Survey reveals mixed opinions about how to gauge success 2 years after ACL surgery

GENEVA — Professional consensus is lacking among sports medicine professionals regarding the outcome measures that best demonstrate an ACL surgery was successful at 2 years postoperatively, according to results of a survey presented at the European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress 2012, here.

A patient’s return to sport, self-reported outcomes, quadriceps and hamstring strength, absence of joint effusion and absence of giving way were all reported in the survey findings as being important, according to the researchers who conducted the study. However, they found that other measures, such as the Tegner and Marx activity rating scales, were rated poorly in the survey results.

Andrew Lynch, PT, of the Department of Physical Therapy at the University of Delaware, in Newark, Del., said at that survey participants agreed on the usefulness of multiple outcome measures to gauge success after ACL surgery, but they widely disagreed on which outcome measures were most important.

“Clinicians agree that a multi-faceted approach is indicated to determine successful outcome after ACL injury or reconstruction,” Lynch said.

Of the nine outcome measures asked about in the questionnaire, 50% of respondents were unfamiliar with certain measures, Lynch said. Knee Outcome Score measures were rated highly, he said, noting that the International Knee Documentation Committee-2000 score — which was also listed in the survey — combines the SAME outcomes into one easy-to-use outcome measure.

Based on the results Lynch presented, the clinicians surveyed also placed importance on hamstring strength as a key outcome although, according to the abstract, its relationship to function is limited.

Functional testing was not identified as important in the study despite it being viewed as useful to track postoperative progress. Radiographic imaging was ranked highly in the results, but Lynch said identifying osteoarthritis on radiographs was not as important at the 1-year or 2-year follow-up.

Reference:

Lynch A, Logerstedt, D, Grindem H, et al. Professional consensus regarding success after ACL surgery does not correspond to published literature. Paper #FP15-1255. Presented at the European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress 2012. May 2-5. Geneva.

Disclosure: Lynch has no relevant financial disclosures.