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ACL reconstruction yielded significant changes in outcome scores
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Compared with pre-injury baseline scores and an uninjured control group, results published in The American Journal of Sports Medicine showed patients with ACL injuries had significant deficits on patient-reported outcome measures at least 2 years after surgical reconstruction.
Among 1,268 first-year students entering the U.S. service academy, Ivan J. Antosh, LTC, MD, and colleagues collected baseline questionnaires that included the KOOS, WOMAC score and Marx Activity Rating Scale from 1,005 students with no previous injuries. Researchers assessed 30 participants who sustained a subsequent ACL injury at the time of surgery and at 6, 12 and 24 months after surgery. Researchers matched participants who sustained an ACL injury with 90 healthy participants who completed follow-up assessments.
At final follow-up, results showed statistically significant differences between the ACL-injured group and the uninjured group across all KOOS and WOMAC subscales. Researchers found a greater than eight-point difference in the pain, symptom, sports and recreation function and knee-related quality of life KOOS subscales and the WOMAC stiffness subscale between groups. This difference exceeded the established minimum clinically important difference (MCID) for these instruments, according to results. However, the Marx Activity Rating Scale showed no significant differences between the ACL-injured group and uninjured group. Compared with pre-injury baseline scores, researchers found significant deficits that exceeded the established MCID values in the ACL-injured group on the WOMAC stiffness subscale, the Marx Activity Rating Scale and all KOOS subscales, except for functional activities of daily living, at final follow-up.
“Even in young, healthy patients with ACL tears who undergo prompt reconstruction and a closely supervised rehabilitation, persistent deficits in functional outcomes persist at 2 years after surgery,” Antosh told Healio.com/Orthopedics. “Patients should understand that their reconstructed knee will likely improve after surgery, but ultimately may not function the same as the uninjured knee.” – by Casey Tingle
Disclosures: Antosh reports he received educational support from Arthrex Inc. and travel and educational support from Smith & Nephew. Please see the full study for a list of all other authors’ relevant financial disclosures.
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