Descriptive epidemiology of the multicenter ACL revision study (MARS) cohort

Rick W. Wright; Laura J. Huston; Kurt P. Spindler; Warren R. Dunn; Amanda K. Haas; Christina R. Allen; Daniel E. Cooper; Thomas M. DeBerardino; Brett A. Lantz; Barton J. Mann; Michael J. Stuart; J. P. Albright; A. N. Amendola; A. F. Anderson; J. T. Andrish; C. C. Annunziata; R. A. Arciero; B. R. Bach; C. L. Baker; A. R. Bartolozzi; K. M. Baumgarten; J. R. Bechler; J. H. Berg; G. A. Bernas; S. F. Brockmeier; R. H. Brophy; C. A. Bush-Joseph; J. B. Butler; J. D. Campbell; J. L. Carey; J. E. Carpenter; B. J. Cole; J. M. Cooper; C. L. Cox; R. A. Creighton; D. L. Dahm; T. S. David; D. C. Flanigan; R. W. Frederick; C. J. Gatt; S. R. Gecha; J. R. Giffin; D. B. Goodfellow; S. L. Hame; J. A. Hannafin; C. D. Harner; N. L. Harris; K. S. Hechtman; E. B. Hershman; R. G. Hoellrich; T. M. Hosea; D. C. Johnson; T. S. Johnson; M. H. Jones; C. C. Kaeding; T. E. Klootwyk; B. A. Levy; C. B. Ma; G. P. Maiers; R. G. Marx; M. J. Matava; G. M. Mathien; D. R. McAllister; E. C. McCarty; R. G. McCormack; B. S. Miller; A. R. Motamedi; C. W. Nissen; D. F. O'Neil; R. D. Parker; M. L. Purnell; A. J. Ramappa; M. A. Rauh; A. Rettig; J. K. Sekiya; K. G. Shea; O. H. Sherman; J. R. Slauterbeck; M. V. Smith; S. J. Svoboda; T. N. Taft; J. J. Tenuta; E. M. Tingstad; A. F. Vidal; D. G. Viskontas; R. A. White; J. S. Williams; M. L. Wolcott; B. R. Wolf; J. J. York

doi:10.1177/0363546510378645

Descriptive epidemiology of the multicenter ACL revision study (MARS) cohort

Rick W. Wright, Laura J. Huston, Kurt P. Spindler, Warren R. Dunn, Amanda K. Haas, Christina R. Allen, Daniel E. Cooper, Thomas M. DeBerardino, Brett A. Lantz, Barton J. Mann, Michael J. Stuart, J. P. Albright, A. N. Amendola, A. F. Anderson, J. T. Andrish, C. C. Annunziata, R. A. Arciero, B. R. Bach, C. L. Baker, A. R. BartolozziK. M. Baumgarten, J. R. Bechler, J. H. Berg, G. A. Bernas, S. F. Brockmeier, R. H. Brophy, C. A. Bush-Joseph, J. B. Butler, J. D. Campbell, J. L. Carey, J. E. Carpenter, B. J. Cole, J. M. Cooper, C. L. Cox, R. A. Creighton, D. L. Dahm, T. S. David, D. C. Flanigan, R. W. Frederick, C. J. Gatt, S. R. Gecha, J. R. Giffin, D. B. Goodfellow, S. L. Hame, J. A. Hannafin, C. D. Harner, N. L. Harris, K. S. Hechtman, E. B. Hershman, R. G. Hoellrich, T. M. Hosea, D. C. Johnson, T. S. Johnson, M. H. Jones, C. C. Kaeding, T. E. Klootwyk, B. A. Levy, C. B. Ma, G. P. Maiers, R. G. Marx, M. J. Matava, G. M. Mathien, D. R. McAllister, E. C. McCarty, R. G. McCormack, B. S. Miller, A. R. Motamedi, C. W. Nissen, D. F. O'Neil, R. D. Parker, M. L. Purnell, A. J. Ramappa, M. A. Rauh, A. Rettig, J. K. Sekiya, K. G. Shea, O. H. Sherman, J. R. Slauterbeck, M. V. Smith, S. J. Svoboda, T. N. Taft, J. J. Tenuta, E. M. Tingstad, A. F. Vidal, D. G. Viskontas, R. A. White, J. S. Williams, M. L. Wolcott, B. R. Wolf, J. J. York

