Prognosis and Predictors of ACL Reconstruction: A Multicenter Cohort Study

ACL 重建的预后和预测因素：多中心队列研究

• 批准号: 9146271
• 负责人: Kurt Paul Spindler
• 金额: $ 63.87万
• 依托单位: CLEVELAND CLINIC LERNER COM-CWRU
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-25 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9146271
• 关键词: Age; Allografting; Anterior Cruciate Ligament; Arthroscopic Surgical Procedures; Basic Science; Caring; Cartilage; Cartilage injury; Characteristics; Clinical; Clinical Research; Clinical assessments; Cohort Studies; Contralateral; Data; Decision Making; Degenerative polyarthritis; Documentation; Enrollment; Evaluation; Excision; Failure; Funding; Future; Gender; Grant; Health; Image; Incidence; Individual; Infection; Inferior; Injury; International; Joints; Knee; Knee Injuries; Knee Osteoarthritis; Knowledge; Lead; Life Style; Longitudinal Studies; Measurement; Measures; Meniscus structure of joint; Modeling; Operative Surgical Procedures; Orthopedics; Outcome; Pain; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Physical activity; Physicians; Policy Maker; Population; Prevention; Procedures; Prospective Studies; Qualifying; Quality of life; Questionnaires; Reporting; Research; Risk; Risk Factors; Sample Size; Schedule; Severities; Signs and Symptoms; Smoking Status; Source; Sports; Surgeon; Symptoms; Techniques; Testing; Time; Work; anterior cruciate ligament reconstruction; anterior cruciate ligament rupture; articular cartilage; clinical predictors; cohort; design; disability; follow-up; graft failure; improved; improved outcome; individual patient; instrument; ligament injury; modifiable risk; outcome forecast; patient population; predictive modeling; prospective; sex; standard of care

 DESCRIPTION (provided by applicant): Injury to the anterior cruciate ligament (ACL) results in a threat to an active lifestyle and exposes the patient to risk of early osteoarthritis. ACL reconstruction is typically chosen by individuals to allow a return to their previous work and sports activities. The results of primary ACL reconstruction have in general been good at restoring functional stability, but patients' long-term outcome remains unknown. The Multicenter Orthopaedic Outcomes Network (MOON) is an established consortium designed to enroll and longitudinally follow a multicenter cohort of ACL reconstructed patients to determine the modifiable predictors (or risk factors) of long-term outcomes of ACL reconstruction in order to establish patient-specific predictive models of clinically important outcomes. The objective of this prospective multicenter cohort of ACL reconstructions is to identify both the long-term prognosis and the potentially modifiable predictors of symptoms of osteoarthritis (OA), sports function, activity and general health through validated patient- reported outcomes, and incidence of ACL reconstruction graft and/or contralateral ACL failures. Our previous grants (R01 AR053684) have allowed us to enroll 3,547 patients and obtain both 2 and 6 year follow-up on this cohort. At both time points, we have been able to obtain a minimum of 84% follow-up using validated patient-reported outcome questionnaires and 93% via phone follow-up. In addition, a nested cohort or 317 ACL reconstructed patients returned onsite after 2 years for a comprehensive clinical assessment, specialized radiologic measurements, along with completing their patient-reported outcomes. The objective of this grant is to longitudinally follow these two cohorts at 10 years utilizing the same validated outcome measurements as well as following incidence of clinical graft and/or contralateral ACL failure. Further, nested cohort will help determine the predictors of and the correlates from clinical assessment with both the symptoms and signs of OA and validated outcomes (in terms of sports function, activity, and general health). This grant focuses on the predictors for ACL reconstruction outcome at 10 year follow-up, and will be accomplished by three Specific Aims. Aim 1 will identify the risk factors or predictors of return to sports function, physical activity level, and patient-reported quality of lfe. Specific Aim 2 will identify those risk factors or predictors measured at the time of the ACL reconstruction associated with symptoms of early osteoarthritis at 10 years post-surgery. Specific Aim 3 will identify incidence of additional surgery and graft failure performed on patient following ACL reconstruction. Once the risk factors or predictors for worse outcomes are identified, surgeons can be educated in potential modifiable variables to improve the outcome.

 描述（由适用提供）：前交叉韧带（ACL）受伤会对积极的生活方式造成威胁，并使患者暴露于早期骨关节炎的风险。 ACL重建通常由个人选择，以允许返回以前的工作和体育活动。通常，原发性ACL重建的结果通常擅长恢复功能稳定性，但患者的长期结局仍然未知。多中心骨科结局网络（月球）是一个已建立的财团，旨在招募和纵向遵循ACL重建患者的多中心队列，以确定ACL重建的长期预测因素（或风险因素）的ACL重建的可修改预测因素（或风险因素），以建立具有临床上重要意见的患者预测模型。 ACL重建的这种前瞻性多中心队列的目的是确定长期的预后和可能修改的骨关节炎症状（OA），运动功能，活动和一般健康的预测因素，通过经过验证的患者报告的结果，以及ACL培养结构移植物和/或相反的ACL ACL ACL ACL失败。我们以前的补助金（R01 AR053684）允许我们注册3,547名患者，并在此队列上同时获得2年和6年的随访。在这两个时间点上，我们都可以使用经过验证的患者报告的结果问卷和93％的随访获得至少84％的随访。此外，嵌套队列或317例ACL重建患者在2年后现场返回，以进行全面的临床评估，专门的放射学测量，并完成其患者报告的结果。这笔赠款的目的是纵向遵循 使用相同的验证结果测量以及临床移植和/或对侧ACL失败的事件，这两个队列在10年时进行了。此外，嵌套的队列将 帮助确定临床评估的预测因素和相关性以及OA的症状和迹象以及经过验证的结果（就运动功能，活动和一般健康而言）。该赠款重点介绍了10年随访的ACL重建结果的预测指标，并将通过三个特定目标来实现。 AIM 1将确定风险因素或 恢复运动功能，体育活动水平和患者报告的LFE质量的预测因素。具体目标2将确定在ACL重建时与早期骨关节炎症状相关的ACL重建时测量的危险因素或预测因素。特定的目标3将确定ACL重建后对患者进行的其他手术和移植失败的发生率。一旦确定了恶劣结果的危险因素或预测因素，就可以通过潜在的可修改变量来教育外科医生，以改善结果。