QUALITY OF LIFE (QOL) FIVE YEARS AFTER ANTERIOR CRUCIATE LIGAMENT (ACL) RECONSTRUCTION

Abstract

Introduction: The International Knee Documentation Committee (IKDC) recommends use of the IKDC score to document subjective, objective and functional ACL outcome. To further improve knowledge concerning patient QOL after ACL reconstruction, an additional specific QOL questionnaire was developed. Using a combination of univariate and multivariate analysis the patient factors and surgical factors that influenced QOL 5- years after ACL reconstruction were determined.

Materials: 500 patients operated on for arthroscopic ACL reconstruction at our institution between 1997 and 2001 were prospectively enrolled. Patient psychosocial profile, sport expectations, knee exam, type of graft, associated lesion, type of anesthesia, complications, IKDC, KT 2000 at 6 moths, 1 year and 2 years were recorded. At five years, patients were asked to complete a 5-subscale validated QOL questionnaire for ACL deficiency. A multivariate analysis was performed to identify the factors influencing 5-year QOL.

Results: 203 patients completed the 5-years QOL questionnaire. Responders did not statistically differ from non responders. Patient subjective factors such as: patient expectations, pre-operative symptoms, work-school concerns, recreations concerns, social and psycho-social concerns were significantly (p< 0.05) and independently associated with the five-year QOL results. Objective factors such as meniscus tears and results of the KT 2000 (p< 0.05) were the two surgical factors correlated with 5-year QOL.

Discussion: In this large prospective study, most of the factors influencing the 5-year QOL results after ACL reconstruction were related to patient expectations, psycho-social, symptoms and work-sport concerns. The presence of a meniscus tear and greater KT 2000 laxity also contributed to poorer 5-year QOL results.