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Patient-Reported Outcome, Return to Sport, and Revision Rates 7-9 Years After Anterior Cruciate Ligament Reconstruction: Results From a Cohort of 2042 Patients
| Content Provider | SAGE Publishing |
|---|---|
| Author | Randsborg, Per-Henrik Cepeda, Nicholas Adamec, Dakota Rodeo, Scott A. Ranawat, Anil Pearle, Andrew D. |
| Copyright Year | 2022 |
| Abstract | Long-term patient-reported outcome measures (PROMs), rates of return to sport, and revision risk after anterior cruciate ligament (ACL) reconstruction (ACLR) are not well understood.Purpose:To provide long-term follow-up of PROMs, return-to-sport rates, and revision rates after ACLR and to identify predictors for poor outcome.Study Design:Case-control study; Level of evidence, 3.Methods:A total of 2042 patients were included in an institutional ACL registry (2009-2013) and longitudinally followed. PROMs were completed preoperatively and at all follow-up time points. Questions regarding return to sport and knee stability were completed at final follow-up. Predictors for poor outcome on the International Knee Documentation Committee (IKDC) score were estimated in a regression model incorporating risk factors such as patient characteristics, graft choice, and concomitant injuries. Revision rates and risk of subsequent non-ACL surgeries were calculated.Results:Autografts were used in 76% of the patients (patellar tendon, 62%; hamstring grafts, 38%). Allografts were used in 24% of patients. The questionnaires were returned by 1045 (51.2%) patients at a mean of 7.2 years (range, 5.0-9.8 years) after surgery. Improvements in IKDC score of >30 points were sustained for all patient categories. The strongest predictor for lesser improvement in IKDC score was a cartilage lesion >2 cm2 identified during surgery. Male sex and college education completion were associated with improved IKDC scores. Meniscal lesions did not predict change) in the IKDC score. A total of 69% of patients had returned to sport after 8.1 years (range, 6.7-9.8 years). The main reason for not returning to sport was fear of reinjury. The revision rate was 7.2% after 9 years (range, 8-11 years), 13% of patients needed subsequent ipsilateral non-ACL surgery, and 6% underwent contralateral ACLR. The absence of a meniscal tear, younger age, and male sex were predictors for revision. Graft choice did not predict PROM results or revision risk.Conclusion:Improvements in IKDC scores were sustained 7 years after ACLR. The strongest predictor for poor outcome was a cartilage lesion >2 cm2. Patients can expect a 70% return-to-sport rate and an 87% chance of their knee feeling stable during daily and athletic activities after 8 years. Young male patients have better PROM scores but a higher risk of revision. There is a 26% chance of subsequent knee surgery within 9 years, including a revision rate of 7%, subsequent non-ACL surgery to the operated knee in 13%, and a 6% chance of contralateral ACLR. |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/03635465211060333?download=true |
| Starting Page | 423 |
| Ending Page | 432 |
| Page Count | 10 |
| ISSN | 03635465 |
| Issue Number | 2 |
| Volume Number | 50 |
| Journal | The American Journal of Sports Medicine (AJS) |
| e-ISSN | 15523365 |
| DOI | 10.1177/03635465211060333 |
| Language | English |
| Publisher | Sage Publications CA |
| Publisher Date | 2022-01-18 |
| Publisher Place | Los Angeles |
| Access Restriction | Open |
| Rights Holder | © 2022 The Author(s) |
| Subject Keyword | revision ACL return to sport IKDC |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Physical Therapy, Sports Therapy and Rehabilitation Sports Science |
