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Self-reported patient outcomes after ACL reconstruction with allograft tissue
Kevin Harreld1, John Nyland, Brad Cottrell
1Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, Louisville, KY 40202, USA.
Purpose:
Self-reported outcomes after primary ACL reconstruction using allograft tissues were compared at > or = 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 > or = 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 > or = 2 standard deviations below the normative population mean. Pooled KOS-ADLS scores were 62.1% (> or = 90%), 18% (89-80%), 10.2% (79-70%), and 9.7% (< 70%). Pooled KOS-SAS scores were 49.5% (102/206, > or = 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 > or = 5 yr after surgery. Decreased sports activity level and frequency are comparable with self-reported outcome studies after primary ACL reconstruction using autograft tissues.