scholarly journals ASSOCIATION BETWEEN PSYCHOLOGICAL READINESS, PATIENT REPORTED OUTCOMES, AND RETURN-TO-SPORT FOLLOWING PRIMARY ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: READINESS OUTCOMES AFFECTING RETURN-TO-SPORT (ROAR)

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0022
Author(s):  
Jessica L. Traver ◽  
Melissa A. Christino ◽  
Ryan Coene ◽  
Tyler Schaeffer ◽  
Kathryn Williams ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Patient Reported Outcomes ◽  
Cruciate Ligament ◽  
Age Groups ◽  
Young Patients ◽  
Return To Sport ◽  
Functional Testing ◽  
Patient Reported ◽  
Anterior Cruciate ◽  
Primary Acl Reconstruction

Background: Successful return-to-sport (RTS) following anterior cruciate ligament (ACL) reconstruction can be affected by several variables, including a patient’s physical and psychological state throughout the rehabilitation process. Several studies have reported patients with increased fear-of-reinjury may be at risk for secondary injury following ACL reconstruction. Purpose: The primary objective was to prospectively compare the relationship between ACL-RSI, Pedi-IKDC, Pedi-FABS, and PROMIS-Psychological Stress Experiences (PSE) across various age groups and graft types between patients undergoing primary ACL reconstruction at the 6-month post-operative visit. Secondary outcomes were timing of RTS clearance and performance on functional RTS testing measures. Methods: Patients enrolled were 8-30 years old who underwent primary ACL reconstruction from August 2018 until January 2019. They were evaluated at their 6-month follow-up appointment and underwent functional RTS testing. Patients were divided into 3 groups based on their age: Pre-Adolescent (ages 8-14), Adolescent (ages 15-18), and Adult (ages >18) to reflect their psychological/emotional maturity. Demographic information, time to RTS clearance, and functional testing measurements were collected Analysis included one-way ANOVA and Kruskal-Wallis tests. Results: A total of 65 patients were included in the study (38 males, 27 females; mean age, 17.2 ± 3.3 years). The 3 age groups consisted of Pre-Adolescent (n=12), Adolescent (n=34), and Adult (n=19). The graft types were HS (n=51), BTB (n=8), ITB (n=6). Mean ACL-RSI scores were significantly different among age groups (Pre-Adolescent 80.1±11.1, Adolescent 64.2±23.5, Adult 52.5±19.9; p=0.003) and graft type (HS 63±21.9, BTB 54.3±26.7, ITB 81.9±10.6; p=0.049). Scores were significantly different among the 3 age groups for IKDC (Pre-Adolescent 86.2±12.2, Adolescent 80.3±13.6, Adult 62.1±6.5; p<0.001) and Pedi-FABS (Pre-Adolescent 25.3±5.5, Adolescent 24.8±7.1, Adult 19.6±10.0; p=0.049). The mean PROMIS-PSE t-scores were significantly different among the age groups (Pre-Adolescent 45.7±8.9, Adolescent 52.8±7.6, Adult 52.6±7.4; p=0.023) and graft type (HS 52.5±7.6, BTB 53.2±7.6, ITB 39.8±4.4; p<0.001). We found that ACL-RSI and IKDC had a Spearman correlation of 0.52 (p<0.001) while ACL-RSI and PROMIS-PSE had a Pearson correlation of -0.32 (p=0.009). There were no differences between functional testing across the 3 age groups (p>0.05). Conclusion: This study suggests that psychological profiles and subjective perceptions of knee function following ACL reconstruction may vary in young patients of different ages. Pre-adolescent patients had better scores on all patient reported outcomes compared to adolescent and adult patients. Age-related differences in patient reported outcomes should be taken into account when evaluating young patients. [Figure: see text]

scholarly journals Association Between Psychological Readiness, Patient Reported Outcomes and Return to Sports Following Primary Anterior Cruciate Ligament Reconstruction: Readiness Outcomes Affecting Return-to-Sport (ROAR)

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0048
Author(s):  
Jessica Traver ◽  
Melissa Christino ◽  
Ryan Coene ◽  
Kathryn Williams ◽  
Dai Sugimoto ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Patient Reported Outcomes ◽  
Cruciate Ligament ◽  
Age Groups ◽  
Return To Sport ◽  
Functional Testing ◽  
Patient Reported ◽  
Anterior Cruciate ◽  
Primary Acl Reconstruction

