Low Prevalence of Anterior and Posterior Cruciate Ligament Injuries in Patients With Achondroplasia

Jaysson T. Brooks, Alim F. Ramji, Tatyana A. Lyapustina, Mary T. Yost, Michael Ain

Research output: Contribution to journalArticle

Abstract

BACKGROUND:: Anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries and their subsequent reconstructions are common in the general population, but there has been no research regarding ACL or PCL injuries in patients with achondroplasia, the most common skeletal dysplasia. Our goals were to (1) evaluate the prevalence of ACL and PCL injuries in adolescents and adults with achondroplasia, (2) compare this prevalence with that reported for the general population, (3) determine how many patients with ACL or PCL injuries underwent ligament reconstruction as treatment, and (4) determine patient activity levels as they relate to the rate of ACL/PCL injuries and reconstructions. METHODS:: We reviewed medical records of 430 patients with achondroplasia seen in the senior author’s clinic from 2002 through 2014. Demographic data were reviewed, as well as any documentation of ACL or PCL injury or reconstruction. We called all 430 patients by telephone, and 148 agreed to participate in our survey, whereas 1 declined. We asked these patients about their history of ACL or PCL injury or reconstruction, as well as current and past physical activity levels. RESULTS:: No ACL or PCL injuries were found on chart review. One patient reached by telephone reported an ACL injury that did not require reconstruction. This yielded a theoretical prevalence of 3/430 (0.7%). Of the 148 patients surveyed, 43 (29%) reported low physical activity, 75 (51%) reported moderate physical activity, and 26 (17%) reported high physical activity. There was no significant difference in the rate of ACL injury when stratified by physical activity level (P=0.102). CONCLUSIONS:: ACL and PCL injuries and reconstructions are extremely rare in patients with achondroplasia, which cannot be completely ascribed to a low level of physical activity. One possible explanation is that patients with achondroplasia, on an average, have a more anterior tibial slope compared with those without achondroplasia, which decreases the force generated within the ACL and may protect against ACL injury. Further research is needed to explore possible causes. LEVEL OF EVIDENCE:: Level IV—retrospective review.

Original languageEnglish (US)
JournalJournal of Pediatric Orthopaedics
DOIs
StateAccepted/In press - Oct 13 2015

Fingerprint

Achondroplasia
Posterior Cruciate Ligament
Anterior Cruciate Ligament
Wounds and Injuries
Exercise
Telephone
Anterior Cruciate Ligament Injuries
Ligaments
Research
Documentation
Population
Medical Records
Demography

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

Cite this

Low Prevalence of Anterior and Posterior Cruciate Ligament Injuries in Patients With Achondroplasia. / Brooks, Jaysson T.; Ramji, Alim F.; Lyapustina, Tatyana A.; Yost, Mary T.; Ain, Michael.

In: Journal of Pediatric Orthopaedics, 13.10.2015.

Research output: Contribution to journalArticle

@article{1b9a4c9a5a2945d3918773ed9a5acd04,
title = "Low Prevalence of Anterior and Posterior Cruciate Ligament Injuries in Patients With Achondroplasia",
abstract = "BACKGROUND:: Anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries and their subsequent reconstructions are common in the general population, but there has been no research regarding ACL or PCL injuries in patients with achondroplasia, the most common skeletal dysplasia. Our goals were to (1) evaluate the prevalence of ACL and PCL injuries in adolescents and adults with achondroplasia, (2) compare this prevalence with that reported for the general population, (3) determine how many patients with ACL or PCL injuries underwent ligament reconstruction as treatment, and (4) determine patient activity levels as they relate to the rate of ACL/PCL injuries and reconstructions. METHODS:: We reviewed medical records of 430 patients with achondroplasia seen in the senior author’s clinic from 2002 through 2014. Demographic data were reviewed, as well as any documentation of ACL or PCL injury or reconstruction. We called all 430 patients by telephone, and 148 agreed to participate in our survey, whereas 1 declined. We asked these patients about their history of ACL or PCL injury or reconstruction, as well as current and past physical activity levels. RESULTS:: No ACL or PCL injuries were found on chart review. One patient reached by telephone reported an ACL injury that did not require reconstruction. This yielded a theoretical prevalence of 3/430 (0.7{\%}). Of the 148 patients surveyed, 43 (29{\%}) reported low physical activity, 75 (51{\%}) reported moderate physical activity, and 26 (17{\%}) reported high physical activity. There was no significant difference in the rate of ACL injury when stratified by physical activity level (P=0.102). CONCLUSIONS:: ACL and PCL injuries and reconstructions are extremely rare in patients with achondroplasia, which cannot be completely ascribed to a low level of physical activity. One possible explanation is that patients with achondroplasia, on an average, have a more anterior tibial slope compared with those without achondroplasia, which decreases the force generated within the ACL and may protect against ACL injury. Further research is needed to explore possible causes. LEVEL OF EVIDENCE:: Level IV—retrospective review.",
author = "Brooks, {Jaysson T.} and Ramji, {Alim F.} and Lyapustina, {Tatyana A.} and Yost, {Mary T.} and Michael Ain",
year = "2015",
month = "10",
day = "13",
doi = "10.1097/BPO.0000000000000662",
language = "English (US)",
journal = "Journal of Pediatric Orthopaedics",
issn = "0271-6798",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Low Prevalence of Anterior and Posterior Cruciate Ligament Injuries in Patients With Achondroplasia

AU - Brooks, Jaysson T.

