The University of Southampton
University of Southampton Institutional Repository

ACL and meniscal injuries increase the risk of primary total knee replacement for osteoarthritis: a matched case–control study using the Clinical Practice Research Datalink (CPRD)

ACL and meniscal injuries increase the risk of primary total knee replacement for osteoarthritis: a matched case–control study using the Clinical Practice Research Datalink (CPRD)
ACL and meniscal injuries increase the risk of primary total knee replacement for osteoarthritis: a matched case–control study using the Clinical Practice Research Datalink (CPRD)
Objectives: The aim of this study was to investigate whether ACL injury (ACLi) or meniscal injury increases the risk of end-stage osteoarthritis (OA) resulting in total knee replacement (TKR).

Methods: A matched case–control study of all TKRs performed in the UK between January 1990 and July 2011 and recorded in the Clinical Practice Research Datalink (CPRD) was undertaken. The CPRD contains longitudinal data on approximately 3.6 million patients. Two controls were selected for each case of TKR, matched on age, sex and general practitioner location as a proxy for socioeconomic status. Individuals with inflammatory arthritis were excluded. The odds of having TKR for individuals with a CPRD-recorded ACLi were compared with those without ACLi using conditional logistic regression, after adjustment for body mass index, previous knee fracture and meniscal injury. The adjusted odds of TKR in individuals with a recorded meniscal injury compared with those without were calculated.

Results: After exclusion of individuals with inflammatory arthritis, there were 49 723 in the case group and 104 353 controls. 153 (0.31%) cases had a history of ACLi compared with 41 (0.04%) controls. The adjusted OR of TKR after ACLi was 6.96 (95% CI 4.73 to 10.31). 4217 (8.48%) individuals in the TKR group had a recorded meniscal injury compared with 669 (0.64%) controls. The adjusted OR of TKR after meniscal injury was 15.24 (95% CI 13.88 to 16.69).

Conclusion: This study demonstrates that ACLi is associated with a sevenfold increased odds of TKR resulting from OA. Meniscal injury is associated with a 15-fold increase odds of TKR for OA.
0306-3674
Khan, Tanvir
1af2dc97-783a-49fb-ad38-d596477f8872
Alvand, Abtin
a9c2d129-d496-4683-829e-d9ff165c928b
Prieto-Alhambra, Daniel
e596722a-2f01-4201-bd9d-be3e180e76a9
Culliford, David J.
25511573-74d3-422a-b0ee-dfe60f80df87
Judge, Andrew
b853f89f-dc44-428e-9fe2-35e925544abe
Jackson, William F.
c7af673e-145b-4045-a1cf-c1d574f105f7
Scammell, Brigitte E.
f1bae236-a7c6-475f-b40f-5acd4ced49ab
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
Price, Andrew James
3e1f1c5b-12d0-4173-995e-d9bba77b5562
Khan, Tanvir
1af2dc97-783a-49fb-ad38-d596477f8872
Alvand, Abtin
a9c2d129-d496-4683-829e-d9ff165c928b
Prieto-Alhambra, Daniel
e596722a-2f01-4201-bd9d-be3e180e76a9
Culliford, David J.
25511573-74d3-422a-b0ee-dfe60f80df87
Judge, Andrew
b853f89f-dc44-428e-9fe2-35e925544abe
Jackson, William F.
c7af673e-145b-4045-a1cf-c1d574f105f7
Scammell, Brigitte E.
f1bae236-a7c6-475f-b40f-5acd4ced49ab
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
Price, Andrew James
3e1f1c5b-12d0-4173-995e-d9bba77b5562

Khan, Tanvir, Alvand, Abtin, Prieto-Alhambra, Daniel, Culliford, David J., Judge, Andrew, Jackson, William F., Scammell, Brigitte E., Arden, Nigel K. and Price, Andrew James (2018) ACL and meniscal injuries increase the risk of primary total knee replacement for osteoarthritis: a matched case–control study using the Clinical Practice Research Datalink (CPRD). British Journal of Sports Medicine. (doi:10.1136/bjsports-2017-097762).

Record type: Article

Abstract

Objectives: The aim of this study was to investigate whether ACL injury (ACLi) or meniscal injury increases the risk of end-stage osteoarthritis (OA) resulting in total knee replacement (TKR).

Methods: A matched case–control study of all TKRs performed in the UK between January 1990 and July 2011 and recorded in the Clinical Practice Research Datalink (CPRD) was undertaken. The CPRD contains longitudinal data on approximately 3.6 million patients. Two controls were selected for each case of TKR, matched on age, sex and general practitioner location as a proxy for socioeconomic status. Individuals with inflammatory arthritis were excluded. The odds of having TKR for individuals with a CPRD-recorded ACLi were compared with those without ACLi using conditional logistic regression, after adjustment for body mass index, previous knee fracture and meniscal injury. The adjusted odds of TKR in individuals with a recorded meniscal injury compared with those without were calculated.

Results: After exclusion of individuals with inflammatory arthritis, there were 49 723 in the case group and 104 353 controls. 153 (0.31%) cases had a history of ACLi compared with 41 (0.04%) controls. The adjusted OR of TKR after ACLi was 6.96 (95% CI 4.73 to 10.31). 4217 (8.48%) individuals in the TKR group had a recorded meniscal injury compared with 669 (0.64%) controls. The adjusted OR of TKR after meniscal injury was 15.24 (95% CI 13.88 to 16.69).

Conclusion: This study demonstrates that ACLi is associated with a sevenfold increased odds of TKR resulting from OA. Meniscal injury is associated with a 15-fold increase odds of TKR for OA.

Text ACL and meniscal injuries increase the risk of primary total knee replacement for osteoarthritis: a matched case–control study using the Clinical Practice Research Datalink (CPRD) - Accepted Manuscript
Download (105kB)
Text ACL and meniscal injuries increase the risk of primary total knee replacement for osteoarthritis: a matched case–control study using the Clinical Practice Research Datalink (CPRD) - Version of Record
Restricted to Repository staff only
Request a copy

More information

Accepted/In Press date: 21 December 2017
e-pub ahead of print date: 13 January 2018

Identifiers

Local EPrints ID: 417103
URI: https://eprints.soton.ac.uk/id/eprint/417103
ISSN: 0306-3674
PURE UUID: 469515bf-dbb9-4654-b35a-409240989581

Catalogue record

Date deposited: 19 Jan 2018 17:30
Last modified: 19 Jan 2018 17:30

Export record

Altmetrics

Contributors

Author: Tanvir Khan
Author: Abtin Alvand
Author: Daniel Prieto-Alhambra
Author: David J. Culliford
Author: Andrew Judge
Author: William F. Jackson
Author: Brigitte E. Scammell
Author: Nigel K. Arden
Author: Andrew James Price

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×