Document Detail


The prognosis and predictors of sports function and activity at minimum 6 years after anterior cruciate ligament reconstruction: a population cohort study.
MedLine Citation:
PMID:  21084660     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Kurt P Spindler; Laura J Huston; Rick W Wright; Christopher C Kaeding; Robert G Marx; Annunziato Amendola; Richard D Parker; Jack T Andrish; Emily K Reinke; Frank E Harrell; ; Warren R Dunn
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-11-17
Journal Detail:
Title:  The American journal of sports medicine     Volume:  39     ISSN:  1552-3365     ISO Abbreviation:  Am J Sports Med     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-08     Completed Date:  2011-06-23     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  348-59     Citation Subset:  IM    
Affiliation:
Vanderbilt Sports Medicine, 4200 Medical Center East, South Tower, 1215 21st Ave South, Nashville, TN 37232-8774, USA. kurt.spindler@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Anterior Cruciate Ligament / surgery*
Athletes*
Cohort Studies
Female
Follow-Up Studies
Humans
Male
Orthopedic Procedures / methods
Prognosis
Quality of Life
Questionnaires
Recovery of Function*
Young Adult
Grant Support
ID/Acronym/Agency:
5 U18-HS016075/HS/AHRQ HHS; 5K23 AR052392-04/AR/NIAMS NIH HHS; R01 AR053684/AR/NIAMS NIH HHS; R01 AR053684/AR/NIAMS NIH HHS; UL1 RR025755/RR/NCRR NIH HHS
Investigator
Investigator/Affiliation:
Angela Pedroza / ; Angel Q An / ; Leah Schmitz / ; Eric C McCarty / ; Brian R Wolf / ; Morgan H Jones / ; Matthew J Matava / ; David C Flanigan / ; Robert H Brophy / ; Armando F Vidal /
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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