Orthopedic Surgery

Research output: Contribution to journal › Article › peer-review

229 Scopus citations

Abstract

Background: Revision anterior cruciate ligament (ACL) reconstruction has worse outcomes than primary reconstructions. Predictors for these worse outcomes are not known. The Multicenter ACL Revision Study (MARS) Group was developed to perform a multisurgeon, multicenter prospective longitudinal study to obtain sufficient subjects to allow multivariable analysis to determine predictors of clinical outcome. Purpose: To describe the formation of MARS and provide descriptive analysis of patient demographics and clinical features for the initial 460 enrolled patients to date in this prospective cohort. Study Design: Cross-sectional study; Level of evidence, 2. Methods: After training and institutional review board approval, surgeons began enrolling patients undergoing revision ACL reconstruction, recording patient demographics, previous ACL reconstruction methods, intra-articular injuries, and current revision techniques. Enrolled subjects completed a questionnaire consisting of validated patient-based outcome measures. Results: As of April 1, 2009, 87 surgeons have enrolled a total of 460 patients (57% men; median age, 26 years). For 89%, the reconstruction was the first revision. Mode of failure as deemed by the revising surgeon was traumatic (32%), technical (24%), biologic (7%), combination (37%), infection (<1%), and no response (<1%). Previous graft present at the time of injury was 70% autograft, 27% allograft, 2% combination, and 1% unknown. Sixty-two percent were more than 2 years removed from their last reconstruction. Graft choice for revision ACL reconstruction was 45% autograft, 54% allograft, and more than 1% both allograft and autograft. Meniscus and/or chondral damage was found in 90% of patients. Conclusion: The MARS Group has been able to quickly accumulate the largest revision ACL reconstruction cohort reported to date. Traumatic reinjury is deemed by surgeons to be the most common single mode of failure, but a combination of factors represents the most common mode of failure. Allograft graft choice is more common in the revision setting than autograft. Concomitant knee injury is extremely common in this population.

Original language	English (US)
Pages (from-to)	1979-1986
Number of pages	8
Journal	American Journal of Sports Medicine
Volume	38
Issue number	10
DOIs	https://doi.org/10.1177/0363546510378645
State	Published - Oct 1 2010

Keywords

anterior cruciate ligament (ACL)
epidemiology
reconstruction
revision

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Orthopedics and Sports Medicine

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10.1177/0363546510378645

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Wright, R. W., Huston, L. J., Spindler, K. P., Dunn, W. R., Haas, A. K., Allen, C. R., Cooper, D. E., DeBerardino, T. M., Lantz, B. A., Mann, B. J., Stuart, M. J., Albright, J. P., Amendola, A. N., Anderson, A. F., Andrish, J. T., Annunziata, C. C., Arciero, R. A., Bach, B. R., Baker, C. L., ... York, J. J. (2010). Descriptive epidemiology of the multicenter ACL revision study (MARS) cohort. American Journal of Sports Medicine, 38(10), 1979-1986. https://doi.org/10.1177/0363546510378645

Wright, RW, Huston, LJ, Spindler, KP, Dunn, WR, Haas, AK, Allen, CR, Cooper, DE, DeBerardino, TM, Lantz, BA, Mann, BJ, Stuart, MJ, Albright, JP, Amendola, AN, Anderson, AF, Andrish, JT, Annunziata, CC, Arciero, RA, Bach, BR, Baker, CL, Bartolozzi, AR, Baumgarten, KM, Bechler, JR, Berg, JH, Bernas, GA, Brockmeier, SF, Brophy, RH, Bush-Joseph, CA, Butler, JB, Campbell, JD, Carey, JL, Carpenter, JE, Cole, BJ, Cooper, JM, Cox, CL, Creighton, RA, Dahm, DL, David, TS, Flanigan, DC, Frederick, RW, Gatt, CJ, Gecha, SR, Giffin, JR, Goodfellow, DB, Hame, SL, Hannafin, JA, Harner, CD, Harris, NL, Hechtman, KS, Hershman, EB, Hoellrich, RG, Hosea, TM, Johnson, DC, Johnson, TS, Jones, MH, Kaeding, CC, Klootwyk, TE, Levy, BA, Ma, CB, Maiers, GP, Marx, RG, Matava, MJ, Mathien, GM, McAllister, DR, McCarty, EC, McCormack, RG, Miller, BS, Motamedi, AR, Nissen, CW, O'Neil, DF, Parker, RD, Purnell, ML, Ramappa, AJ, Rauh, MA, Rettig, A, Sekiya, JK, Shea, KG, Sherman, OH, Slauterbeck, JR, Smith, MV, Svoboda, SJ, Taft, TN, Tenuta, JJ, Tingstad, EM, Vidal, AF, Viskontas, DG, White, RA, Williams, JS, Wolcott, ML, Wolf, BR & York, JJ 2010, 'Descriptive epidemiology of the multicenter ACL revision study (MARS) cohort', American Journal of Sports Medicine, vol. 38, no. 10, pp. 1979-1986. https://doi.org/10.1177/0363546510378645

