Prospective analysis of health-related quality of life and clinical evaluations in patients with anterior cruciate ligament injury undergoing reconstruction

Ochiai, Satoshi; Hagino, Tetsuo; Tonotsuka, Hisahiro; Haro, Hirotaka

doi:10.1007/s00402-011-1309-2

Cited by 15 publications

(17 citation statements)

References 18 publications

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“…The authors showed that the PCS component of the SF-36 score significantly improves after ACLR, and those improvements are sustained at 6 years. This finding is consistent with previous publications demonstrating that the SF-36 is responsive for patients who undergo ACLR [14,18]. This is also similar to previous publications from this cohort, which show improvement in a number of patient-reported outcome measures, including the Knee Documentation Committee (IKDC) questionnaire, the Knee injury and Osteoarthritis Outcome score (KOOS), and the Marx Activity Scale [19].…”

Section: Commentarysupporting

confidence: 92%

“…Although only one of the 36 questions included in the SF-36 applies directly to knee function, [23] it has been shown to correlate with certain disease-specific measurements of knee function and to be responsive to ACL reconstruction. [14,18] . However, it is important to note that preoperative SF-36 scores may not accurately represent pre-injury health status, and it is possible that similar improvements in PCS would be observed without surgical intervention.…”

Section: Commentarymentioning

confidence: 99%

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Quality of Life following ACL Reconstruction: Baseline Predictors of Patient-Reported Outcomes

Johnson

Garcia

Garner

et al. 2016

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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The study by Dunn et al., "Baseline Predictors of Health-Related Quality of Life after Anterior Cruciate Ligament Reconstruction: A longitudinal analysis of a multicenter cohort at two and six years," evaluates patient factors that are predictive of outcomes following anterior cruciate ligament reconstruction. The current review critically analyzes the findings of this study in light of the current body of literature on the subject and assesses its contribution to the development of evidence-based guidelines. The authors' primary endpoint, the Short Form-36 (SF-36), is used ubiquitously in health care research and allows their results to be compared across different disease states and studies. Despite its widespread use, the SF-36 has been shown to be sensitive to outcomes following anterior cruciate ligament reconstruction. The authors' use of generic health-related quality of life outcome as a primary endpoint represents an important contribution to the field, and their findings allow for improved preoperative counseling by identifying baseline patient factors that predict outcomes following anterior cruciate ligament reconstruction. Furthermore, by deriving utilities from SF-36 scores, the authors are able to assess the value of anterior cruciate ligament reconstruction as compared to other medical and surgical procedures.

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Section: Commentarysupporting

confidence: 92%

Section: Commentarymentioning

confidence: 99%

Quality of Life following ACL Reconstruction: Baseline Predictors of Patient-Reported Outcomes

Johnson

Garcia

Garner

et al. 2016

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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“…This tool has the potential to enhance quality of care by providing daily updates about the patient’s physical impairment and mental health. 13 Furthermore, while ACL reconstruction is considered a safe procedure with low complication rates, some complications can occur. Infection is rare and can occur in 0.3% to 1.7% of patients, with cases ranging from superficial infection of the surgical site to septic arthritis of the knee.…”

mentioning

confidence: 99%

Mobile Web-Based Follow-up for Postoperative ACL Reconstruction: A Single-Center Experience

Higgins

Semple

Murnaghan

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:The initial 6 weeks after surgery has been identified as an area for improvement in patient care. During this period, the persistence of symptoms that go unchecked can lead to unscheduled emergency room and clinic visits, calls to surgeons’ offices, and readmissions.Purpose:To analyze postoperative data from a previous study examining postoperative outcomes in 2 patient populations following breast reconstruction and anterior cruciate ligament (ACL) reconstruction with use of a patient-centered mobile application. Here, the authors establish whether this method of follow-up can provide useful insight specific to the orthopaedic patient population, and they determine whether the mobile platform has the potential to modify their postoperative treatment. In addition, the authors examine its utility for orthopaedic physicians and patients.Study Design:Case series; Level of evidence, 4.Methods:Eligible patients undergoing ACL reconstruction from 2 surgeons were consecutively recruited to use a mobile smartphone application that allowed physicians to monitor their recovery at home. Data from 32 patients were collected via the application and analyzed to evaluate recovery trends during the first 6 postoperative weeks. Following completion of the study, patients and physicians were interviewed on their experience.Results:Data collected from each question in the mobile application provided insightful trends on daily real-time indicators of postoperative recovery. The application identified 1 patient who required in-person reassessment to rule out a possible infection, following surgeon review of an uploaded image. It was estimated that the majority of patients could have avoided follow-up at 2 and 6 weeks, owing to the application’s efficacy. Participants described their satisfaction with the device as excellent (43%), good (40%), fair (10%), and poor (7%), and 94% (n = 30) of patients reported that they would respond to questions using a similar application in the future. Both physicians rated their experience as positive and identified useful traits in the web portal.Conclusion:This system can accurately assess patient recovery; it has the potential to change how postoperative orthopaedic patients are followed, and it is well received by patients and physicians. Recognition of the study’s limitations and employment of user feedback to improve the current application are essential before a formal randomized controlled trial is conducted.

