Variable | Total (n=22 928) | Only one ACLR (n=21 748) | One revision ACLR (n=1144) | Multiple revision ACLR (n=36) | P value | Test between groups p value | ||
Only one ACLR vs one revision ACLR | Only one ACLR vs more than one revision ACLR | One revision ACLR vs more than one revision ACLR | ||||||
Age at the time of surgery (years) | 28.7±10.6 26 (16–74) | 29.1±10.7 26 (16–74) | 22.9±7.6 20 (16–56) | 22.6±7.2 20.5 (16–44) | <0.0001 | 0.0020 | 0.0020 | 0.86 |
Sex (male) | 12 055 (52.6) | 11 429 (52.6) | 604 (52.8) | 22 (61.1) | 0.58 | |||
BMI (kg/m2) | 24.7±3.3 24.2 (15.1–49.8) | 24.7±3.3 24.2 (15.1–49.8) | 24.5±3.1 24.2 (17.6; 37.6) | 24.7±3.2 23.5 (19.6–34) | 0.42 | |||
Time from index ACLR to first revision (years) | 3.25±2.49 2.39 (0.02–14.44) | 3.27±2.51 2.44 (0.02–14.44) | 2.34±1.63 1.75 (0.77–6.54) | 0.032 | ||||
Time from index ACLR to last revision (years) | 3.35±2.57 2.53 (0–14.44) | 3.26±2.51 2.43 (0–14.44) | 6.07±2.99 5.75 (0.97–13.33) | <0.0001 | ||||
Time from injury to index surgery (months) | 20.4±36.6 8.3 (0–551) | 20.9±37.3 8.5 (0–551) | 11.3±18.6 5.7 (0–242.7) | 16.6±38.2 5 (1–167.3) | <0.0001 | 0.0020 | 0.63 | 0.14 |
ACL graft (yes) | ||||||||
Patellar tendon autograft | 1276 (5.6) | 1214 (5.6) | 62 (5.5) | 0 | ||||
Semitendinosus autograft | 20 898 (92.2) | 19 821 (92.2) | 1041 (92.5) | 36 (100.0) | ||||
Quadriceps tendon autograft | 354 (1.6) | 338 (1.6) | 16 (1.4) | 0 | ||||
Allograft | 82 (0.4) | 77 (0.4) | 5 (0.4) | 0 | ||||
Direct suture/synthetic/other | 44 (0.2) | 42 (0.2) | 2 (0.2) | 0 | 0.90 | |||
Meniscus injury (yes) | ||||||||
Lateral meniscus | 5557 (24.2) | 5239 (24.1) | 313 (27.4) | 5 (13.9) | 0.015 | 0.014 | 0.21 | 0.097 |
Medial meniscus | 6026 (26.3) | 5783 (26.6) | 236 (20.6) | 7 (19.4) | <0.0001 | <0.0001 | 0.44 | 1.00 |
Cartilage injury (yes) | ||||||||
Lateral femoral condyle | 1257 (5.5) | 1208 (5.6) | 48 (4.2) | 1 (2.8) | 0.11 | 0.051 | 0.80 | 1.00 |
Medial femoral condyle | 4216 (18.4) | 4050 (18.6) | 160 (14.0) | 6 (16.7) | 0.0004 | <0.0001 | 0.97 | 0.79 |
Lateral patella | 687 (3.0) | 669 (3.1) | 18 (1.6) | 0 | 0.0084 | 0.0024 | 0.65 | 1.00 |
Medial patella | 1190 (5.2) | 1149 (5.3) | 41 (3.6) | 0 | 0.015 | 0.010 | 0.28 | 0.55 |
Lateral tibial plateau | 1461 (6.4) | 1412 (6.5) | 49 (4.3) | 0 | 0.0034 | 0.0022 | 0.18 | 0.42 |
Medial tibial plateau | 1217 (5.3) | 1181 (5.4) | 34 (3.0) | 2 (5.6) | 0.0014 | 0.0001 | 1.00 | 0.60 |
Trochlea | 721 (3.1) | 699 (3.2) | 22 (1.9) | 0 | 0.028 | 0.013 | 0.62 | 1.00 |
Collateral ligament injury (yes) | ||||||||
MCL | 963 (4.2) | 913 (4.2) | 47 (4.1) | 3 (8.3) | 0.46 | |||
LCL | 232 (1.0) | 225 (1.0) | 7 (0.6) | 0 | 0.32 | |||
PLC injury (yes) | 51 (0.2) | 48 (0.2) | 3 (0.3) | 0 | 0.92 | |||
Activity at the time of injury (yes) | ||||||||
Alpine/skiing | 3798 (16.6) | 3693 (17.0) | 103 (9.0) | 2 (5.6) | ||||
Pivoting sport | 14 565 (63.6) | 13 638 (62.8) | 900 (78.7) | 27 (75.0) | ||||
Non-pivoting sport | 991 (4.3) | 954 (4.4) | 36 (3.1) | 1 (2.8) | ||||
Other physical activity | 986 (4.3) | 953 (4.4) | 33 (2.9) | 0 | ||||
