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Functional recovery after anterior cruciate ligament reconstruction, a study of health-related quality of life based on the Swedish National Knee Ligament Register

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To restore functional stability of the knee joint and to prevent secondary injuries to the cartilage and menisci are the main goals of an anterior cruciate ligament (ACL) reconstruction. Functional stability can be assessed by health-related quality of life questionnaires, but characterising differences between a satisfactory and non-satisfactory result can be challenging.

Methods

The aim of this study based on the Swedish National Knee Ligament Register was to find predictors for a satisfactory result defined as functional recovery (FR) or a non-satisfactory result defined as treatment failure (TF), with special emphasis on waiting time before surgery and additional injuries. FR was defined as a Knee Osteoarthritis Outcome Score (KOOS) above: 90 for Pain, 84 for Symptoms, 91 for ADL, 80 for Sport/Rec and 81 for quality of life (QoL). TF was defined as a KOOS, QoL < 44.

Results

A complete KOOS was available for 41.4 % of a cohort of 8,584 patients 2 years after the ACL reconstruction. Of all patients, 19.7 % were FR and 28.9 % were TF. Male gender was a predictor for FR. Previous surgery of the menisci and a patella graft was predictors for TF and negative predictors for FR. A medial meniscus suture or resection at the time of reconstruction was a predictor for TF. Waiting time was a predictor for medial meniscus and cartilage injury at the time of reconstruction.

Conclusions

Functional recovery after an ACL reconstruction can be achieved; gender and additional injuries are important predictors for a functional recovery. To time surgery early, that is, before recurring giving ways has occurred is essential to decrease additional injuries and increase the chance of functional recovery.

Level of evidence

II.

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Acknowledgments

Statistician Lina Benson at the Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, for statistical analysis and model control.

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Authors and Affiliations

  1. Section of Orthopaedics, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 11883, Stockholm, Sweden

    Björn Barenius & Karl Eriksson

  2. Stockholm Sports Trauma Research Center, Karolinska Institutet, Capio Artro Clinic, Box 5605, 114 86, Stockholm, Sweden

    Magnus Forssblad & Björn Engström

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  1. Björn Barenius
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  2. Magnus Forssblad
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  3. Björn Engström
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  4. Karl Eriksson
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Correspondence to Björn Barenius.

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Barenius, B., Forssblad, M., Engström, B. et al. Functional recovery after anterior cruciate ligament reconstruction, a study of health-related quality of life based on the Swedish National Knee Ligament Register. Knee Surg Sports Traumatol Arthrosc 21, 914–927 (2013). https://doi.org/10.1007/s00167-012-2162-8

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