Age and chronic ACL injury are associated with reduced ramp-region vascularity during ACL reconstruction

IF 1.8 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2026-05-01 Epub Date: 2026-02-11 DOI:10.1016/j.jor.2026.02.049

Tsuneari Takahashi , Katsushi Takeshita

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引用次数: 0

Abstract

Purpose

To evaluate arthroscopic vascularity of the medial meniscus ramp region during anterior cruciate ligament (ACL) reconstruction and to identify factors associated with reduced ramp-region vascularity.

Methods

This retrospective cohort study reviewed consecutive patients who underwent primary ACL reconstruction between January 2020 and January 2026. Ramp-region vascularity was assessed arthroscopically using a transcondylar view from the anterolateral portal and dichotomized as adequate versus not adequate based on visible synovial vessels and hyperemia, without inducing iatrogenic bleeding. Chronic ACL injury was defined as surgery performed ≥12 months after injury. Univariate comparisons were performed, followed by Bayesian information criterion (BIC)-based multivariable logistic regression analysis to identify independent factors associated with reduced ramp-region vascularity.

Results

A total of 192 patients were screened, and 126 patients were included for analysis. Ramp-region vascularity was adequate in 74 patients and not adequate in 52 patients. Patients with reduced vascularity were significantly older than those with adequate vascularity (47.0 ± 17.5 vs 30.6 ± 17.0 years, P < 0.001), and chronic injury was more common in the reduced vascularity group (29/52 vs 12/74, P < 0.001). In multivariable analysis, older age was independently associated with reduced vascularity (odds ratio [OR], 1.04 per year; 95% confidence interval [CI], 1.01–1.07; P = 0.004). Chronic injury (not chronic vs chronic: OR, 0.273; 95% CI, 0.094–0.790; P = 0.017), arthroscopically visible ramp lesions (OR, 0.170; 95% CI, 0.058–0.494; P = 0.001), and preoperative Lysholm score (OR, 1.03; 95% CI, 1.01–1.06; P = 0.010) were also retained in the final model.

Conclusion

Reduced ramp-region vascularity during ACL reconstruction was independently associated with older age and chronic ACL injury. Patient age and injury chronicity may help identify knees with a biologically unfavorable ramp environment.

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年龄和慢性前交叉韧带损伤与前交叉韧带重建时斜坡区血管的减少有关

目的评价关节镜下前交叉韧带（ACL）重建中半月板内侧斜坡区的血管状况，并确定斜坡区血管状况降低的相关因素。方法：本回顾性队列研究回顾了2020年1月至2026年1月期间接受初级ACL重建的连续患者。通过关节镜从前外侧门静脉经髁观察评估斜区血管，并根据可见的滑膜血管和充血情况将其分为适当与不适当，未引起医源性出血。慢性前交叉韧带损伤定义为损伤后≥12个月进行手术。进行单因素比较，然后进行基于贝叶斯信息准则（BIC）的多变量logistic回归分析，以确定与斜坡区血管性降低相关的独立因素。结果共筛选192例患者，其中126例纳入分析。74例斜坡区血管充足，52例不充足。血管功能减少的患者明显比血管功能充足的患者年龄大（47.0±17.5岁vs 30.6±17.0岁，P < 0.001），血管功能减少组的慢性损伤更常见（29/52 vs 12/74, P < 0.001）。在多变量分析中，年龄越大与血管功能减少独立相关（优势比[OR]， 1.04 /年；95%可信区间[CI]， 1.01-1.07; P = 0.004）。最终模型中还保留了慢性损伤（非慢性vs慢性：OR， 0.273; 95% CI, 0.094-0.790; P = 0.017）、关节镜下可见斜坡病变（OR, 0.170; 95% CI, 0.058-0.494; P = 0.001）和术前Lysholm评分（OR, 1.03; 95% CI, 1.01-1.06; P = 0.010）。结论前交叉韧带重建时斜坡区血管减少与年龄和慢性前交叉韧带损伤独立相关。患者的年龄和损伤的慢性程度可以帮助确定膝关节是否具有生物学上不利的斜坡环境。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.