Objectives: Successful return-to-sport (RTS) following anterior cruciate ligament (ACL) reconstruction can be affected by several variables, including a patient’s physical and psychological states throughout the rehabilitation process. Several studies have reported patients with increased fear-of-reinjury may be at risk for secondary injury following ACL reconstruction. The primary objective was to compare the relationship between ACL-RSI, Pedi-IKDC, Pedi-FABS, and PROMIS-Psychological Stress Experiences (PSE) across various age groups and graft types between patients undergoing primary ACL reconstruction at the 6 month post-operative visit. Secondary outcome was timing of RTS clearance. Methods: Patients prospectively enrolled were 8-30 years old who underwent primary ACL reconstruction at a large pediatric academic sports medicine center from August 2018 until February 2019. They were evaluated at their 6 month follow-up appointment and underwent functional RTS testing. Patients were divided into 3 groups based on their age: Pre-Adolescent (ages 8-14), Adolescent (ages 15-18), and Adult (ages >18) to reflect their psychological/emotional maturity. Demographic information, time to RTS clearance, and functional testing measurements were collected. Analysis included one-way ANOVA and Kruskal-Wallis tests. Results: A total of 100 patients were included in the study (57 males, 43 females; mean age, 17.3±2.9 years). RTS functional testing was performed at a mean of 6.3±0.7 months after primary ACL reconstruction. The 3 age groups consisted of Pre-Adolescent (n=13), Adolescent (n=62), and Adult (n=25). The graft types were HS (n=79), BTB (n=14), ITB (n=7). Mean ACL-RSI scores were significantly different among age groups (Pre-Adolescent 80.3±10.6, Adolescent 60.4±23.3, Adult 54.3±21.3; p=0.003) and graft type (HS 61.2±22.0, BTB 52.9±26.4, ITB 82.1±9.7; p=0.019). Scores were significantly different among the 3 age groups for IKDC (Pre-Adolescent 85.4±12.1, Adolescent 77.5±13.8, Adult 61.0±8.4; p<0.001). Scores were not significantly different among the three age groups for Pedi-FABS (Pre-Adolescent 24.9±5.4, Adolescent 23.6±8.1, Adult 20.6±9.2; p=0.212). The mean PROMIS-PSE t-scores were significantly different among the age groups (Pre-Adolescent 45.8±8.6, Adolescent 52.0±7.2, Adult 53.8±8.1; p=0.009) and graft type (HS 52.4±7.7, BTB 52.7±6.6, ITB 40.9±4.9; p<0.001). There were no significant differences for average timing of RTS clearance among the 3 age groups (Pre-Adolescent 8.5±1.5 months, Adolescent 8.0±1.3 months, Adult 8.1±1.2 months; p=0.618). Conclusion: This study suggests that psychological profiles and subjective perceptions of knee function following ACL reconstruction may vary in young patients of different ages. Pre-adolescent patients had better scores on all patient reported outcomes compared to adolescent and adult patients. Age-related differences in patient reported outcomes should be considered when evaluating young athletes. [Figure: see text]

scholarly journals 726 Return to Sport, Patient Reported Outcomes and Satisfaction Following Anterior Cruciate Ligament Reconstruction

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
C Simpson ◽  
D MacDonald ◽  
J Keating
Keyword(s):  
Anterior Cruciate Ligament ◽  
Patient Satisfaction ◽  
Acl Reconstruction ◽  
Patient Reported Outcomes ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Healthcare Experience ◽  
Patient Reported ◽  
Anterior Cruciate

Abstract Introduction Anterior Cruciate Ligament(ACL) rupture is a common sporting injury. Return to sport is a key objective for patients. The aim of this study was to investigate return to pre-injury level sport at 12- and 24-months post reconstruction and to relate this to types of sport and to patient satisfaction. Method A questionnaire was developed, piloted, and then completed by 77 patients that had undergone ACL reconstruction between 2013-2016. Results 30% of patients returned to pre-injury level of sport at 12 months and 43% by 24 months’ post ACL reconstruction. There was a significant(P = 0.037) relationship between the type of sports that participants played prior to injury and the return to pre-injury level. Sports that involved jumping, hard pivoting and cutting were associated with a lower rate of return to sport. General health profile of the patients was found to be significantly higher in patients that returned to sport(P = 0.024). There was a significant association with return to sport and higher satisfaction and healthcare experience score(P = 0.001). Conclusions Patient satisfaction correlated with return to sport. This was inversely related to sports involving jumping, hard pivoting and cutting. Which further illustrates how patient satisfaction post ACL reconstruction was linked to type of sport.