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title = "Descriptive epidemiology of the multicenter ACL revision study (MARS) cohort",

abstract = "Background: Revision anterior cruciate ligament (ACL) reconstruction has worse outcomes than primary reconstructions. Predictors for these worse outcomes are not known. The Multicenter ACL Revision Study (MARS) Group was developed to perform a multisurgeon, multicenter prospective longitudinal study to obtain sufficient subjects to allow multivariable analysis to determine predictors of clinical outcome. Purpose: To describe the formation of MARS and provide descriptive analysis of patient demographics and clinical features for the initial 460 enrolled patients to date in this prospective cohort. Study Design: Cross-sectional study; Level of evidence, 2. Methods: After training and institutional review board approval, surgeons began enrolling patients undergoing revision ACL reconstruction, recording patient demographics, previous ACL reconstruction methods, intra-articular injuries, and current revision techniques. Enrolled subjects completed a questionnaire consisting of validated patient-based outcome measures. Results: As of April 1, 2009, 87 surgeons have enrolled a total of 460 patients (57% men; median age, 26 years). For 89%, the reconstruction was the first revision. Mode of failure as deemed by the revising surgeon was traumatic (32%), technical (24%), biologic (7%), combination (37%), infection (<1%), and no response (<1%). Previous graft present at the time of injury was 70% autograft, 27% allograft, 2% combination, and 1% unknown. Sixty-two percent were more than 2 years removed from their last reconstruction. Graft choice for revision ACL reconstruction was 45% autograft, 54% allograft, and more than 1% both allograft and autograft. Meniscus and/or chondral damage was found in 90% of patients. Conclusion: The MARS Group has been able to quickly accumulate the largest revision ACL reconstruction cohort reported to date. Traumatic reinjury is deemed by surgeons to be the most common single mode of failure, but a combination of factors represents the most common mode of failure. Allograft graft choice is more common in the revision setting than autograft. Concomitant knee injury is extremely common in this population.",

keywords = "anterior cruciate ligament (ACL), epidemiology, reconstruction, revision",

author = "Wright, {Rick W.} and Huston, {Laura J.} and Spindler, {Kurt P.} and Dunn, {Warren R.} and Haas, {Amanda K.} and Allen, {Christina R.} and Cooper, {Daniel E.} and DeBerardino, {Thomas M.} and Lantz, {Brett A.} and Mann, {Barton J.} and Stuart, {Michael J.} and Albright, {J. P.} and Amendola, {A. N.} and Anderson, {A. F.} and Andrish, {J. T.} and Annunziata, {C. C.} and Arciero, {R. A.} and Bach, {B. R.} and Baker, {C. L.} and Bartolozzi, {A. R.} and Baumgarten, {K. M.} and Bechler, {J. R.} and Berg, {J. H.} and Bernas, {G. A.} and Brockmeier, {S. F.} and Brophy, {R. H.} and Bush-Joseph, {C. A.} and Butler, {J. B.} and Campbell, {J. D.} and Carey, {J. L.} and Carpenter, {J. E.} and Cole, {B. J.} and Cooper, {J. M.} and Cox, {C. L.} and Creighton, {R. A.} and Dahm, {D. L.} and David, {T. S.} and Flanigan, {D. C.} and Frederick, {R. W.} and Gatt, {C. J.} and Gecha, {S. R.} and Giffin, {J. R.} and Goodfellow, {D. B.} and Hame, {S. L.} and Hannafin, {J. A.} and Harner, {C. D.} and Harris, {N. L.} and Hechtman, {K. S.} and Hershman, {E. B.} and Hoellrich, {R. G.} and Hosea, {T. M.} and Johnson, {D. C.} and Johnson, {T. S.} and Jones, {M. H.} and Kaeding, {C. C.} and Klootwyk, {T. E.} and Levy, {B. A.} and Ma, {C. B.} and Maiers, {G. P.} and Marx, {R. G.} and Matava, {M. J.} and Mathien, {G. M.} and McAllister, {D. R.} and McCarty, {E. C.} and McCormack, {R. G.} and Miller, {B. S.} and Motamedi, {A. R.} and Nissen, {C. W.} and O'Neil, {D. F.} and Parker, {R. D.} and Purnell, {M. L.} and Ramappa, {A. J.} and Rauh, {M. A.} and A. Rettig and Sekiya, {J. K.} and Shea, {K. G.} and Sherman, {O. H.} and Slauterbeck, {J. R.} and Smith, {M. V.} and Svoboda, {S. J.} and Taft, {T. N.} and Tenuta, {J. J.} and Tingstad, {E. M.} and Vidal, {A. F.} and Viskontas, {D. G.} and White, {R. A.} and Williams, {J. S.} and Wolcott, {M. L.} and Wolf, {B. R.} and York, {J. J.}",

