Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 23, Issue 4, pp 1135–1140 | Cite as

Associations between inadequate knee function detected by KOOS and prospective graft failure in an anterior cruciate ligament-reconstructed knee

  • Lars-Petter GrananEmail author
  • Valborg Baste
  • Lars Engebretsen
  • Maria C. S. Inacio



First, to evaluate whether the 2 year post-operative Knee injury and Osteoarthritis Outcome Score (KOOS) in primary anterior cruciate ligament reconstructions (ACLRs) was significantly different between patients that did not go on to have a subsequent revision after the 2 year post-operative control and the ones that did. Second, to test whether the “clinically failure” value of KOOS quality of life (QoL) < 44 was indicative of a clinically relevant difference in the risk of subsequent revision ACLR.


ACLRs reported to the Norwegian Knee Ligament Registry between June 2004 and December 2009. 5,517 primary ACLRs with at least 2-year follow-up with KOOS QoL before revision surgery.


There were clinically significant differences, adjusted and unadjusted, in both the KOOS Sport and Recreation and QoL subscales in patients with a later revision surgery compared to those that did not have a revision surgery. In adjusted models, the risk of later ACLR revision was 3.7 (95 % CI 2.2–6.0) higher in patients with a 2-year KOOS QoL < 44 compared to patients with a KOOS QoL ≥ 44. For every 10-point reduction in the KOOS QoL, a 33.6 % (95 % CI 21.2–47.5 %) higher risk for later ACLR revision was observed.


This study reveals an association between inadequate knee function, as measured by KOOS, and a prospective ACL-reconstructed graft failure.

Level of evidence

Prognostic study (prospective cohort study), Level II.


Anterior cruciate ligament Revision Registry Patient-reported outcome measures 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Lars-Petter Granan
    • 1
    • 2
    • 3
    Email author
  • Valborg Baste
    • 4
  • Lars Engebretsen
    • 5
    • 1
    • 2
  • Maria C. S. Inacio
    • 6
  1. 1.Oslo Sports Trauma Research CenterNorwegian School of Sport SciencesOsloNorway
  2. 2.Norwegian Knee Ligament RegistryBergenNorway
  3. 3.Department of Physical Medicine and RehabilitationOslo University HospitalOsloNorway
  4. 4.Norwegian Arthroplasty RegisterBergenNorway
  5. 5.Department of Orthopaedic SurgeryOslo University HospitalOsloNorway
  6. 6.Surgical Outcomes and Analysis DepartmentKaiser PermanenteSan DiegoUSA

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