Table 3

2-year and 5-year outcomes stratified by ACL healing status as visualised on MRI and ACL management strategy

2-year outcomes5-year outcomes
Rehab alone at 2 years (no ACLR)Rehab+delayed ACLR within 2 years (n=24)Early ACLR+rehab (n=62)Rehab alone at 5 years (no ACLR)Rehab+delayed ACLR within 5 years (n=30)Early ACLR+rehab (n=62)
Evidence of ACL healing (n=16)Non-healed ACL (n=14)Evidence of ACL healing (n=14)Non-healed ACL (n=10)
KOOS Sport/Rec88 (14)67 (28)66 (30)72 (27)84 (25)81 (19)78 (26)76 (23)
KOOS QOL76 (17)54 (25)63 (24)67 (24)77 (18)61 (22)72 (24)71 (21)
KOOS Pain96 (6)86 (14)85 (16)87 (16)92 (13)91 (9)91 (13)91 (12)
KOOS Symptoms94 (6)81 (18)79 (19)79 (21)91 (16)87 (19)85 (14)83 (17)
Tegner Activity Score, mean (SD), (median, IQR)6 (3) (6, 4–9)6 (3) (6, 4–8)6 (2) (6, 4–7)6 (3) (7, 3–8)5 (2) (6, 4-7)5 (3) (4, 3–7)5 (3) (4, 2–7)5 (3) (4, 3–7)
Passive knee laxity
 Normal/nearly normal pivot shift test12 (75%)6 (46%)22 (92%)60 (100%)10 (71%)7 (70%)29 (97%)58 (98%)
 Normal/nearly normal Lachman’s test7 (44%)4 (31%)20 (83%)56 (93%)5 (36%)6 (60%)28 (93%)57 (97%)
 KT-1000, mean (SD), mm9.4 (3.3)8.2 (2.9)7.3 (2.7)6.6 (2.4)
Radiographic TFJ OA2 (14%)1 (10%)1 (3%)9 (15%)
Radiographic PFJ OA1 (7%)1 (10%)6 (21%)14 (24%)
  • Data represent mean (SD) or count (%); ‘evidence of ACL healing’ = Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS) score of 0 to 2 (0=normal ligament with hypointense signal and regular thickness and continuity; 1=thickened ligament and/or high intraligamentous signal with normal course and continuity; 2=thinned or elongated but continuous ligament); ‘non-healed ACL’ = ACLOAS score of 3 (3=absent ligament or complete discontinuity); normal or nearly normal pivot shift test represents grade 0 (normal) or grade 1 (nearly normal (+, glide)); Lachman’s test was scored from 0 (normal translation) to 3 (severely increased translation), with 0–1 indicating normal or nearly normal translation; four persons had missing healing status at 2 years, 4 persons had missing healing status at 5 years; of persons with non-missing healing status one had missing radiographic OA status.

  • ACL, anterior cruciate ligament; ACLR, ACL reconstruction; KOOS, Knee injury and Osteoarthritis Outcome Score; PFJ OA, patellofemoral osteoarthritis; QOL, quality of life; Sport/Rec, patient-reported sport and recreational function .