year = "2010",

month = oct,

day = "1",

doi = "10.1177/0363546510378645",

language = "English (US)",

volume = "38",

pages = "1979--1986",

journal = "American Journal of Sports Medicine",

issn = "0363-5465",

publisher = "SAGE Publications Inc.",

number = "10",

}

TY - JOUR

T1 - Descriptive epidemiology of the multicenter ACL revision study (MARS) cohort

AU - Wright, Rick W.

AU - Huston, Laura J.

AU - Spindler, Kurt P.

AU - Dunn, Warren R.

AU - Haas, Amanda K.

AU - Allen, Christina R.

AU - Cooper, Daniel E.

AU - DeBerardino, Thomas M.

AU - Lantz, Brett A.

AU - Mann, Barton J.

AU - Stuart, Michael J.

AU - Albright, J. P.

AU - Amendola, A. N.

AU - Anderson, A. F.

AU - Andrish, J. T.

AU - Annunziata, C. C.

AU - Arciero, R. A.

AU - Bach, B. R.

AU - Baker, C. L.

AU - Bartolozzi, A. R.

AU - Baumgarten, K. M.

AU - Bechler, J. R.

AU - Berg, J. H.

AU - Bernas, G. A.

AU - Brockmeier, S. F.

AU - Brophy, R. H.

AU - Bush-Joseph, C. A.

AU - Butler, J. B.

AU - Campbell, J. D.

AU - Carey, J. L.

AU - Carpenter, J. E.

AU - Cole, B. J.

AU - Cooper, J. M.

AU - Cox, C. L.

AU - Creighton, R. A.

AU - Dahm, D. L.

AU - David, T. S.

AU - Flanigan, D. C.

AU - Frederick, R. W.

AU - Gatt, C. J.

AU - Gecha, S. R.

AU - Giffin, J. R.

AU - Goodfellow, D. B.

AU - Hame, S. L.

AU - Hannafin, J. A.

AU - Harner, C. D.

AU - Harris, N. L.

AU - Hechtman, K. S.

AU - Hershman, E. B.

AU - Hoellrich, R. G.

AU - Hosea, T. M.

AU - Johnson, D. C.

AU - Johnson, T. S.

AU - Jones, M. H.

AU - Kaeding, C. C.

AU - Klootwyk, T. E.

AU - Levy, B. A.

AU - Ma, C. B.

AU - Maiers, G. P.

AU - Marx, R. G.

AU - Matava, M. J.

AU - Mathien, G. M.

AU - McAllister, D. R.

AU - McCarty, E. C.

AU - McCormack, R. G.

AU - Miller, B. S.

AU - Motamedi, A. R.

AU - Nissen, C. W.

AU - O'Neil, D. F.

AU - Parker, R. D.

AU - Purnell, M. L.

AU - Ramappa, A. J.

AU - Rauh, M. A.

AU - Rettig, A.

AU - Sekiya, J. K.

AU - Shea, K. G.

AU - Sherman, O. H.

AU - Slauterbeck, J. R.

AU - Smith, M. V.

AU - Svoboda, S. J.

AU - Taft, T. N.

AU - Tenuta, J. J.

AU - Tingstad, E. M.

AU - Vidal, A. F.

AU - Viskontas, D. G.

AU - White, R. A.

AU - Williams, J. S.

AU - Wolcott, M. L.

AU - Wolf, B. R.

AU - York, J. J.

