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Self-Reported Patient Outcomes after ACL Reconstruction with Allograft Tissue

HARRELD, KEVIN; NYLAND, JOHN; COTTRELL, BRAD; CABORN, DAVID N. M.

Medicine & Science in Sports & Exercise: December 2006 - Volume 38 - Issue 12 - pp 2058-2067
doi: 10.1249/01.mss.0000235355.93813.d1
CLINICAL SCIENCES: Clinically Relevant

Purpose: Self-reported outcomes after primary ACL reconstruction using allograft tissues were compared at ≥ 5 yr (group 1) and at 2-4 yr (group 2) after surgery.

Methods: The IKDC Subjective Knee Evaluation and Current Health Assessment and the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS) and the Sports Activity Scale (KOS-SAS) were mailed to 335 consecutive former patients at ≥ 2 yr after surgery.

Results: Surveys were completed and returned by 64.6% of former patients. Time after surgery for group 1 (N = 90) and group 2 (N = 116) was 7.8 ± 2.7 and 2.8 ± 0.8 yr, respectively. Groups did not differ for IKDC Subjective Knee Evaluation or KOS-ADLS scores, although group 1 displayed a lower mean KOS-SAS score. Pooled IKDC Subjective Knee Evaluation scores were 42.7% normal (A), 22.8% nearly normal (B), 24.8% abnormal (C), or 9.7% severely abnormal (D). Pooled standardized IKDC Subjective Knee Evaluation z scores were −0.80 ± 1.4 standard deviations below the reported population mean for unimpaired individuals with 33.5% scoring at or above the normative population mean, 28.2% scoring < 1 standard deviation below the normative population mean, 18.8% scoring between 1 and 2 standard deviations below the normative population mean, and 19% scoring ≥ 2 standard deviations below the normative population mean. Pooled KOS-ADLS scores were 62.1% (≥ 90%), 18% (89-80%), 10.2% (79-70%), and 9.7% (< 70%). Pooled KOS-SAS scores were 49.5% (102/206, ≥ 90%), 25.7% (53/206, 89-80%), 9.7% (20/206, 79-70%), and 15.1% (31/206, < 70%). Groups displayed comparable knee function before injury and at the time of the survey. Pooled knee-function scores decreased from 9.5 ± 1.6 before injury to 8 ± 2.5 current function (84% return). Both groups displayed decreases in current sports activity level from strenuous to moderate and frequency from 4-7 to 1-3 times per week.

Conclusions: Self-reported outcomes did not differ between groups for the IKDC Subjective Knee Evaluation or for the KOS-ADLS score, although group 1 displayed decreased mean KOS-SAS scores, suggesting decreased perceived sporting activity knee function at ≥ 5 yr after surgery. Decreased sports activity level and frequency are comparable with self-reported outcome studies after primary ACL reconstruction using autograft tissues.

Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, Louisville, KY

Address for correspondence: John Nyland, EdD, Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, 210 East Gray St., Suite 1003, Louisville, KY 40202; E-mail: john.nyland@louisville.edu.

Submitted for publication September 2005.

Accepted for publication June 2006.

©2006The American College of Sports Medicine