Hot Topics in the Multicenter Orthopedics Outcomes Network: Anterior Cruciate Ligament

Since 2015, the Multicenter Orthopedic Outcomes Network (MOON) has addressed several factors associated with patient outcome after anterior cruciate ligament (ACL) injury. These factors include predictors of high grade knee laxity, the impact of meniscus treatment on joint space narrowing after surgery, graft selection, treating diabetic patients, predictors of clinically significant pain, and outcomes of patients where meniscus tears were left in situ without treatment. The presence of meniscus tears and generalized laxity predict a lax examination under anesthesia prior to surgery. Allograft reconstructions carry a 5.2 times increased risk of re-tear compared to autograft. Patients with diabetes should be counseled they may be at increased risk (odds ratio 18.8) for infection after surgery. Subsequent ipsilateral knee surgery is the strongest predictor of postoperative pain after ACLR. Stable, partial thickness meniscus tears measuring less than 1 cm can be left alone without treatment with low re-operation rates at 6-years.