PY - 2010/10/1

Y1 - 2010/10/1

N2 - Background: Revision anterior cruciate ligament (ACL) reconstruction has worse outcomes than primary reconstructions. Predictors for these worse outcomes are not known. The Multicenter ACL Revision Study (MARS) Group was developed to perform a multisurgeon, multicenter prospective longitudinal study to obtain sufficient subjects to allow multivariable analysis to determine predictors of clinical outcome. Purpose: To describe the formation of MARS and provide descriptive analysis of patient demographics and clinical features for the initial 460 enrolled patients to date in this prospective cohort. Study Design: Cross-sectional study; Level of evidence, 2. Methods: After training and institutional review board approval, surgeons began enrolling patients undergoing revision ACL reconstruction, recording patient demographics, previous ACL reconstruction methods, intra-articular injuries, and current revision techniques. Enrolled subjects completed a questionnaire consisting of validated patient-based outcome measures. Results: As of April 1, 2009, 87 surgeons have enrolled a total of 460 patients (57% men; median age, 26 years). For 89%, the reconstruction was the first revision. Mode of failure as deemed by the revising surgeon was traumatic (32%), technical (24%), biologic (7%), combination (37%), infection (<1%), and no response (<1%). Previous graft present at the time of injury was 70% autograft, 27% allograft, 2% combination, and 1% unknown. Sixty-two percent were more than 2 years removed from their last reconstruction. Graft choice for revision ACL reconstruction was 45% autograft, 54% allograft, and more than 1% both allograft and autograft. Meniscus and/or chondral damage was found in 90% of patients. Conclusion: The MARS Group has been able to quickly accumulate the largest revision ACL reconstruction cohort reported to date. Traumatic reinjury is deemed by surgeons to be the most common single mode of failure, but a combination of factors represents the most common mode of failure. Allograft graft choice is more common in the revision setting than autograft. Concomitant knee injury is extremely common in this population.

AB - Background: Revision anterior cruciate ligament (ACL) reconstruction has worse outcomes than primary reconstructions. Predictors for these worse outcomes are not known. The Multicenter ACL Revision Study (MARS) Group was developed to perform a multisurgeon, multicenter prospective longitudinal study to obtain sufficient subjects to allow multivariable analysis to determine predictors of clinical outcome. Purpose: To describe the formation of MARS and provide descriptive analysis of patient demographics and clinical features for the initial 460 enrolled patients to date in this prospective cohort. Study Design: Cross-sectional study; Level of evidence, 2. Methods: After training and institutional review board approval, surgeons began enrolling patients undergoing revision ACL reconstruction, recording patient demographics, previous ACL reconstruction methods, intra-articular injuries, and current revision techniques. Enrolled subjects completed a questionnaire consisting of validated patient-based outcome measures. Results: As of April 1, 2009, 87 surgeons have enrolled a total of 460 patients (57% men; median age, 26 years). For 89%, the reconstruction was the first revision. Mode of failure as deemed by the revising surgeon was traumatic (32%), technical (24%), biologic (7%), combination (37%), infection (<1%), and no response (<1%). Previous graft present at the time of injury was 70% autograft, 27% allograft, 2% combination, and 1% unknown. Sixty-two percent were more than 2 years removed from their last reconstruction. Graft choice for revision ACL reconstruction was 45% autograft, 54% allograft, and more than 1% both allograft and autograft. Meniscus and/or chondral damage was found in 90% of patients. Conclusion: The MARS Group has been able to quickly accumulate the largest revision ACL reconstruction cohort reported to date. Traumatic reinjury is deemed by surgeons to be the most common single mode of failure, but a combination of factors represents the most common mode of failure. Allograft graft choice is more common in the revision setting than autograft. Concomitant knee injury is extremely common in this population.

KW - anterior cruciate ligament (ACL)

KW - epidemiology

KW - reconstruction

KW - revision

UR - http://www.scopus.com/inward/record.url?scp=77958184440&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77958184440&partnerID=8YFLogxK

U2 - 10.1177/0363546510378645

DO - 10.1177/0363546510378645

M3 - Article

C2 - 20889962

AN - SCOPUS:77958184440

SN - 0363-5465

VL - 38

SP - 1979

EP - 1986

JO - American Journal of Sports Medicine

JF - American Journal of Sports Medicine

IS - 10

ER -

Descriptive epidemiology of the multicenter ACL revision study (MARS) cohort

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Keywords

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