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Patient-Reported Outcome, Return to Sport, and Revision Rates 7-9 Years After Anterior Cruciate Ligament Reconstruction: Results From a Cohort of 2042 Patients.
- Source :
- American Journal of Sports Medicine; Feb2022, Vol. 50 Issue 2, p423-432, 10p
- Publication Year :
- 2022
-
Abstract
- Background: Long-term patient-reported outcome measures (PROMs), rates of return to sport, and revision risk after anterior cruciate ligament (ACL) reconstruction (ACLR) are not well understood. Purpose: To provide long-term follow-up of PROMs, return-to-sport rates, and revision rates after ACLR and to identify predictors for poor outcome. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 2042 patients were included in an institutional ACL registry (2009-2013) and longitudinally followed. PROMs were completed preoperatively and at all follow-up time points. Questions regarding return to sport and knee stability were completed at final follow-up. Predictors for poor outcome on the International Knee Documentation Committee (IKDC) score were estimated in a regression model incorporating risk factors such as patient characteristics, graft choice, and concomitant injuries. Revision rates and risk of subsequent non-ACL surgeries were calculated. Results: Autografts were used in 76% of the patients (patellar tendon, 62%; hamstring grafts, 38%). Allografts were used in 24% of patients. The questionnaires were returned by 1045 (51.2%) patients at a mean of 7.2 years (range, 5.0-9.8 years) after surgery. Improvements in IKDC score of >30 points were sustained for all patient categories. The strongest predictor for lesser improvement in IKDC score was a cartilage lesion >2 cm<superscript>2</superscript> identified during surgery. Male sex and college education completion were associated with improved IKDC scores. Meniscal lesions did not predict change) in the IKDC score. A total of 69% of patients had returned to sport after 8.1 years (range, 6.7-9.8 years). The main reason for not returning to sport was fear of reinjury. The revision rate was 7.2% after 9 years (range, 8-11 years), 13% of patients needed subsequent ipsilateral non-ACL surgery, and 6% underwent contralateral ACLR. The absence of a meniscal tear, younger age, and male sex were predictors for revision. Graft choice did not predict PROM results or revision risk. Conclusion: Improvements in IKDC scores were sustained 7 years after ACLR. The strongest predictor for poor outcome was a cartilage lesion >2 cm<superscript>2</superscript>. Patients can expect a 70% return-to-sport rate and an 87% chance of their knee feeling stable during daily and athletic activities after 8 years. Young male patients have better PROM scores but a higher risk of revision. There is a 26% chance of subsequent knee surgery within 9 years, including a revision rate of 7%, subsequent non-ACL surgery to the operated knee in 13%, and a 6% chance of contralateral ACLR. [ABSTRACT FROM AUTHOR]
- Subjects :
- SPORTS participation
HOMOGRAFTS
CONFIDENCE intervals
PREOPERATIVE period
AGE distribution
MULTIPLE regression analysis
HEALTH outcome assessment
CASE-control method
SURGERY
PATIENTS
REGRESSION analysis
FEAR
RACE
EPIDEMIOLOGY
MENISCECTOMY
TREATMENT effectiveness
RISK assessment
PRE-tests & post-tests
AUTOGRAFTS
SEX distribution
T-test (Statistics)
PEARSON correlation (Statistics)
PHYSICAL activity
REOPERATION
ANTERIOR cruciate ligament injuries
POSTOPERATIVE period
PATELLAR tendon
HAMSTRING muscle
QUESTIONNAIRES
DESCRIPTIVE statistics
QUALITY assurance
CHI-squared test
ANTERIOR cruciate ligament surgery
WOUNDS & injuries
ARTICULAR cartilage
BODY mass index
SMOKING
DATA analysis software
LONGITUDINAL method
KNEE
EDUCATIONAL attainment
MENISCUS injuries
KNEE surgery
EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 03635465
- Volume :
- 50
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- American Journal of Sports Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 155178597
- Full Text :
- https://doi.org/10.1177/03635465211060333