Zusammenfassung

BACKGROUND: Long-term individual prognosis and risk factors for quality of life and disability following anterior cruciate ligament (ACL) reconstruction remain unknown. HYPOTHESIS/PURPOSE: Our objective was to identify patient-reported outcomes and patient-specific risk factors from a large prospective cohort at a minimum 10-year follow-up after ACL reconstruction. We hypothesized that meniscus and articular cartilage injuries, revision ACL reconstruction, subsequent knee surgery, and certain demographic characteristics would be significant risk factors for inferior outcomes at 10 years. STUDY DESIGN: Prospective longitudinal cohort study METHODS: Unilateral ACL reconstructions were identified and prospectively enrolled between 2002 and 2004 from 7 sites in the Multicenter Orthopaedics Outcome Network (MOON). Patients pre-operatively completed a series of validated outcome instruments, including the IKDC, KOOS, and Marx activity rating scale. At the time of surgery, physicians documented all intraarticular pathology, treatment, and surgical techniques utilized. Patients were followed at 2, 6, and 10 years post-op, and asked to complete the same outcome instruments that they completed at baseline. Incidence and details of any subsequent knee surgeries were also obtained. Multivariable regression analysis was used to identify significant predictors of outcome. RESULTS: A total of 1592 patients were enrolled (57% male; median age 24 years). Ten-year follow-up was obtained on 83% (1320) of the cohort. Both IKDC and KOOS scores significantly improved at 2 years and were maintained at 6 and 10 years. Conversely, Marx activity level scores dropped markedly over time, from a median score of 12 points at baseline, 9 points at 2 years, 7 points at 6 years, to 6 points at 10 years. The patient-specific risk factors for inferior 10-year outcomes were lower baseline outcome scores, higher BMI, smoker at baseline, having a medial or lateral meniscus procedure done prior to the index ACL reconstruction, having a revision ACL ...