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 population 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 initial grant (R01 AR053684) allowed us to enroll over 2,300 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 85% follow-up using validated patient-reported outcome questionnaires and 93% via phone follow-up. Two of the original three Aims from the parent grant will be advanced in this competitive revision, 1) validated patient-reported outcomes of sports function, activity level, general health, and symptomatic OA, and 2) ACL graft or contralateral ACL failures. The objective of this revision is to complete 6 year follow-up on an additional unfunded MOON cohort of 1251 ACL reconstructed patients (with an already completed 86% 2 year follow-up rate) in the last 1.5 years of the parent grant (4/2014 - 8/2015). This would increase our existing sample size by ~ 50%, and would enable us to build the most comprehensive """"""""personalized"""""""" models to address detailed contributions of meniscus and articular cartilage injury and treatment (and their interactions) to several patient reported outcomes and OA symptoms. Furthermore, we would be the first to perform complex multivariable predictive modeling of ACL graft and contralateral ACL failure. The additional variables incorporated into longer 6 year time interval is particularly important for establishing the longer-term outcomes and symptoms of OA and incidence of both ipsilateral and contralateral ACL tears.

Public Health Relevance

This multicenter, multi-surgeon prospective study will allow determination of the clinical predictors of inferior outcomes following ACL reconstruction. Once the predictors for good and poor outcomes are identified, surgeons and patients can be educated to the potential modifiable variables that improve patient's outcomes.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
3R01AR053684-09S1
Application #
8679064
Study Section
Musculoskeletal Rehabilitation Sciences Study Section (MRS)
Program Officer
Panagis, James S
Project Start
2006-04-01
Project End
2015-08-31
Budget Start
2014-09-12
Budget End
2015-08-31
Support Year
9
Fiscal Year
2014
Total Cost
$193,995
Indirect Cost
$70,431
Name
Vanderbilt University Medical Center
Department
Surgery
Type
Schools of Medicine
DUNS #
004413456
City
Nashville
State
TN
Country
United States
Zip Code
37212
Brophy, Robert H; Huston, Laura J; Wright, Rick W et al. (2016) Outcomes of ACL Reconstruction in Patients with Diabetes. Med Sci Sports Exerc 48:969-73
Darnley, James E; Léger-St-Jean, Benjamin; Pedroza, Angela D et al. (2016) Anterior Cruciate Ligament Reconstruction Using a Combination of Autograft and Allograft Tendon: A MOON Cohort Study. Orthop J Sports Med 4:2325967116662249
Magnussen, Robert A; Reinke, Emily K; Huston, Laura J et al. (2016) Factors Associated With High-Grade Lachman, Pivot Shift, and Anterior Drawer at the Time of Anterior Cruciate Ligament Reconstruction. Arthroscopy 32:1080-5
Dunn, Warren R; Wolf, Brian R; Harrell Jr, Frank E et al. (2015) Baseline predictors of health-related quality of life after anterior cruciate ligament reconstruction: a longitudinal analysis of a multicenter cohort at two and six years. J Bone Joint Surg Am 97:551-7
Kaeding, Christopher C; Pedroza, Angela D; Reinke, Emily K et al. (2015) Risk Factors and Predictors of Subsequent ACL Injury in Either Knee After ACL Reconstruction: Prospective Analysis of 2488 Primary ACL Reconstructions From the MOON Cohort. Am J Sports Med 43:1583-90
Wright, Rick W; Haas, Amanda K; Anderson, Joy et al. (2015) Anterior Cruciate Ligament Reconstruction Rehabilitation: MOON Guidelines. Sports Health 7:239-43
Wasserstein, D; Huston, L J; Nwosu, S et al. (2015) KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study. Osteoarthritis Cartilage 23:1674-84
Lynch, T Sean; Parker, Richard D; Patel, Ronak M et al. (2015) The Impact of the Multicenter Orthopaedic Outcomes Network (MOON) Research on Anterior Cruciate Ligament Reconstruction and Orthopaedic Practice. J Am Acad Orthop Surg 23:154-63
Mariscalco, Michael W; Magnussen, Robert A; Mitchell, Joshua et al. (2015) How much hamstring graft needs to be in the femoral tunnel? A MOON cohort study. Eur Orthop Traumatol 6:9-13
Duchman, Kyle R; Westermann, Robert W; Spindler, Kurt P et al. (2015) The Fate of Meniscus Tears Left In Situ at the Time of Anterior Cruciate Ligament Reconstruction: A 6-Year Follow-up Study From the MOON Cohort. Am J Sports Med 43:2688-95

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