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Patient satisfaction tied to function after ACL reconstruction at 10 years
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A 10-year follow-up of nearly 300 patients who underwent ACL reconstruction shows high patient-reported satisfaction and indicates this finding is linked with function.
“Patient satisfaction at an average of 14 years postoperatively was more dependent on function and activity level than on treatment of the meniscus or chondral defect,” said Karen K. Briggs, MBA, MPH, during her presentation at a recent meeting.
Briggs and her colleagues examined patient-centered outcomes at 10 years after ACL reconstruction in order to “determine if concurrent surgery for meniscal injuries or chondral defects affected that outcome.”
The Director for the Center for Outcomes-Based Orthopaedic Research at the Steadman Philippon Research Institute, Briggs noted, “The definition [of success] following surgical interventions has been redefined with the evolution of health care. We have to know who does [well] and who does [poorly]; patient assessment has therefore gained increasing importance in helping evaluate patient outcomes.”
Data at 10 years
Information for the study was drawn from a prospective data registry, and patients who had undergone a bone-patella-bone ACL reconstruction by a single surgeon were included. Outcome measures for the study included the WOMAC, SF-12, Lysholm and Tegner scales as well as patient satisfaction based on a scale of one to 10.
The study included 278 patients with an average age of 33 years and an average 14 years follow-up. Reported pathologies included: 37 patients with treated chondral defects and meniscus tears; 47 patients with only chondral defects; 122 patients with a meniscus treated; and 73 patients without a meniscal or chondral lesion.
Correlation to function
Overall, Briggs said patients demonstrated “good function and a high level of satisfaction at 10 years following surgery.” However, patients with both meniscal and chondral tears reported lower scores. “The satisfaction with outcome was significantly correlated with the functional outcome scores and the osteoarthritis score and the activity level, which one would expect,” said Briggs. “The presences of chondral defects and meniscus tears requiring treatment does result in lower outcomes and higher dysfunction.”
Overall, the average Lysholm score at 10 years was 82, on a scale of 25 to 100; the median Tegner score was six amid a three to 10 range; the average WOMAC score was 8.4 in a range of zero to 55; and the average SF-12 mental component summary and physical component summary scores were 54 and 53, respectively. The median satisfaction score at 10-year follow-up was 10. Time to follow-up did not affect outcome scores, according to Briggs.
“Difference in outcome scores was seen based in associated pathologies; however, we need to make sure that we meet the minimum detectable difference for those scores,” said Briggs. “There is limited data right now on the minimally clinically important difference at 10 years following surgery.” – by Katie Pfaff
Reference:
Briggs KK. Patient-centered outcomes 10 years following ACL reconstruction. Presented at: EFORT Congress; June 4-6, 2014; London.
For more information:
Karen K. Briggs, MBA, MPH, can be reached at Steadman Philippon Research Institute, 181 W. Meadow Dr., Suite 1000, Vail, CO 81657; email: karen.briggs@sprivail.org.
Disclosure: Briggs receives institute support from Smith & Nephew, Ossur, Siemens, Arthrex and Vail Valley Medical Center.