Health-related quality of life in patients with anterior cruciate ligament insufficiency undergoing arthroscopic reconstruction: a practice-based Italian normative group in comorbid-free patients

Abstract

BackgroundHealth-related quality of life (HRQoL) in anterior cruciate ligament (ACL) insufficiency has not been assessed in comorbid-free patients to date. An observational study was therefore conducted on a practice-based sample to test the hypothesis that SF-36 scoring in patients with chronic ACL insufficiency differs from the age- and gender-matched Italian norm.Materials and methodsChronically ACL-insufficient patients with or without meniscal and/or focal chondral lesions were enrolled in the study. Exclusion criteria were acute ACL tear, severe and diffuse chondral lesions, concomitant knee major ligamentous injuries and/or fractures requiring surgery, previous ACL surgery and infectious, neoplastic and inflammatory disease. Knee function was evaluated by International Knee Documentation Committee (IKDC) form, HRQoL with the SF-36 questionnaire, and associated medical comorbidities by a Self-Administered Comorbidity Questionnaire (SCQ).ResultsA total of 316 consecutive patients, 265 males and 51 females (median age 25 years, range 15–52 years) met the inclusion/exclusion criteria. SF-36 norm-based scoring showed that the Physical Functioning, Role Physical, Bodily Pain, and Social Functioning domains were significantly lower than the Italian norm; the Role Emotional domain was also lower than the norm, but the difference was not significant. Conversely, the General Health and Mental Health domains scored significantly higher than the norm; the Vitality domain also exceeded, albeit not significantly, the norm.ConclusionsThe decision-making process leading to ACL reconstruction currently emphasises the evaluation of knee function and patients’ level of activity. The findings in our study, by showing that chronic ACL insufficiency significantly affects HRQoL in otherwise healthy patients, suggest that a multidimensional evaluation including HRQoL in addition to knee function might be integrated into outcome assessment.

Changes in Self-Reported Knee Function and Health-Related Quality of Life After Knee Injury in Female Athletes

“…In addition, much has also been written about the impact of serious knee injuries on young females, such as ACL tears. 35 Our findings indicate that sustaining a meniscus or ACL injury can negatively impact KF and HRQOL before significant medical intervention and time lost from sport activity ensues. Clinicians should be aware that in addition to providing treatment to the injured knee, taking a holistic approach to address the physical and emotional issues of the injured patient may be warranted.…”

“…Although most normative data have been collected using adults as subjects, the SF-12 has been used in patients as young as 14 years. 35 The SF-12 produces 2 composite scores: the mental composite score (MCS) and physical composite score (PCS), as well as 8 subscales: (1) physical functioning, (2) Each of the subscales is scored within the 0 to 100 range with a higher score indicating better HRQOL. The US population-based norm (mean ± SD) for each subscale and composite score is 50.0 ± 10.0, but age-specific and genderspecific normative data differ by varying degrees.…”

“…The SF-12 has been used to measure HRQOL in adults after knee surgery. 35,36 Data Collection Potential subjects were contacted during their initial clinic visit by research staff to determine the date of injury and the activity the subjects were participating in when injured. A sports medicine physician performed a history and clinical examination on each subject and provided a diagnosis.…”

The Role of Emotional Health in Functional Outcomes After Orthopaedic Surgery: Extending the Biopsychosocial Model to Orthopaedics

“…In particular, higher feelings of self-efficacy before surgery positively influenced the recovery and satisfaction of the patient after surgery 15,16 . When compared with an age and sex-matched normal population, patients with chronic ACL insufficiency had significantly lower scores on the SF-36, the results of which are considered to be a measure of health-related quality of life 17 .…”

The long-term function of the knee in patients with fibular hemimelia and anterior cruciate ligament deficiency

“…13,16 Statistical analysis. Unpaired t-tests were used to determine significance between each tested variable.…”