4}},
  doi          = {{10.1186/s40634-023-00638-4}},
  volume       = {{10}},
  year         = {{2023}},
}