Quality of life of patients with ACL reconstruction is interrelated with sporting activity and significantly improved when their concomitant meniscal rupture has been repaired. A long-term follow-up study

Abstract

The goal of the present study is to report patient-reported outcomes after anatomic ACL reconstruction with a hamstrings autograft, to investigate how a concomitant meniscal injury and its management could affect these outcomes and to identify a possible correlation between quality of life and activity levels at a minimum of 10-years follow-up. Patients from a single center, treated with a unilateral anatomic ACL reconstruction with or without a concomitant meniscal injury, between 2003 and 2011 were investigated. Patients were asked to provide the following validated patient-reported outcome measures (PROMs): the International Knee Documentation Committee Subjective Knee Function (IKDC-SKF) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Lysholm knee score, the Tegner Activity Scale, the EQ-5D-5L questionnaire and a patient acceptable symptom state (PASS). Sex, age, BMI, and meniscal status were examined as patient-specific risk factors regarding long-term activity and quality of life. Mean follow-up was 13.2 years. In a total sample of 131 patients, response rate was 81% and finally, 106 patients, 90 men (85%) and 16 women (15%) were enrolled in the study. Re-tear rate was 2.8%. The majority (90.5%) of patients considered their knee state, satisfactory during follow-up. Mean IKDC score was 80 ± 16, mean KOOS score was 87 ± 15, mean Lysholm score was 90 ± 11, mean Tegner score was 5.6 ± 1.9 and mean EQ-5D-5L score was 91 ± 14. Patients who had been treated with meniscectomy had statistically significantly lower scores in all PROMs except for the Tegner score and the EQ-5D-5L score, when compared to patients treated with meniscal repair. Patient sex, age, and BMI did not affect patient-reported outcomes. There was a statistically significant, strong positive correlation between quality of life and activity levels. Patients have few or no symptoms and consider their knee state satisfactory, 13.2 years after surgery. Patients having undergone meniscal repair have improved PROMs compared to those treated with meniscectomy. Participation in sporting activities is interrelated with quality-of-life and does not seem to be affected by sex, BMI and age.