Assessing Physical Activity After ACL Injury: Moving Beyond Return to Sport

2021 ◽  
pp. 194173812110253
Author(s):  
Christopher Kuenze ◽  
Katherine Collins ◽  
Karin Allor Pfeiffer ◽  
Caroline Lisee
Keyword(s):  
Physical Activity ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Young Patients ◽  
Return To Sport ◽  
Acl Injury ◽  
Noncommunicable Diseases ◽  
Successful Recovery ◽  
Patient Reported ◽  
Anterior Cruciate

Context: Return to sport is widely utilized by sports medicine researchers and clinicians as a primary outcome of interest for successful recovery when working with young patients who have undergone anterior cruciate ligament (ACL) reconstruction (ACLR). While return-to-sport outcomes are effective at tracking progress post-ACLR, they are limited because they do not necessarily capture physical activity (PA) engagement, which is important to maintain knee joint health and reduce the risk of noncommunicable diseases. Therefore, there is a critical need (1) to describe current PA participation and measurement recommendations; (2) to appraise common PA measurement approaches, including patient-reported outcomes and device-based methodologies; and (3) to provide clinical recommendations for future evaluation. Evidence Acquisition: Reports of patient-reported or device-based PA in patients with ACL injury were acquired and summarized based on a PubMed search (2000 through July 2020). Search terms included physical activity OR activity AND anterior cruciate ligament OR ACL. Study Design: Clinical review. Level of Evidence: Level 5. Results: We highlight that (1) individuals with ACLR are 2.36 times less likely to meet the US Department of Health and Human Services PA recommendations even when reporting successful return to sport, (2) common patient-reported PA assessments have significant limitations in the data that can be derived, and (3) alternative patient-reported and device-based assessments may provide improved assessment of PA in this patient population. Conclusion: Clinicians and researchers have relied on return to sport status or self-reported PA participation via surveys. These approaches are not consistent with current recommendations for PA assessment and do not allow for comparison with contemporary PA recommendations or guidelines. Return to sport, patient-reported outcome measures, and device-based assessment approaches should be used in complementary manners to comprehensively assess PA participation after ACLR. However, appropriate techniques should be used when assessing PA in adult and adolescent populations.

Timeline for Maximal Subjective Outcome Improvement After Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 47 (10) ◽  
pp. 2501-2509 ◽  
Author(s):  
Avinesh Agarwalla ◽  
Richard N. Puzzitiello ◽  
Joseph N. Liu ◽  
Gregory L. Cvetanovich ◽  
Anirudh K. Gowd ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Clinical Significance ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Pubmed Database ◽  
Patient Reported ◽  
Clinically Significant ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears are one of the most common traumatic knee injuries experienced by athletes. Return to sport is considered the pinnacle endpoint among patients receiving ACL reconstruction. However, at the time of return to sport, patients may not be participating at their previous levels of function, as defined by clinical metrics. Purpose: To establish when patients perceive maximal subjective medical improvement according to patient-reported outcome measures (PROMs). Study Design: Systematic review. Methods: A systematic review of the PubMed database was conducted to identify studies that reported sequential PROMs up to a minimum of 2 years after ACL reconstruction. Pooled analysis was conducted for PROMs at follow-up points of 3 months, 6 months, 1 year, and 2 years. Clinically significant improvement was determined between pairs of intervals with the minimal clinically important difference. Results: This review contains 30 studies including 2253 patients who underwent ACL reconstruction. Clinically significant improvement in the KOOS (Knee injury and Osteoarthritis Outcome Score) was seen up to 1 year after ACL reconstruction, but no clinical significance was noted from 1 to 2 years. Clinically significant improvement in the IKDC (International Knee Documentation Committee) and Lysholm questionnaires was seen up to 6 months postoperatively, but no clinical significance was noted beyond that. Conclusion: After ACL reconstruction, maximal subjective medical improvement is established 1 year postoperatively, with no further perceived clinical improvement beyond this time point according to current PROMs. The KOOS may be a more responsive metric to subjective improvements in this patient cohort than other patient-reported outcomes, such as the IKDC and Lysholm. Clinical Relevance: After ACL reconstruction, patients perceive interval subjective improvements until 1 year postoperatively.

