Prognostic indicators of lower extremity functional recovery after anterior cruciate ligament reconstruction

To create a predictive model of early post-operative function after anterior cruciate ligament reconstruction (ACLR) using demographic and surgical prognostic indicators.

Retrospective cohort study.

Outpatient academic hospital.

962 adult patients with ACLR.

The longitudinal trajectory of Lower Extremity Functional Scale (LEFS) scores over the first 26 weeks post-ACLR was modeled using a negative exponential function with three parameters: an initial functional status immediately after ACLR (pseudo-intercept), a recovery rate constant, and a recovery plateau (asymptote). Associations of demographic (age, sex, body mass index [BMI]) and surgical factors (graft type, concomitant surgical procedures) with each of the parameters were evaluated. A multivariate model was created from significant prognostic indicators identified.

Lower initial function was associated with quadriceps tendon autografts and concomitant procedures. Female sex, quadriceps tendon autografts, and concomitant procedures were associated with slower recovery rates. Older age and higher BMI were associated with lower recovery plateaus. Inclusion of demographic and surgical predictors improved model performance compared to time post-ACLR alone.

Demographic and surgical factors are prognostic of early post-operative function after ACLR, and a predictive model for postoperative LEFS scores created using these factors may provide insights useful for rehabilitation planning.