A new study suggests that patients undergoing surgery to repair and rebuild an anterior cruciate ligament (ACL) tear, exhibited significant improvement in physical function at 2 years, which continued for at least 6 years post-surgery.
A news release from that American Academy of Orthopaedic Surgeons (AAOS) reports that younger patient age, lower body mass index (BMI), and having the remnants of the torn ACL completely excised during surgery, were among the strongest predictors of positive, long-term outcome.
During the study, the release says researchers reviewed and evaluated the outcomes of 1,411 patients (44% female, average age of patients at enrollment was 23) who underwent ACL surgery between 2002 and 2004 at four major medical centers. Each patient completed questionnaires designed to assess health, well-being, and function—prior to surgery, and again at 2 and 6 years post-surgery.
Warren R. Dunn, MD, MPH, lead study author, University of Wisconsin orthopaedic surgeon, explains that the researchers “found that health related quality of life was significantly improved following ACL reconstruction, and this improvement was still present 6 years following surgery. The predictors for good and poorer outcomes may be helpful when counseling patients who are considering ACL surgery.”
Specifically, the release reports that the average physical health score was 41.9 and the mean mental health score was 51.7 at baseline. At 2 years post-surgery, the physical and mental health scores were stable at 53.6 and 52 points, respectively, and 54 and 52.4 at year six.
According to the release, additional study findings indicate that ACL reconstruction resulted in large improvements in the physical function scores, with a mean improvement of 12 points (out of 100) at 2 years and 6 years post-surgery. At 6 years following ACL surgery, patients gained a mean 5.3 quality-adjusted life years (QALYs). One QALY represents 1 year of perfect health; .5 QALY, 6 months, the release notes.
Study findings also suggest that predictors of worse postoperative outcomes were a shorter follow-up time following surgery, revision ACL reconstruction, smoking at baseline, fewer years of education, and damage to the cartilage under the knee cap (chondromalacia patella). Physical function, the release states, continued to improve over the long term following reconstruction. Patients requiring a revision reconstruction did not fare as well as patients undergoing a single reconstruction. The release adds that mental health scores during the 6-year period did not significantly change, yet scores consistently remained above the population norm of 50 points.
Source(s): Science Daily, American Academy of Orthopaedic Surgeons