Traffic-related | 409 (1.8) | 396 (1.8) | 11 (1.0) | 2 (5.6) | ||||
Other | 2135 (9.3) | 2071 (9.5) | 60 (5.2) | 4 (11.1) | <0.0001 | <0.0001 | 0.14 | 0.063 |
Tibial fixation (yes) | ||||||||
Interference screw | 14 545 (63.4) | 13 802 (63.5) | 719 (62.8) | 24 (66.7) | ||||
Intratunnel fixation | 473 (2.1) | 457 (2.1) | 16 (1.4) | 0 | ||||
Suture post | 5053 (22.0) | 4780 (22.0) | 265 (23.2) | 8 (22.2) | ||||
Retroscrew | 280 (1.2) | 253 (1.2) | 25 (2.2) | 2 (5.6) | ||||
Fixed suspensory fixation | 22 (0.1) | 21 (0.1) | 1 (0.1) | 0 | ||||
Adjustable suspensory fixation | 2555 (11.1) | 2435 (11.2) | 118 (10.3) | 2 (5.6) | 0.022 | 0.019 | 0.17 | 0.68 |
Femoral fixation (yes) | ||||||||
Fixed suspensory fixation | 9644 (42.1) | 9099 (41.8) | 531 (46.4) | 14 (38.9) | ||||
Intratunnel fixation | 3817 (16.6) | 3646 (16.8) | 164 (14.3) | 7 (19.4) | ||||
Interference screw | 3219 (14.0) | 3014 (13.9) | 194 (17.0) | 11 (30.6) | ||||
Adjustable suspensory fixation | 6248 (27.3) | 5989 (27.5) | 255 (22.3) | 4 (11.1) | <0.0001 | <0.0001 | 0.012 | 0.080 |
Follow-up time after most recent surgery (years) | 9.19±4.07 9.2 (1.21–17.14) | 9.32±4.06 9.34 (2.2–17.14) | 6.73±3.51 6.44 (1.21–17.05) | 5.62±2.69 4.99 (2.35–14.04) | <0.0001 | 0.0020 | 0.0020 | 0.066 |
Values are given as n (%) and mean±SD or median (minimum–maximum) for categorical and continuous as well as ordinal variables, respectively. The sums may vary because of missing values. The variables with missing values, n (%) of the total sample were BMI 7900 (34.2), time from injury to surgery 618 (2.7) and activity at the time of injury 44 (0.2).
Pivoting sport (American football/rugby, basketball, dancing, floorball, gymnastics, handball, ice hockey/bandy, martial arts, racket sports, soccer, volleyball, wrestling); non-pivoting sport (cross-country skiing, cycling, horseback riding, motocross/endure, skateboarding, snowboarding and surfing/wakeboarding); alpine/skiing; other physical activity (other recreational sport, exercise, trampoline); traffic related; and other (other outdoor activity and work). Tibial fixation devices were divided into six different subcategories: (1) interference screw (metal screw, metal screw with backup staple fixation, resorbable screw, resorbable screw with backup post fixation, metal screw with backup osteosuture, intrafix); (2) intratunnel fixation (rigidfix); (3) suture post (AO screw, suture washer); (4) retroscrew; (5) fixed suspensory fixation (retrobutton); (6) adjustable suspensory fixation (tightrope). Femoral fixation devices were also divided into four different subcategories: (1) fixed suspensory fixation (endobutton, retrobutton, ezloc); (2) intratunnel fixation (rigidfix, transfix); (3) interference screw (metal screw); (4) adjustable suspensory fixation (toggleloc, ultrabutton).
signficant p value are in bold.
ACL, anterior cruciate ligament; ACLR, anterior cruciate ligament reconstruction; BMI, body mass index; LCL, lateral collateral ligament; LM, lateral meniscus; MCL, medial collateral ligament; PLC, posterior lateral corner.