RT Journal Article
SR Electronic
T1 When ACL reconstruction does not help: risk factors associated with not achieving the minimal important change for the KOOS Sport/Rec and QoL
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 528
OP 535
DO 10.1136/bjsports-2022-106191
VO 57
IS 9
A1 Janina Kaarre
A1 Rebecca Simonson
A1 Viktor Ris
A1 Thorkell Snaebjörnsson
A1 James J Irrgang
A1 Volker Musahl
A1 Kristian Samuelsson
A1 Eric Hamrin Senorski
YR 2023
UL http://bjsm.bmj.com/content/57/9/528.abstract
AB Objectives To determine factors associated with not achieving a minimal important change (MIC) in the Knee injury and Osteoarthritis Outcome Score (KOOS) Function in Sport and Recreation (Sport/Rec), and Knee-Related Quality of Life (QoL) subscales 1 year after anterior cruciate ligament reconstruction (ACL-R).Methods This study used data from the Swedish National Knee Ligament Registry. Multivariable logistic regression models were used to identify factors associated with not achieving a MIC. The change in the preoperative and postoperative KOOS Sport/Rec and QoL subscale scores were dichotomised based on not achieving MIC for both subscales versus achieving MIC for either one or both subscales. The MICs for the Sport/Rec and QoL subscales were 12.1 and 18.3, respectively, and were used to combine both subscales into a single variable (Sport & QoL).Results Of 16 131 included patients, 44% did not achieve the MIC for the combined Sport/Rec and QoL subscales 1 year after ACL-R. From the multivariable stepwise logistic regression, older patients (OR 0.91, 95% CI 0.88 to 0.94; p<0.0001), males (OR 0.93, 95% CI 0.87 to 0.99; p=0.034) and patients receiving hamstring tendon autograft ACL-R (OR 0.70, 95% CI 0.60 to 0.81; p<0.0001) had lower odds of not achieving the MIC 1 year after ACL-R compared with younger patients, females and patients receiving patellar tendon autograft. Furthermore, patients with cartilage injuries (OR 1.17, 95% CI 1.09 to 1.27; p<0.0001) and higher pre-operative KOOS Sport/Rec and QoL scores (OR 1.34, 95% CI 1.31 to 1.36; p<0.0001) had higher odds of not achieving the MIC.Conclusion Younger patients, females and patients with cartilage injuries and higher pre-operative Sport/Rec and QoL KOOS scores are less likely to benefit from ACL-R and subsequently, have a lower probability for improved Sport/Rec and QoL scores after ACL-R. Furthermore, graft choice may also affect the risk of not achieving the MIC.Level of evidence Retrospective cohort study, level III.Data are available on reasonable request.