10-year outcomes and risk factors after ACL reconstruction
In this study, consistent risk factors were identified - both modifiable and non-modifiable - that are predictive of inferior 10 year outcomes post ACL reconstruction (ACLR).
The findings further provided support against more commonly held beliefs thought to negatively effect long-term outcomes. Clinically, information gained may provide insight into prognostics after surgical intervention.
This prospective longitudinal study reviewed 1592 eligible patients who had undergone a primary or revision ACLR. Patient reported outcomes (IKDC, KOOS and Marx) were administered due the unique vantage point of analysis of interventions and were given at baseline, 2 year, 6 year and 10 year follow-up.
Consistent risk factors for inferior reports at 10 years included: lower baseline score, higher BMI, smoker at baseline and having prior medial meniscus procedure performed prior to ACLR. Other notable factors included; female sex, older age, lower education level, surgical revision, having articular cartilage grade 3 to 4 or having any further surgery post ACLR.
Coincidently, sport type, level of competition, graft type, MCL or LCL lesions at time of ACLR or surgeon selection were not found to have negative impact on 10 year outcome. Furthermore, IKDC and KOOS scores were found to increase after ACLR and were sustained at 10-year follow-up.
The authors suggest the findings of this study may help the focus education in management of expectations when considering ACLR surgery, as well as help recognize the need for further research into modifiable risk factors that may further improve outcomes post ACLR.
> From: MOON Knee Group, Am J Sports Med 46 (2018) 815-825. All rights reserved to The Author(s). Click here for the online summary.