AU - Ramji, Alim F.

AU - Lyapustina, Tatyana A.

AU - Yost, Mary T.

AU - Ain, Michael

PY - 2015/10/13

Y1 - 2015/10/13

N2 - BACKGROUND:: Anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries and their subsequent reconstructions are common in the general population, but there has been no research regarding ACL or PCL injuries in patients with achondroplasia, the most common skeletal dysplasia. Our goals were to (1) evaluate the prevalence of ACL and PCL injuries in adolescents and adults with achondroplasia, (2) compare this prevalence with that reported for the general population, (3) determine how many patients with ACL or PCL injuries underwent ligament reconstruction as treatment, and (4) determine patient activity levels as they relate to the rate of ACL/PCL injuries and reconstructions. METHODS:: We reviewed medical records of 430 patients with achondroplasia seen in the senior author’s clinic from 2002 through 2014. Demographic data were reviewed, as well as any documentation of ACL or PCL injury or reconstruction. We called all 430 patients by telephone, and 148 agreed to participate in our survey, whereas 1 declined. We asked these patients about their history of ACL or PCL injury or reconstruction, as well as current and past physical activity levels. RESULTS:: No ACL or PCL injuries were found on chart review. One patient reached by telephone reported an ACL injury that did not require reconstruction. This yielded a theoretical prevalence of 3/430 (0.7%). Of the 148 patients surveyed, 43 (29%) reported low physical activity, 75 (51%) reported moderate physical activity, and 26 (17%) reported high physical activity. There was no significant difference in the rate of ACL injury when stratified by physical activity level (P=0.102). CONCLUSIONS:: ACL and PCL injuries and reconstructions are extremely rare in patients with achondroplasia, which cannot be completely ascribed to a low level of physical activity. One possible explanation is that patients with achondroplasia, on an average, have a more anterior tibial slope compared with those without achondroplasia, which decreases the force generated within the ACL and may protect against ACL injury. Further research is needed to explore possible causes. LEVEL OF EVIDENCE:: Level IV—retrospective review.

AB - BACKGROUND:: Anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries and their subsequent reconstructions are common in the general population, but there has been no research regarding ACL or PCL injuries in patients with achondroplasia, the most common skeletal dysplasia. Our goals were to (1) evaluate the prevalence of ACL and PCL injuries in adolescents and adults with achondroplasia, (2) compare this prevalence with that reported for the general population, (3) determine how many patients with ACL or PCL injuries underwent ligament reconstruction as treatment, and (4) determine patient activity levels as they relate to the rate of ACL/PCL injuries and reconstructions. METHODS:: We reviewed medical records of 430 patients with achondroplasia seen in the senior author’s clinic from 2002 through 2014. Demographic data were reviewed, as well as any documentation of ACL or PCL injury or reconstruction. We called all 430 patients by telephone, and 148 agreed to participate in our survey, whereas 1 declined. We asked these patients about their history of ACL or PCL injury or reconstruction, as well as current and past physical activity levels. RESULTS:: No ACL or PCL injuries were found on chart review. One patient reached by telephone reported an ACL injury that did not require reconstruction. This yielded a theoretical prevalence of 3/430 (0.7%). Of the 148 patients surveyed, 43 (29%) reported low physical activity, 75 (51%) reported moderate physical activity, and 26 (17%) reported high physical activity. There was no significant difference in the rate of ACL injury when stratified by physical activity level (P=0.102). CONCLUSIONS:: ACL and PCL injuries and reconstructions are extremely rare in patients with achondroplasia, which cannot be completely ascribed to a low level of physical activity. One possible explanation is that patients with achondroplasia, on an average, have a more anterior tibial slope compared with those without achondroplasia, which decreases the force generated within the ACL and may protect against ACL injury. Further research is needed to explore possible causes. LEVEL OF EVIDENCE:: Level IV—retrospective review.

UR - http://www.scopus.com/inward/record.url?scp=84944348627&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84944348627&partnerID=8YFLogxK

U2 - 10.1097/BPO.0000000000000662

DO - 10.1097/BPO.0000000000000662

M3 - Article

JO - Journal of Pediatric Orthopaedics

JF - Journal of Pediatric Orthopaedics

SN - 0271-6798

ER -