Outcomes of Quadriceps Tendon With Patellar Bone Block Anterior Cruciate Ligament Reconstruction in Adolescent Patients With a Minimum 2-Year Follow-up

2019 ◽  
Vol 48 (1) ◽  
pp. 93-98 ◽  
Author(s):  
Alexia G. Gagliardi ◽  
Patrick M. Carry ◽  
Harin B. Parikh ◽  
Jay C. Albright
Keyword(s):  
Acl Reconstruction ◽  
Graft Failure ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Quadriceps Tendon ◽  
Acl Injuries ◽  
Patient Reported ◽  
Adolescent Patients ◽  
Anterior Cruciate

Background: The incidence of anterior cruciate ligament (ACL) injury in the adolescent population is increasing. The quadriceps tendon–patellar bone autograft (QPA) has been established as a reliable graft choice for ACL reconstruction in the adult population. Purpose: To investigate graft failure, ability to return to sport, patient-reported functional outcomes, joint laxity, and subsequent injury among adolescent patients >2 years after primary ACL reconstruction with the QPA. Study Design: Case series; Level of evidence, 4. Methods: Consecutive patients who underwent QPA ACL reconstruction performed by a single surgeon were identified from an existing database. Information available in the database included demographics, concomitant/subsequent injuries, surgical procedures, graft failure, return to sport, and Lachman examination collected by medical record review. Pediatric International Knee Documentation Committee (Pedi-IKDC) and Lysholm scores were collected by telephone or during a clinic visit >2 years postoperatively. Results: The final cohort included 81 of 104 consecutive adolescent patients aged 10 to 18 years (mean ± SD, 15.9 ± 1.7 years at the time of surgery) for whom follow-up information was collected at >2 years after surgery. The cumulative incidence of graft failure within the 36-month follow-up period was 1.2% (95% CI, 0.1%-11.4%). The rate of ipsilateral non-ACL injuries was similar (1.2%; 95% CI, 0.2%-7.6%). Contralateral ACL and non-ACL injuries requiring surgical intervention were documented in 9.8% (95% CI, 4.9%-19.5%). The median Pedi-IKDC score was 94 (interquartile range, 89-98). The median Lysholm score was 99.5 (interquartile range, 89.0-100.0). At 36 months after surgery, 87.9% (95% CI, 81.4%-94.9%) of individuals had returned to play. Conclusion: The quadriceps tendon–patellar autograft is a novel graft that demonstrates excellent stability and favorable patient-reported outcomes. Based on these results, the QPA is a reliable choice for primary ACL reconstruction in adolescent patients.

How Is Psychological Outcome Related to Knee Function and Return to Sport Among Adolescent Athletes After Anterior Cruciate Ligament Reconstruction?

2019 ◽  
Vol 47 (7) ◽  
pp. 1567-1575 ◽  
Author(s):  
Susanne Beischer ◽  
Eric Hamrin Senorski ◽  
Christoffer Thomeé ◽  
Kristian Samuelsson ◽  
Roland Thomeé
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Self Efficacy ◽  
Muscle Function ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Adolescent Athletes ◽  
Psychological Outcome ◽  
Patient Reported ◽  
Anterior Cruciate

Background: Adult patients who succeed in returning to their preinjury levels of sport after anterior cruciate ligament (ACL) reconstruction have been characterized by a more positive psychological response. It is not known whether this relationship is valid for adolescent athletes. Purpose: To investigate psychological readiness to return to sport, knee-related self-efficacy, and motivation among adolescent (15-20 years old) and adult (21-30 years old) athletes after ACL reconstruction. A further aim was to compare athletes (15-30 years old) who had recovered their muscle function and returned to sport with athletes who had not. Study Design: Case-control study; Level of evidence, 3. Methods: Data were extracted from a rehabilitation-specific register 8 and 12 months after ACL reconstruction. Athletes previously involved in knee-strenuous sport who had undergone primary ACL reconstruction were included. Data comprised psychological patient-reported outcomes and results from 5 tests of muscle function. Comparisons were performed between age groups, between athletes who had and had not recovered their muscle function, and between patients who had returned to sport and not. Results: In all, 384 (50% females) and 271 athletes (52% females) were included at the 8- and 12- month follow-ups, respectively. Enhanced self-efficacy was reported at both follow-ups by adolescents and by athletes who had recovered their muscle function. Athletes who had recovered their muscle function reported higher ( P = .0007) motivation to achieve their goals. Subgroup analyses on patient sex revealed findings similar to those in the main analyses for females but not for males. Moreover, adolescent and adult athletes who had returned to sport reported significantly higher levels on the Knee Self-Efficacy Scale and the ACL–Return to Sport After Injury scale at both follow-ups. Conclusion: Adolescent athletes, especially females, perceived enhanced self-efficacy, had a higher return-to-sport rate, and were more motivated to reach their goals after ACL reconstruction compared with adults. Regardless of age, athletes who had returned to sport and athletes with more symmetrical muscle function had a stronger psychological profile.

