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Predictors of successful ACL reconstruction identified

Researchers have found that a patient’s age and the type of tissue graft have a direct impact on ACL reconstructive surgery (ACLR) outcomes, according to an exhibit presented at the 2014 (AAOS) annual meeting in New Orleans.

Researchers from and six other member institutions presented findings on surgical reconstruction of anterior cruciate ligaments from the (MOON), led by Cleveland Clinic’s , M.D., principal investigator of the project for over 10 years.

“The goal is to improve a majority of ACL reconstruction outcomes and highlight the changes in ACLR practice. For instance, the use of auto-graft (vs. allograft) tissue resulted in lower percent failure after ACLR surgery for high school, college, and competitive athletes,” said Dr. Spindler, Vice Chairman of Research at Cleveland Clinic’s Orthopaedic & Rheumatologic Institute. “This is the first time we looked at risk factors and found that with the right combination, athletes can avoid complete failure and future ACL reconstructions post-surgery.”

MOON consists of 17 surgeons from seven institutions. It has helped to establish a new “gold standard” for conducting multi-center, multi-surgeon orthopaedic research.

“This is a compilation of all of the clinically important questions we’ve answered that will positively benefit patients and enhance their quality of life,” said Richard D. Parker, M.D., Chair of Orthopaedic Surgery at Cleveland Clinic.

MOON is a hypothesis-driven, prospective study designed to determine prognosis and predictors of ACLR outcomes. The project has provided a model for multicenter, multi-surgeon orthopaedic research and comparative effectiveness research in orthopaedics. The MOON consortium was created in 2001, and enrolled and followed 2,340 ACLR procedures from seven institutions.

With an estimated 200,000 ACLRs performed annually in the U.S., there is an emphasis to help guide more informed, personalized decision making between physicians and patients. Other modifications include treatment options for meniscus and cartilage injuries, as well as post-ACLR lifestyle choices.

Dr. Spindler recently joined Cleveland Clinic after 23 years as Head Team Physician, Director of Sports Medicine, and Vice Chairman of Orthopaedics at Vanderbilt University. He returned to Cleveland Clinic after a sports medicine/orthopaedics fellowship in 1990-91.


This research was supported by grants from the National Institutes of Health (5R01 AR053684 and 5K23 AR052392) , and the Center for Education and Research on Therapeutics – Agency of Health Research and Quality (5 U18-HS016075).

Cleveland Clinic