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Joint awareness and return to pre-injury level of activities after ACL reconstruction in athletes vs non-athletes

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The outcome of arthroscopic anterior cruciate ligament reconstruction (ACLR) in the non-athlete population is under-reported. The study aimed to compare the functional outcomes of ACLR in the non-athlete and athlete population by patient reported outcome measures (PROMs)- International Knee Documentation Committee score (IKDC), Lysholm knee scoring scale, Forgotten joint score (FJS-12) and return to pre-injury activity level. The study also correlated the FJS-12 score with other commonly used PROM’s (IKDC and Lysholm).

Methods

This was a prospective comparative study including patients undergoing ACLR. Patients were divided into two groups. Group-1 (non-athletes) and Group-2 (athletes, defined as those with pre-injury Tegner activity level > 5). Demographic profile, management of associated meniscal injury, perioperative and midterm complications were noted. All patients had 24 months follow-up. Knee laxity assessment by pivot shift test, functional outcome scores (Lysholm and IKDC) and FJS-12 were assessed preoperatively and postoperatively at 12 and 24 months.

Results

Group 1 and 2 included 69 and 47 participants, respectively, (total 116 patients). The mean age of group 1 was significantly higher than group 2 (33.1 ± 8.0 vs 25.0 ± 4.9 years; p < 0.005). There was no statistically significant difference in PROMs and FJS-12 scores between the groups at any follow-up. Return to pre-injury Tegner activity level post-ACLR was 88.4% (n = 61) and 46.8% (n = 22) in group 1 and 2, respectively (p). The ceiling effect in FJS-12, IKDC, and Lysholm scores were achieved by 9.3%, 19.5%, and 34.7% of patients (n = 116), respectively, at 2-year follow-up. The ceiling effect of FJS-12, Lysholm, and IKDC scores between the groups at final follow-up was not statistically significant (p = 1, p = .524, p = .09, respectively).

Conclusion

The functional outcome of ACLR was comparable between athletes and non-athletes. FJS-12 has a lower ceiling effect and better discriminatory power than Lysholm and IKDC scores. FJS-12 score can be satisfactorily used in ACLR to observe and monitor changes in patient satisfaction and outcome.

Level of study

II, Prospective comparative study.

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Funding

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Authors and Affiliations

  1. Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India

    Lakshmana Das & Tarun Goyal

  2. University Hospitals of Morecambe Bay NHS Trust—Royal Lancaster Infirmary, Ashton Road, Lancaster, LA1 4RP, UK

    Anant Shiv Johri

  3. Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India

    V. Abdusamad

  4. Department of Musculoskeletal Research, Hospital of Trauma Surgery, Marktredwitz Hospital, Marktredwitz, Germany

    Alexander Schuh

Authors
  1. Lakshmana Das
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  4. Alexander Schuh
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  5. Tarun Goyal
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Contributions

Conceptualization was contributed by TG. Methodology was contributed by TG, LD, AS. Formal analysis and investigation were contributed by ASJ, VA. Writing—original draft preparation, was contributed by LD, ASJ, VA. Writing—review and editing, was contributed by TG, AS. Resources was contributed by TG. Supervision was contributed by TG.

Corresponding author

Correspondence to Tarun Goyal.

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Conflict of Interest

The authors declare that they have no conflict of interest. Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Ethical approval

The institutional ethics committee approved the study (AIIMS/IEC/18/141).

Informed consent

Informed consent was obtained from all individual participants included in the study. The study was conducted in All India Institute of Medical Sciences, Rishikesh, India.

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Das, L., Johri, A.S., Abdusamad, V. et al. Joint awareness and return to pre-injury level of activities after ACL reconstruction in athletes vs non-athletes. Eur J Orthop Surg Traumatol 33, 819–827 (2023). https://doi.org/10.1007/s00590-022-03208-z

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