scholarly journals Poor Associations Between Radiographic Tibiofemoral Osteoarthritis and Patient-Reported Outcomes at 16 Years After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 8 (9) ◽  
pp. 232596712095117
Author(s):  
Fredrik Identeg ◽  
Eric Hamrin Senorski ◽  
Eleonor Svantesson ◽  
Kristian Samuelsson ◽  
Ninni Sernert ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Patient Reported Outcomes ◽  
Cruciate Ligament ◽  
Patient Reported ◽  
Long Term Follow Up ◽  
Ikdc Score ◽  
Anterior Cruciate ◽  
Grade 3

Background: Radiographic tibiofemoral (TF) osteoarthritis (OA) is common in patients after anterior cruciate ligament (ACL) reconstruction at long-term follow-up. The association between radiographic OA and patient-reported outcomes has not been thoroughly investigated. Purpose: To determine the association between radiographic TF OA and patient-reported outcome measure (PROM) scores at 16 years after ACL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: This study was based on 2 randomized controlled studies comprising 193 patients who underwent unilateral ACL reconstruction. A long-term follow-up was carried out at 16.4 ± 1.7 years after surgery and included a radiographic examination of the knee and recording of PROM scores. Correlation analyses were performed between radiographic OA (Kellgren-Lawrence [K-L], Ahlbäck, and cumulative Fairbank grades) and the PROMs of the International Knee Documentation Committee (IKDC) subjective knee form, Lysholm score, and Tegner activity scale. A linear univariable regression model was used to assess how the IKDC score differed with each grade of radiographic OA. Results: Of 193 patients at baseline, 147 attended the long-term follow-up. At long-term follow-up, 44.2% of the patients had a K-L grade of ≥2 in the injured leg, compared with 6.8% in the uninjured leg. The mean IKDC score at follow-up was 71.2 ± 19.9. Higher grades of radiographic OA were significantly correlated with lower IKDC and Lysholm scores ( r = –0.36 to –0.22). Patients with a K-L grade of 3 to 4 had significantly lower IKDC scores compared with patients without radiographic OA (K-L grade 0-1). Adjusted beta values were –15.7 (95% CI, –27.5 to –4.0; P = .0093; R 2 = 0.09) for K-L grade 3 and –25.2 (95% CI, –41.7 to –8.6; P = .0033; R 2 = 0.09) for K-L grade 4. Conclusion: There was a poor but significant correlation between radiographic TF OA and more knee-related limitations, as measured by the IKDC form and the Lysholm score. Patients with high grades of radiographic TF OA (K-L grade 3-4) had a statistically significant decrease in IKDC scores compared with patients without radiographic TF OA at 16 years after ACL reconstruction. No associations were found between radiographic TF OA and the Tegner activity level.

scholarly journals Development of the KOOSglobal Platform to Measure Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 46 (12) ◽  
pp. 2915-2921 ◽  
Author(s):  
Cale A. Jacobs ◽  
Michael R. Peabody ◽  
Christian Lattermann ◽  
Jose F. Vega ◽  
Laura J. Huston ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Acl Reconstruction ◽  
Relative Efficiency ◽  
Convergent Validity ◽  
Patient Reported Outcomes ◽  
Short Form ◽  
Cruciate Ligament ◽  
Patient Reported ◽  
Anterior Cruciate