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“…Compared with traditional measures of disease-specific function, the VR-12 is unique in that it addresses both physical and mental health status, asking questions regarding general health, emotions, physical activity, pain, and personal feelings after injury. 22 Previous authors 23 have identified relationships between the Lysholm Knee Scoring scale and subscales of the SF-36 at 6 (physical functioning, bodily pain, role emotional) and 12 (role physical, bodily pain, vitality) months after ACLR. However, it is unclear how quadriceps function is related to subjective ratings of global health status.…”

mentioning

confidence: 99%

Quadriceps Function and Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction in Patients With or Without Knee Osteoarthritis

Norte

Hertel

Saliba

et al. 2018

Journal of Athletic Training

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Context: Relationships between quadriceps function and patient-reported outcomes after anterior cruciate ligament reconstruction (ACLR) are variable and may be confounded by including patients at widely different time points after surgery. Understanding these relationships during the clinically relevant phases of recovery may improve our knowledge of specific factors that influence clinical outcomes.Objective: To identify the relationships between quadriceps function and patient-reported outcomes in patients ,2 years (early) and .2 years (late) after ACLR, including those with posttraumatic knee osteoarthritis.Design: Cross-sectional study. Setting: Laboratory. Patients or Other Participants: A total of 72 patients after ACLR: early (n ¼ 34, time from surgery ¼ 9.0 6 4.3 months), late (n ¼ 30, time from surgery ¼ 70.5 6 41.6 months), or osteoarthritis (n ¼ 8, time from surgery ¼ 115.9 6 110.0 months).Main Outcome Measure(s): The total Knee Injury and Osteoarthritis Outcome Score (KOOS) and Veterans RAND 12-Item Health Survey (VR-12) were used to quantify knee function and global health. Predictors of patient-reported outcomes were involved-limb and symmetry indices of quadriceps function (isokinetic strength [peak torque, total work, average power], maximum voluntary isometric contraction torque, fatigue index, central activation ratio, Hoffmann reflex, active motor threshold) and demographics (age, activity level, pain, kinesiophobia, time since surgery). Multiple linear regression analyses were used to predict KOOS and VR-12 scores in each group.Results: In the early patients, knee-extensor work, active motor threshold symmetry, pain, and activity level explained 67.8% of the variance in the KOOS score (P , .001); kneeextensor work, activity level, and pain explained 53.0% of the variance in the VR-12 score (P , .001). In the late patients, age and isokinetic torque symmetry explained 28.9% of the variance in the KOOS score (P ¼ .004). In the osteoarthritis patients, kinesiophobia and isokinetic torque explained 77.8% of the variance in the KOOS score (P ¼ .010); activity level explained 86.4% of the variance in the VR-12 score (P ¼ .001).Conclusions: Factors of muscle function and demographics that explain patient-reported outcomes were different in patients early and late after ACLR and in those with knee osteoarthritis.Factors of quadriceps function that explained patient-reported outcomes were different in patients early and late after anterior cruciate ligament reconstruction and in those with osteoarthritis. Patient-reported outcomes were best explained in patients early after reconstruction and in those with osteoarthritis, suggesting the need for early identification of impairments. Objective measures of quadriceps function and subjective patient-related factors (pain, activity level, kinesiophobia) should be included when assessing patient-reported outcomes after anterior cruciate ligament reconstruction.

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Prospective analysis of health-related quality of life and clinical evaluations in patients with anterior cruciate ligament injury undergoing reconstruction

Cited by 15 publications

References 18 publications

Quality of Life following ACL Reconstruction: Baseline Predictors of Patient-Reported Outcomes

Quality of Life following ACL Reconstruction: Baseline Predictors of Patient-Reported Outcomes

Mobile Web-Based Follow-up for Postoperative ACL Reconstruction: A Single-Center Experience

Quadriceps Function and Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction in Patients With or Without Knee Osteoarthritis

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