High activity level before ACL reconstruction may yield inability to regain activity level
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Key takeaways:
- Overall, 39% of patients returned to preinjury level of activity at follow-up.
- Patients with high preinjury activity levels were less likely to return to preinjury level of activity.
WASHINGTON — Results presented here showed that patients with a high activity level prior to ACL reconstruction were less likely to regain their activity level at 2-year follow-up.
“These data convincingly demonstrate the extent to which patients with a high baseline activity are difficult to treat,” Andrew J. Sheean, MD, FAAOS, said in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting. “The higher the preinjury Marx activity score, the less likely he or she was able to return to their preinjury level of activity.”
Sheean and colleagues collected Marx activity scores at the time of injury and 2-year follow-up among 1,188 adults aged 17 to 51 who underwent ACL reconstruction and were prospectively enrolled in the Multicenter Orthopaedic Outcomes Network (MOON) cohort.
“We defined highly active as a Marx activity score between 12 and 16 points and employed predictive multivariable modeling to determine and identify risk factors that predicted the inability to return to activity,” Sheean said. “Inability to return to activity was defined as a decrease in 2-year follow-up Marx activity score of greater than 2 points from the preinjury level.”
At the time of injury, results showed 54% of patients reported a maximum Marx activity score of 16. According to Sheean, 39% of patients were able to return to their preinjury level of activity at 2-year follow-up. He said negative predictors of inability to return to preinjury activity level included sex, smoking status, education level, baseline activity score and mental health represented by the SF-36 mental component summary.
Sheean said patients with 12 years of education had a consistent decrease in the likelihood of returning to activity. He added older patients with 16 years of education were more likely to return to activity “at a certain inflection point.”
“The higher the preinjury Marx activity score, the less likely the patient was to return to their preinjury level of activity,” Sheean said. “The higher the preinjury mental health score, the more likely those patients were to return to their preinjury level of activity.”
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Sheean AJ, et al. Paper 62. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 12-16, 2023; Washington, D.C.
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