What can the first 2 months tell us about outcomes after anterior cruciate ligament reconstruction?

• Published in: Journal of athletic training 2015-05, Vol.50 (5), p.508-515
• Main Authors: Christensen, Jesse C, Goldfine, Laura R, Barker, Tyler, Collingridge, Dave S
• Format: Article
• Language: English
• Subjects: Adult; Anterior Cruciate Ligament Reconstruction - adverse effects; Anterior Cruciate Ligament Reconstruction - methods; Anterior Cruciate Ligament Reconstruction - rehabilitation; Body Composition; Body Mass Index; Cohort Studies; Evidence; Exercise Therapy - methods; Female; Humans; Injuries; Knee; Knee Joint - physiopathology; Ligaments; Male; Middle Aged; Muscular Strength; Obesity; Original Research; Outcome Assessment (Health Care); Outcome Measures; Participant Characteristics; Patients; Postoperative Period; Prognosis; Range of Motion, Articular; Recovery of Function; Self Efficacy; Sports injuries; Studies; Surgery; Time Factors; Workers Compensation
• ISSN: 1062-6050; 1938-162X
• DOI: 10.4085/1062-6050-49.3.95

Substantial research has been conducted on anterior cruciate ligament reconstruction (ACLR) to evaluate patient outcomes. However, little attention has been given to outcomes during the early phase of recovery and how early deficits affect both short- and long-term outcomes. To identify relationships between demographic (age, sex, and body mass index [BMI]) and intraoperative (isolated ACLR versus primary ACLR + secondary procedures), and postoperative (range-of-motion [ROM] and peak isometric knee-extension force [PIF]) variables during the first 2 months after ACLR using self-reported outcomes. Cohort study. Outpatient orthopaedic hospital. A total of 63 patients (38 men, 25 women; age = 33.0 ± 12.1 years; BMI = 26.3 ± 6.5 kg/m(2)) who underwent ACLR. Demographic, intraoperative, and postoperative variables were collected at 1 and 2 months after ACLR and were compared with International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form scores at 1, 2, and ≥12 months. Significant relationships were identified between ≥12-month IKDC scores and the 1-month (Pearson correlation, r = 0.283, r(2) = 0.08; P = .025) and 2-month (r = 0.301, r(2) = 0.09; P = .017) IKDC scores. After controlling for other variables, we found that the PIF ratio measures at 1 and 2 months were positively associated with 1- and 2-month IKDC scores (P < .001) and BMI was negatively associated with both 1- and 2-month IKDC scores (P < .05). One-month IKDC scores were related to the 1-month difference in knee-flexion ROM (P = .04). The IKDC scores during the first 2 months were positively correlated with patients' perceptions of function on long-term IKDC scores. It also appears that improvements in lower extremity strength and flexion ROM deficits were positively associated with short-term IKDC scores. Higher BMI was negatively associated with patients' perceptions of function on short-term IKDC scores.