Anterior cruciate ligament reconstruction: the short-term recovery using the Knee Injury and Osteoarthritis Outcome Score (KOOS)
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The use of patient reported outcome measures has gained increasing prominence in reporting surgical outcomes following primary anterior cruciate ligament reconstruction (ACLR). Many peer-reviewed journals now require ‘end-result’ outcomes in excess of 24 months following surgery for publication. As such, there is less focus on early recovery when the greatest rate of change is experienced and when key rehabilitation decisions are made relating to restricted activity and return to sports. We sought to examine the early recovery profile of patients following primary ACLR, determine the presence of any plateau effect of recovery and establish a source of reference for future study.
One hundred and sixty-five patients undergoing primary ACLR were identified from a prospective database. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was recorded pre-operatively and at the 3-, 6- and 12-month follow-up reviews. Mean scores were developed to plot a standard ‘recovery profile’ of statistical analysis for the presence of any plateau effect.
There were significant improvements in all mean KOOS domains at 12 months following ACLR (P < 0.001) and between each recording point (P < 0.003), discounting any plateau effect. Rates of graft rupture and other surgical complications were low (1.2 and 1.8 %). The recovery profile of mean KOOS scores illustrated a reduced rate of recovery over time with sports/recreation and knee-related quality of life KOOS domains demonstrating the greatest sensitivity to change.
This study profiles the early recovery of patients following primary ACLR using the KOOS demonstrating continued recovery of function throughout the full first 12 months with no evidence of a plateau effect. The early results in ACLR have not previously been reported in a study of this size and provide important data upon which key rehabilitation decisions can be based.
Level of evidence
Therapeutic study–case series with no comparison group, Level IV.
KeywordsACL Reconstruction PROM Recovery Outcome KOOS
The authors would like to thank Joanne Zamani and Stephanie Hughes (Department of Research and Development, Frimley Park Hospital NHS Foundation Trust, Camberley, Surrey, GU16 7UJ, UK) for their advice and assistance in the preparation and statistical analysis of the results.
Conflict of interest
The authors declare that they have no conflict of interest.
This study was conducted in accordance with the standards required by the Research Ethics Committee at Royal Berkshire Hospital NHS Foundation Trust. Informed consent was obtained from all patients prior to their inclusion in the study.
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