Risk Factors for Contralateral ACL Injury: A Single Institution Case-Control Study

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Anterior cruciate ligament (ACL) injuries are common, particularly in athletes.
• Contralateral ACL reconstruction may be required due to various factors.
• Identifying predictors for contralateral ACL reconstruction is crucial for patient management.

Purpose of the Study:

• To investigate associations between demographics, patient characteristics, and surgery-specific factors with the need for contralateral anterior cruciate ligament (ACL) reconstruction.
• To identify patient groups at higher risk for requiring a second ACL surgery.

Main Methods:

• Retrospective analysis of a prospectively collected database of patients undergoing primary ACL reconstruction between 2012 and 2014.
• Comparison of patients who underwent contralateral ACL reconstruction with a control cohort.
• Evaluation of incidence, demographics, family history, graft choice, injury activity, and injury mechanism.

Main Results:

• 16 patients (4.8%) required contralateral ACL reconstruction.
• Females were more likely to require contralateral reconstruction (p=0.049).
• Tibialis anterior allograft use significantly increased the likelihood of contralateral reconstruction (p=0.0002).
• Playing lacrosse was associated with a higher risk of contralateral ACL injury (p=0.03).
• No significant association was found with age, other graft types, or injury mechanism.

Conclusions:

• Females, patients receiving tibialis anterior allografts, and individuals injured while playing lacrosse are at elevated risk for contralateral ACL reconstruction.
• These findings can inform patient education and surgical decision-making regarding ACL injury and reconstruction.