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Combining age, sex, body mass index, sport level, and preoperative quadriceps strength improves the predictive ability of quadriceps strength recovery after anterior cruciate ligament reconstruction

PURPOSE: This study compared the predictive ability of each independent predictor with that of a combination of predictors for quadriceps strength recovery one year after anterior cruciate ligament (ACL) reconstruction. METHODS: Patients who underwent primary ACL reconstruction using hamstring autog...

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Autores principales: Ueda, Yuya, Matsushita, Takehiko, Shibata, Yohei, Takiguchi, Kohei, Ono, Kumiko, Kida, Akihiro, Nishida, Kyohei, Nagai, Kanto, Hoshino, Yuichi, Matsumoto, Tomoyuki, Sakai, Yoshitada, Kuroda, Ryosuke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471663/
https://www.ncbi.nlm.nih.gov/pubmed/37354214
http://dx.doi.org/10.1007/s00167-023-07492-y
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author Ueda, Yuya
Matsushita, Takehiko
Shibata, Yohei
Takiguchi, Kohei
Ono, Kumiko
Kida, Akihiro
Nishida, Kyohei
Nagai, Kanto
Hoshino, Yuichi
Matsumoto, Tomoyuki
Sakai, Yoshitada
Kuroda, Ryosuke
author_facet Ueda, Yuya
Matsushita, Takehiko
Shibata, Yohei
Takiguchi, Kohei
Ono, Kumiko
Kida, Akihiro
Nishida, Kyohei
Nagai, Kanto
Hoshino, Yuichi
Matsumoto, Tomoyuki
Sakai, Yoshitada
Kuroda, Ryosuke
author_sort Ueda, Yuya
collection PubMed
description PURPOSE: This study compared the predictive ability of each independent predictor with that of a combination of predictors for quadriceps strength recovery one year after anterior cruciate ligament (ACL) reconstruction. METHODS: Patients who underwent primary ACL reconstruction using hamstring autografts were enrolled. Quadriceps strength, hamstring strength, and anterior tibial translation were measured, and the limb symmetry index (LSI) of the quadriceps and the hamstrings was calculated preoperatively and one year after surgery. Patients were classified into two groups according to the LSI of the quadriceps strength at one year postoperatively (≥ 80% or < 80%). Multivariate logistic regression analysis identified the independent predictors of quadriceps strength recovery, and the cut-off value was calculated using the receiver operating characteristic curve. A model assessing predictive ability of the combination of independent predictors was created, and the area under the curve (AUC) for each independent predictor was calculated by using the receiver-operating characteristic curves and the DeLong method. RESULTS: Of the 646 patients, 414 (64.1%) had an LSI of at least 80% for quadriceps strength one year after surgery, and 232 patients (35.9%) had an LSI of < 80%. Age, sex, body mass index (BMI), preinjury sport level, and LSI of preoperative quadriceps strength were independently associated with quadriceps strength recovery one year after ACL reconstruction. The cut-off values were age: 22.5 years; sex: female; BMI: 24.3 kg/m(2); preinjury sport level: no sport; and LSI of preoperative quadriceps strength: 63.3%. The AUC of the model assessing the predictive ability of the combination of age, sex, BMI, preinjury sport level, and LSI of preoperative quadriceps strength was significantly higher (0.73) than that of similar factors of preoperative quadriceps strength (AUC: 0.63, 0.53, 0.56, 0.61, and 0.68, p < 0.01, respectively). CONCLUSION: The combination of age, sex, BMI, preinjury sport level, and LSI of preoperative quadriceps strength had a superior predictive ability for quadriceps strength recovery at one year after ACL reconstruction than these predictors alone. Multiple factors, including patient characteristics and preoperative quadriceps strength, should be considered when planning rehabilitation programs to improve quadriceps strength recovery after ACL reconstruction. LEVEL OF EVIDENCE: III.
