The Journal of Bone and Joint Surgery (American). 2005;87:1673-1679.
doi:10.2106/JBJS.D.01842
© 2005 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow [Related Editorial]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Related articles in JBJS
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Spindler, K. P.
Right arrow Articles by Wright, R. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Spindler, K. P.
Right arrow Articles by Wright, R. W.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?

Clinical Outcome at a Minimum of Five Years After Reconstruction of the Anterior Cruciate Ligament

Kurt P. Spindler, MD1, Todd A. Warren, NP, ATC1, J. Claiborne Callison, Jr., BA1, Michelle Secic, MS2, Sheryl B. Fleisch1 and Rick W. Wright, MD3

1 Vanderbilt Orthopaedic Institute, Medical Center East, South Tower, Suite 4200, Nashville, TN 37232-8774
2 Secic Statistical Consulting, Inc., P.O. Box 745, Chardon, OH 44024-0745
3 Department of Orthopaedic Surgery, Washington University School of Medicine at Barnes-Jewish Hospital, One Barnes-Jewish Hospital Plaza, Suite 11300, West Pavilion, St. Louis, MO 63110. E-mail address: rwwright1{at}aol.com

Investigation performed at the Department of Orthopaedics and Rehabilitation, Vanderbilt University, Nashville, Tennessee

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from the Orthopaedic Research and Education Foundation, Aircast, and the Vanderbilt Sports Medicine Research Fund. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Presented at the Annual Meeting of the American Orthopaedic Society for Sports Medicine, San Diego, California, July 20-23, 2003.

Background: We are not aware of any previous studies in which independent measurements of function with validated outcome questionnaires such as the Knee Injury and Osteoarthritis Outcome Score and the International Knee Documentation Committee score were evaluated five years after reconstruction of the anterior cruciate ligament. We hypothesized that patient demographics, mechanism of injury, and intra-articular injuries and their treatment are factors associated with function five years after reconstruction of the anterior cruciate ligament.

Methods: A consecutive series of unilateral, arthroscopically assisted primary reconstructions of the anterior cruciate ligament performed by one surgeon using a patellar tendon graft was evaluated. Data on patient demographics, injury variables, and intra-articular lesions noted at the time of surgery were collected prospectively. Multivariable regression analysis was used to identify independent predictors of outcomes as measured with five questionnaires.

Results: Sixty-nine percent (217) of 314 knees with a reconstruction of the anterior cruciate ligament were followed for an average of 5.4 years. The average age at the time of the operation was twenty-seven years. Independent predictors of a worse outcome, which was measured with the overall Knee Injury and Osteoarthritis Outcome Score, the International Knee Documentation Committee score, the Lysholm score, and the Western Ontario and McMaster Universities Osteoarthritis Index score, included the patient's recollection of hearing or feeling a pop at the time of the injury, a weight gain of >15 lb (6.8 kg), and no change in educational level since the surgery. There was a lack of association between the outcome and either the occurrence or the form of treatment of a meniscal tear or chondromalacia of the articular cartilage.

Conclusions: To our knowledge, we performed the first prospective cohort study to evaluate the prognosis following reconstruction of the anterior cruciate ligament by identifying significant associations between multiple variables and clinical outcomes as measured with validated questionnaires. The clinician can counsel patients about the intermediate-term functional outcomes of reconstructions of the anterior cruciate ligament on the basis of these findings. Suggestions regarding weight control and future education may improve intermediate-term outcomes.

Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?

Related articles in JBJS:

Are Validated Questionnaires Valid?
James D. Heckman
JBJS 2006 88: 446. [Extract] [Full Text]  



This article has been cited by other articles:


Home page
 Am J Sports MedHome page
C. V. Toman, W. R. Dunn, K. P. Spindler, A. Amendola, J. T. Andrish, J. A. Bergfeld, D. Flanigan, M. H. Jones, C. C. Kaeding, R. G. Marx, et al.
Success of Meniscal Repair at Anterior Cruciate Ligament Reconstruction
Am. J. Sports Med., June 1, 2009; 37(6): 1111 - 1115.
[Abstract] [Full Text] [PDF]

Home page
 Ann Rheum DisHome page
L S Lohmander, M Gerhardsson de Verdier, J Rollof, P M Nilsson, and G Engstrom
Incidence of severe knee and hip osteoarthritis in relation to different measures of body mass: a population-based prospective cohort study
Ann Rheum Dis, April 1, 2009; 68(4): 490 - 496.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
Y. Lu, M. D. Markel, B. Nemke, S. Wynn, and B. Graf
Comparison of Single-Versus Double-Tunnel Tendon-to-Bone Healing in an Ovine Model: A Biomechanical and Histological Analysis
Am. J. Sports Med., March 1, 2009; 37(3): 512 - 517.
[Abstract] [Full Text] [PDF]

Home page
 J Am Acad Orthop SurgHome page
R. W. Wright
Knee Injury Outcomes Measures
J. Am. Acad. Ortho. Surg., January 1, 2009; 17(1): 31 - 39.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
B. Lebel, C. Hulet, B. Galaud, G. Burdin, B. Locker, and C. Vielpeau
Arthroscopic Reconstruction of the Anterior Cruciate Ligament Using Bone-Patellar Tendon-Bone Autograft: A Minimum 10-Year Follow-up
Am. J. Sports Med., July 1, 2008; 36(7): 1275 - 1282.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
F. H. Fu, W. Shen, J. S. Starman, N. Okeke, and J. J. Irrgang
Primary Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction: A Preliminary 2-Year Prospective Study
Am. J. Sports Med., July 1, 2008; 36(7): 1263 - 1274.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
L. S. Lohmander, P. M. Englund, L. L. Dahl, and E. M. Roos
The Long-term Consequence of Anterior Cruciate Ligament and Meniscus Injuries: Osteoarthritis
Am. J. Sports Med., October 1, 2007; 35(10): 1756 - 1769.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
R. W. Wright, W. R. Dunn, A. Amendola, J. T. Andrish, J. Bergfeld, C. C. Kaeding, R. G. Marx, E. C. McCarty, R. D. Parker, M. Wolcott, et al.
Risk of Tearing the Intact Anterior Cruciate Ligament in the Contralateral Knee and Rupturing the Anterior Cruciate Ligament Graft During the First 2 Years After Anterior Cruciate Ligament Reconstruction: A Prospective MOON Cohort Study
Am. J. Sports Med., July 1, 2007; 35(7): 1131 - 1134.
[Abstract] [Full Text] [PDF]

Home page
 ptjournalHome page
J. J Irrgang
Invited Commentary
Physical Therapy, July 1, 2006; 86(7): 1033 - 1037.
[Full Text] [PDF]

Home page
 JBJSHome page
B. D. Beynnon, E. Roos, S. Lohmander, and R. J. Johnson

J. Bone Joint Surg. Am., February 1, 2006; 88(2): 448 - 448.
[Full Text] [PDF]

Home page
 JBJSHome page
A. F. Anderson and J. J. Irrgang

J. Bone Joint Surg. Am., February 1, 2006; 88(2): 446 - 447.
[Full Text] [PDF]