TY - JOUR
T1 - The prognosis and predictors of sports function and activity at minimum 6 years after anterior cruciate ligament reconstruction
T2 - A population cohort study
AU - Spindler, Kurt P.
AU - Huston, Laura J.
AU - Wright, Rick W.
AU - Kaeding, Christopher C.
AU - Marx, Robert G.
AU - Amendola, Annunziato
AU - Parker, Richard D.
AU - Andrish, Jack T.
AU - Reinke, Emily K.
AU - Harrell, Frank E.
AU - Pedroza, Angela
AU - An, Angel Q.
AU - Schmitz, Leah
AU - McCarty, Eric C.
AU - Wolf, Brian R.
AU - Jones, Morgan H.
AU - Matava, Matthew J.
AU - Flanigan, David C.
AU - Brophy, Robert H.
AU - Vidal, Armando F.
AU - Dunn, Warren R.
PY - 2011/2
Y1 - 2011/2
N2 - Background: The predictors of anterior cruciate ligament reconstruction (ACLR) outcome at 6 years as measured by validated patient-based outcome instruments are unknown. Hypothesis: Certain variables evaluated at the time of ACLR will predict return to sports function (as measured by the International Knee Documentation Committee [IKDC] questionnaire and the Knee injury and Osteoarthritis Outcome Score [KOOS] Sports and Recreation subscale), knee-related quality of life (KOOS Knee Related Quality of Life subscale), and activity level (Marx Activity Scale). Potential predictor variables include demographic factors, surgical technique and graft choice for ACLR, and intra-articular injuries and treatment. Study Design: Cohort study; Level of evidence, 2. Methods: All patients with unilateral ACLRs from 2002 currently enrolled in the MOON (Multicenter Orthopaedic Outcomes Network) cohort were evaluated. Patients completed the validated outcome instruments preoperatively. Physicians documented intra-articular pathologic abnormalities, treatment, and surgical techniques used at the time of surgery. At 2 and 6 years postoperatively, patients completed the same validated outcome instruments. Results: Follow-up was obtained at 2 years (88%) and at 6 years (84%). The cohort was 57% male with a median age of 23 years at enrollment. The ability to perform sports function was maintained at 6 years, but the Marx activity level continued to decline from baseline. Revision ACLR and use of allograft predicted worse outcomes on the IKDC and both KOOS subscales. Lateral meniscus treatment, smoking status, and body mass index at baseline were each predictors on 2 of 3 scales. The predictors of lower activity level were revision ACLR and female sex. Conclusion: Six years after ACLR, patients could perform sports-related functions and maintain a high knee-related quality of life similar to their 2-year level, although their physical activity level (Marx) dropped over time. Choosing autograft rather than allograft, not smoking, and having normal body mass index are advised to improve long-term outcomes.
AB - Background: The predictors of anterior cruciate ligament reconstruction (ACLR) outcome at 6 years as measured by validated patient-based outcome instruments are unknown. Hypothesis: Certain variables evaluated at the time of ACLR will predict return to sports function (as measured by the International Knee Documentation Committee [IKDC] questionnaire and the Knee injury and Osteoarthritis Outcome Score [KOOS] Sports and Recreation subscale), knee-related quality of life (KOOS Knee Related Quality of Life subscale), and activity level (Marx Activity Scale). Potential predictor variables include demographic factors, surgical technique and graft choice for ACLR, and intra-articular injuries and treatment. Study Design: Cohort study; Level of evidence, 2. Methods: All patients with unilateral ACLRs from 2002 currently enrolled in the MOON (Multicenter Orthopaedic Outcomes Network) cohort were evaluated. Patients completed the validated outcome instruments preoperatively. Physicians documented intra-articular pathologic abnormalities, treatment, and surgical techniques used at the time of surgery. At 2 and 6 years postoperatively, patients completed the same validated outcome instruments. Results: Follow-up was obtained at 2 years (88%) and at 6 years (84%). The cohort was 57% male with a median age of 23 years at enrollment. The ability to perform sports function was maintained at 6 years, but the Marx activity level continued to decline from baseline. Revision ACLR and use of allograft predicted worse outcomes on the IKDC and both KOOS subscales. Lateral meniscus treatment, smoking status, and body mass index at baseline were each predictors on 2 of 3 scales. The predictors of lower activity level were revision ACLR and female sex. Conclusion: Six years after ACLR, patients could perform sports-related functions and maintain a high knee-related quality of life similar to their 2-year level, although their physical activity level (Marx) dropped over time. Choosing autograft rather than allograft, not smoking, and having normal body mass index are advised to improve long-term outcomes.
KW - 6-year follow-up
KW - International Knee Documentation Committee
KW - Knee injury and Osteoarthritis Outcome Score
KW - Marx Activity Scale
KW - activity
KW - anterior cruciate ligament reconstruction
KW - sports function
UR - http://www.scopus.com/inward/record.url?scp=79952300248&partnerID=8YFLogxK
U2 - 10.1177/0363546510383481
DO - 10.1177/0363546510383481
M3 - Article
C2 - 21084660
AN - SCOPUS:79952300248
SN - 0363-5465
VL - 39
SP - 348
EP - 359
JO - American Journal of Sports Medicine
JF - American Journal of Sports Medicine
IS - 2
ER -