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spelling pubmed-104716632023-09-02 Combining age, sex, body mass index, sport level, and preoperative quadriceps strength improves the predictive ability of quadriceps strength recovery after anterior cruciate ligament reconstruction Ueda, Yuya Matsushita, Takehiko Shibata, Yohei Takiguchi, Kohei Ono, Kumiko Kida, Akihiro Nishida, Kyohei Nagai, Kanto Hoshino, Yuichi Matsumoto, Tomoyuki Sakai, Yoshitada Kuroda, Ryosuke Knee Surg Sports Traumatol Arthrosc Knee PURPOSE: This study compared the predictive ability of each independent predictor with that of a combination of predictors for quadriceps strength recovery one year after anterior cruciate ligament (ACL) reconstruction. METHODS: Patients who underwent primary ACL reconstruction using hamstring autografts were enrolled. Quadriceps strength, hamstring strength, and anterior tibial translation were measured, and the limb symmetry index (LSI) of the quadriceps and the hamstrings was calculated preoperatively and one year after surgery. Patients were classified into two groups according to the LSI of the quadriceps strength at one year postoperatively (≥ 80% or < 80%). Multivariate logistic regression analysis identified the independent predictors of quadriceps strength recovery, and the cut-off value was calculated using the receiver operating characteristic curve. A model assessing predictive ability of the combination of independent predictors was created, and the area under the curve (AUC) for each independent predictor was calculated by using the receiver-operating characteristic curves and the DeLong method. RESULTS: Of the 646 patients, 414 (64.1%) had an LSI of at least 80% for quadriceps strength one year after surgery, and 232 patients (35.9%) had an LSI of < 80%. Age, sex, body mass index (BMI), preinjury sport level, and LSI of preoperative quadriceps strength were independently associated with quadriceps strength recovery one year after ACL reconstruction. The cut-off values were age: 22.5 years; sex: female; BMI: 24.3 kg/m(2); preinjury sport level: no sport; and LSI of preoperative quadriceps strength: 63.3%. The AUC of the model assessing the predictive ability of the combination of age, sex, BMI, preinjury sport level, and LSI of preoperative quadriceps strength was significantly higher (0.73) than that of similar factors of preoperative quadriceps strength (AUC: 0.63, 0.53, 0.56, 0.61, and 0.68, p < 0.01, respectively). CONCLUSION: The combination of age, sex, BMI, preinjury sport level, and LSI of preoperative quadriceps strength had a superior predictive ability for quadriceps strength recovery at one year after ACL reconstruction than these predictors alone. Multiple factors, including patient characteristics and preoperative quadriceps strength, should be considered when planning rehabilitation programs to improve quadriceps strength recovery after ACL reconstruction. LEVEL OF EVIDENCE: III. Springer Berlin Heidelberg 2023-06-24 2023 /pmc/articles/PMC10471663/ /pubmed/37354214 http://dx.doi.org/10.1007/s00167-023-07492-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Knee
Ueda, Yuya
Matsushita, Takehiko
Shibata, Yohei
Takiguchi, Kohei
Ono, Kumiko
Kida, Akihiro
Nishida, Kyohei
Nagai, Kanto
Hoshino, Yuichi
Matsumoto, Tomoyuki
Sakai, Yoshitada
Kuroda, Ryosuke
Combining age, sex, body mass index, sport level, and preoperative quadriceps strength improves the predictive ability of quadriceps strength recovery after anterior cruciate ligament reconstruction
title Combining age, sex, body mass index, sport level, and preoperative quadriceps strength improves the predictive ability of quadriceps strength recovery after anterior cruciate ligament reconstruction
title_full Combining age, sex, body mass index, sport level, and preoperative quadriceps strength improves the predictive ability of quadriceps strength recovery after anterior cruciate ligament reconstruction
title_fullStr Combining age, sex, body mass index, sport level, and preoperative quadriceps strength improves the predictive ability of quadriceps strength recovery after anterior cruciate ligament reconstruction
title_full_unstemmed Combining age, sex, body mass index, sport level, and preoperative quadriceps strength improves the predictive ability of quadriceps strength recovery after anterior cruciate ligament reconstruction
title_short Combining age, sex, body mass index, sport level, and preoperative quadriceps strength improves the predictive ability of quadriceps strength recovery after anterior cruciate ligament reconstruction
title_sort combining age, sex, body mass index, sport level, and preoperative quadriceps strength improves the predictive ability of quadriceps strength recovery after anterior cruciate ligament reconstruction
topic Knee
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471663/
https://www.ncbi.nlm.nih.gov/pubmed/37354214
http://dx.doi.org/10.1007/s00167-023-07492-y
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