Background: The Knee injury and Osteoarthritis Outcome Score (KOOS) has demonstrated inferior psychometric properties when compared with the International Knee Documentation Committee (IKDC) subjective knee form when assessing outcomes after anterior cruciate ligament (ACL) reconstruction. The KOOS, Joint Replacement (KOOS, JR) is a validated short-form instrument to assess patient-reported outcomes (PROs) after knee arthroplasty, and the purpose of this study was to determine if augmenting the KOOS, JR with additional KOOS items would allow for the creation of a short-form KOOS-based global knee score for patients undergoing ACL reconstruction, with psychometric properties similar to those of the IKDC. Hypothesis: An augmented version of the KOOS, JR could be created that would demonstrate convergent validity with the IKDC but avoid the ceiling effects and limitations previously noted with several of the KOOS subscales. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Based on preoperative and 2-year postoperative responses to the KOOS questionnaires from a sample of 1904 patients undergoing ACL reconstruction, an aggregate score combining the KOOS, JR and the 4 KOOS Quality of Life subscale questions, termed the KOOSglobal, was developed. Psychometric properties of the KOOSglobal were then compared with those of the IKDC subjective score. Convergent validity between the KOOSglobal and IKDC was assessed with a Spearman correlation (ρ). Responsiveness of the 2 instruments was assessed by calculating the pre- to postoperative effect size and relative efficiency. Finally, the presence of a preoperative floor or postoperative ceiling effect was defined with the threshold of 15% of patients reporting either the worst possible (0 for KOOSglobal and IKDC) or the best possible (100 for KOOSglobal and IKDC) scores, respectively. Results: The newly developed KOOSglobal was responsive after ACL reconstruction and demonstrated convergent validity with the IKDC. The KOOSglobal significantly correlated with the IKDC scores (ρ = 0.91, P < .001), explained 83% of the variability in IKDC scores, and was similarly responsive (relative efficiency = 0.63). While there was a higher rate of perfect postoperative scores with the KOOSglobal (213 of 1904, 11%) than with the IKDC (6%), the KOOSglobal was still below the 15% ceiling effect threshold. Conclusion: The large ceiling effects limit the ability to use several of the KOOS subscales with the younger, more active ACL population. However, by creating an aggregate score from the KOOS, JR and 4 KOOS Quality of Life subscale questions, the 11-item KOOSglobal offers a responsive PRO tool after ACL reconstruction that converges with the information captured with the IKDC. Also, by offering the ability to calculate multiple scores from a single questionnaire, the KOOSglobal may provide the orthopaedic community a single PRO platform to be used across knee-related subspecialties. Registration: NCT00478894 ( ClinicalTrials.gov identifier).

scholarly journals Influence of Meniscal and Chondral Lesions on Patient-Reported Outcomes After Primary Anterior Cruciate Ligament Reconstruction at 2-Year Follow-up

2018 ◽  
Vol 6 (2) ◽  
pp. 232596711775418 ◽  
Author(s):  
Mark E. Cinque ◽  
Jorge Chahla ◽  
Justin J. Mitchell ◽  
Gilbert Moatshe ◽  
Jonas Pogorzelski ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Patient Reported Outcomes ◽  
Cruciate Ligament ◽  
Chondral Lesions ◽  
Meniscal Lesions ◽  
Patient Reported ◽  
Outcome Scores ◽  
The Mean ◽  
Anterior Cruciate

Background: Meniscal and chondral lesions are commonly associated with anterior cruciate ligament (ACL) tears, and these lesions may play a role in patient outcomes after ACL reconstruction. Purpose: To determine the effects of the presence and location of meniscal and chondral lesions at the time of ACL reconstruction on patient-reported outcomes at a minimum 2-year follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with no prior knee surgery who underwent primary ACL reconstruction by a single surgeon between 2010 and 2014 were included in this study. Those meeting inclusion criteria were divided into the following groups based on the arthroscopic diagnosis: patients without concomitant meniscal or chondral lesions, patients with isolated meniscal lesions, patients with isolated chondral lesions, and patients with both chondral and meniscal lesions. Patient-reported outcomes (Short Form–12 [SF-12] physical component summary [PCS] and mental component summary [MCS], Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], and Lysholm scale) were assessed at a minimum of 2 years from the index surgery. Results: A total of 151 patients met the inclusion criteria and were included in the study. The mean age at the time of surgery was 36.2 years (range, 14-73 years), and the mean follow-up was 3.2 years (range, 2.0-5.6 years). At the time of surgery, 33 (22%) patients had no concomitant lesions and served as the control group, 63 (42%) patients had isolated meniscal lesions, 21 (14%) patients had isolated chondral lesions, and 34 (22%) patients had both chondral and meniscal lesions. There was significant improvement in all outcome scores postoperatively for the 3 groups ( P < .05 for all outcome scores). The presence of a meniscal tear and laterality of the meniscal lesion did not have a negative effect on any postoperative outcome scores. Patients with isolated chondral lesions had significantly lower postoperative WOMAC scores compared with patients without chondral lesions ( P < .05). No significant differences were found for all other scores. Patients with patellofemoral chondral lesions had significantly lower postoperative SF-12 PCS and Lysholm scores than patients with tibiofemoral chondral lesions ( P < .05). Conclusion: Patients with ACL tears achieved improved functional scores at a mean 3.2 years after ACL reconstruction. While meniscal lesions did not affect postoperative outcomes in the short term, chondral lesions were identified as a predictor for worse outcomes.

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