Related Experiment Videos
Revision ACL reconstruction outcomes: MOON cohort
Rick Wright1, Kurt Spindler, Laura Huston
1Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri 63131, USA. wright@wudosis.wustl.edu
The Journal of Knee Surgery
|February 7, 2012
Summary
Revision anterior cruciate ligament (ACL) reconstruction shows worse patient outcomes than primary ACL reconstruction. Patients reported lower activity levels and knee function scores two years after revision surgery.
Area of Science:
- Orthopaedic surgery
- Sports medicine
- Reconstructive surgery
Background:
- Clinician perception suggests poorer outcomes for revision anterior cruciate ligament (ACL) reconstruction compared to primary ACL reconstruction.
- Limited prospective studies exist evaluating revision ACL reconstruction using validated patient-based metrics.
Purpose of the Study:
- To prospectively evaluate and compare patient-reported outcomes of revision ACL reconstruction versus primary ACL reconstruction.
- To assess functional outcomes and patient satisfaction at 2-year follow-up.
Main Methods:
- A prospective, multicenter cohort study of patients undergoing ACL reconstruction was conducted.
- Validated patient-oriented questionnaires, including Marx activity level, Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) scores, were administered preoperatively and at 2-year follow-up.
- 393 patients (33 revision, 360 primary) with 2-year follow-up were analyzed.
Main Results:
- Revision ACL reconstruction patients demonstrated a significant decline in Marx activity scores compared to primary ACL reconstruction patients at 2 years (p=0.03).
- International Knee Documentation Committee (IKDC) scores were significantly lower in the revision group (75.9) versus the primary group (83.9) (p=0.003).
- Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, including Knee Related Quality of Life (KRQOL) and Sports and Recreation, were significantly worse in the revision group (p < 0.001, p=0.005 respectively).
Conclusions:
- Revision ACL reconstruction is associated with significantly worse patient-reported outcomes at 2-year follow-up compared to primary ACL reconstruction.
- Patient-based metrics indicate reduced activity levels and functional knee status following revision ACL surgery.
- These findings challenge the notion that revision ACL reconstruction yields comparable results to primary procedures.