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Cited by 15Knee injuries and reconstruction techniquesFoot and Ankle SurgeryTotal Knee Arthroplasty Outcomes

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Poorer patient-reported knee function and quality of life, but not activity level, after revision ACL reconstruction compared with primary ACL reconstruction: a matched-pair analysis with a minimum 5-year follow-up

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Koca, Firathan, Stålman, Anders, Vestberg, Cornelia, Cristiani, Riccardo, Fältström, Anne·2023·BMC Musculoskeletal Disorders
DOI 10.1186/s12891-023-06954-1PMC PMC10594802
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Abstract

Background: An appropriate method for comparing knee function and activity level between patients with primary and revision anterior cruciate ligament reconstruction (ACLR) is to perform a matched-group analysis. The aim was to assess and compare knee function, knee-related quality of life and activity level between patients with revision ACLR and primary ACLR at a minimum of 5 years of follow-up. Methods: Patients aged ≤ 40 years old who underwent revision ACLR between 2010 and 2015 and a matched control group (primary ACLR) (1:1) with age ± 2 years, year of ACLR, sex, and pre-injury sport and Tegner Activity Scale (TAS) were retrospectively identified in our clinic database. The preoperative Knee injury and Osteoarthritis Outcome Score (KOOS) and surgical data were extracted and analyzed. Patients were mailed KOOS and EQ-5D questionnaires at a minimum of 5-years after revision ACLR. Study-specific questions about knee function, limitation in sport, satisfaction, and activity level according to the TAS (all scales of 1–10, 10 best) were also asked by telephone. Results: Seventy-eight patients with a revision ACLR (mean age ± SD, 29.9 ± 6.0 years) matched with seventy-eight patients with a primary ACLR (30.2 ± 5.8 years) were included. The follow-up for the revision ACLR group was 7.0 ± 1.5 years and for the primary ACLR group 7.7 ± 1.6 years. The revision ACLR group reported poorer KOOS scores in all subscales (p < 0.05) except the Symptoms subscale, poorer EQ-5D VAS (mean 79.2 ± 20.1 vs 86.0 ± 20.1, p = 0.012), and less satisfaction with current knee function (median 7 (6–8) vs 8 (7–9), p < 0.001). Patients with revision ACLR also experienced greater limitation in sports (median 7 (4–8) vs 8 (6–9), p < 0.001). There were no significant differences in the EQ-5D (mean 0.86 ± 0.17 vs 0.89 ± 0.11, p = 0.427), activity level (median 2 (2–5) vs 4 (2–7), p = 0.229), or satisfaction with activity level (median 8 (5–9) vs 8 (6–10), p = 0.281) between the groups. Conclusions: At a minimum 5-year follow-up, the revision ACLR group reported poorer knee function and quality of life, less satisfaction with knee function and a greater limitation in sports but no differences in activity level and satisfaction with activity level compared with the primary ACLR group.

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Crossref · 10.1186/s12891-023-06954-1

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Figures

Fig. 1 Flow chart of patient enrolment. A Revision ACLR Group and B Primary ACLR group. ACLR, anterior cruciate ligament reconstruction, CACL, contralateral anterior cruciate ligament
Fig. 1 Flow chart of patient enrolment. A Revision ACLR Group and B Primary ACLR group. ACLR, anterior cruciate ligament reconstruction, CACL, contralateral anterior cruciate ligamentCC BY · PubMed Central
Fig. 2 The proportion of patients attaining a patient-acceptable symptom state on the KOOS subscales during follow-up was examined in both the revision ACLR group (n = 65) and the primary ACLR group (n = 72). ACLR anterior cruciate ligament reconstruction, ADL Activities of Daily Living, KOOS Knee injury and Osteoarthritis Outcome Score, QOL Quality of Life, Sports/Rec Sports/Recreation
Fig. 2 The proportion of patients attaining a patient-acceptable symptom state on the KOOS subscales during follow-up was examined in both the revision ACLR group (n = 65) and the primary ACLR group (n = 72). ACLR anterior cruciate ligament reconstruction, ADL Activities of Daily Living, KOOS Knee injury and Osteoarthritis Outcome Score, QOL Quality of Life, Sports/Rec Sports/RecreationCC BY · PubMed Central

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Citations

Cites

Research works printed but not linked: 32

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Metadata

Authors
Koca, F., Stålman, A., Vestberg, C., Cristiani, R., & Fältström, A.
Affiliations
  • Karolinska Institutet (SE)
  • Linköping University (SE)
Corresponding author
Fältström, Anne
ORCID
Venue
BMC Musculoskeletal Disorders
Publisher
Springer Science and Business Media LLC
Published
2023-10-23
Volume
24
Issue
1
Pages
831-831
ISSN
1471-2474 (ISSN-L)
DOI
10.1186/s12891-023-06954-1
PMC
PMC10594802
OpenAlex
W4387880833
Cited by
15
References
1
Citations by year
2026: 6 · 2025: 6 · 2024: 3
FWCI
3.37
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Musculoskeletal Disorders (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DiVA (Linkoping University) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Linköping University
Topics
  • Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Foot and Ankle Surgery
  • Health Sciences › Medicine › Surgery › Total Knee Arthroplasty Outcomes
Keywords
revision anterior cruciate ligament reconstruction, knee function, knee-related quality of life, activity level, Tegner score, KOOS, EQ-5D, patient satisfaction, sports participation, matched-pair analysis, long-term outcomes, knee osteoarthritis risk, knee swelling, knee stiffness, knee laxity
MeSH terms
Anterior Cruciate Ligament Injuries, Patient Reported Outcome Measures, Adult, Follow-Up Studies, Humans, Knee Joint, Quality of Life, Retrospective Studies, Matched-Pair Analysis

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