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Researchers call for consideration of pre-injury status in ACL reconstruction evaluations

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LIVERPOOL, United Kingdom — Investigators who studied outcomes following ACL reconstruction said they believe patients’ pre-injury status has been overlooked in determining postoperative results.

Ayman Gabr, MD, presented results of the prospective comparative study at the British Orthopaedic Association Annual Meeting, here.

“Function scores improved postoperatively at 1 year in comparison to preoperative post injury scores. At 1-year follow-up, the majority of patients feel they achieved their pre-injury status. It remains to be seen whether these patients will achieve their pre-injury score at 2 years follow-up, and the message is the evaluation of ACL reconstruction outcomes needs to consider the pre-injury scores rather than the immediate preoperative scores which are usually collected,” he said.

Gabr and colleagues prospectively studied 313 patients who underwent ACL reconstruction (169 men, 144 women; mean age 27 years) between January 2008 and January 2013.

Each patient completed two copies of the KOOS, Lysholm and Tegner at their first assessment and a third copy of each score 1 year after ACL reconstruction. Gabr said the KOOS subscale scores improved with surgery, but patients did not reach their pre-injury functional level.

The average Tegner score was 7 pre-injury and it reached 6 at 1 year postoperatively.

“That was down post injury at an average of 3,” Gabr said.

Average preinjury Lysholm scores were 95. They were 75 at post injury and 85 at the 1-year follow-up.

Discuss in OrthoMind

The study had some limitations, according to Gabr. The reconstructions were done with different techniques in 2008 and 2009 than in the later years, and there was possible recall bias when patients scored their pre-injury function. – by Susan M. Rapp

Reference:

Gabr A, et al. Paper #546. Presented at: British Orthopaedic Association Annual Congress; Sept. 15-18, 2015; Liverpool, United Kingdom.

Disclosure: Gabr reports no relevant financial disclosures.