PURPOSE: The purpose of this study was to identify preoperative and intraoperative factors that predict patient-oriented outcome as measured by the International Knee Documentation Committee (IKDC) Subjective Knee Form after anterior cruciate ligament (ACL) reconstruction. METHODS: We identified 402 subjects who had undergone primary single-bundle arthroscopic ACL reconstruction at a mean follow-up of 6.3 years (range, 2 to 15 years). The IKDC Subjective Knee Form was used to measure patient-reported outcome and was dichotomized as above or below the patient-specific age- and gender-matched population mean. Potential predictor variables included subject demographics, activity level before surgery, previous meniscectomy, and surgical variables. Multivariate logistic regression analysis was performed to identify the best subset of predictors for determining the likelihood that the IKDC score was better than the age- and gender-matched population mean. RESULTS: The dichotomized IKDC score was associated with body mass index (BMI), smoking status, education, previous medial meniscectomy, and medial chondrosis at the time of ACL reconstruction. The multivariate model containing only factors known before surgery included BMI and smoking status. Subjects with a BMI greater than 30 kg/m(2) had 0.35 times the odds of success as subjects with a normal BMI. Subjects who smoked had 0.36 times the odds of success as subjects who did not smoke. A model including medial chondrosis at the time of surgery had a slightly higher discriminatory power (area under the receiver operating characteristic curve, 0.65 v 0.61) and negative predictive value (71.4% v 60.0%) but similar positive predictive power (86.3% v 85.9%). CONCLUSIONS: Lower patient-reported outcome after ACL reconstruction was strongly associated with obesity, smoking, and severe chondrosis at the time of surgery. LEVEL OF EVIDENCE: Level III, prognostic case-control study.
PURPOSE: The purpose of this study was to identify preoperative and intraoperative factors that predict patient-oriented outcome as measured by the International Knee Documentation Committee (IKDC) Subjective Knee Form after anterior cruciate ligament (ACL) reconstruction. METHODS: We identified 402 subjects who had undergone primary single-bundle arthroscopic ACL reconstruction at a mean follow-up of 6.3 years (range, 2 to 15 years). The IKDC Subjective Knee Form was used to measure patient-reported outcome and was dichotomized as above or below the patient-specific age- and gender-matched population mean. Potential predictor variables included subject demographics, activity level before surgery, previous meniscectomy, and surgical variables. Multivariate logistic regression analysis was performed to identify the best subset of predictors for determining the likelihood that the IKDC score was better than the age- and gender-matched population mean. RESULTS: The dichotomized IKDC score was associated with body mass index (BMI), smoking status, education, previous medial meniscectomy, and medial chondrosis at the time of ACL reconstruction. The multivariate model containing only factors known before surgery included BMI and smoking status. Subjects with a BMI greater than 30 kg/m(2) had 0.35 times the odds of success as subjects with a normal BMI. Subjects who smoked had 0.36 times the odds of success as subjects who did not smoke. A model including medial chondrosis at the time of surgery had a slightly higher discriminatory power (area under the receiver operating characteristic curve, 0.65 v 0.61) and negative predictive value (71.4% v 60.0%) but similar positive predictive power (86.3% v 85.9%). CONCLUSIONS: Lower patient-reported outcome after ACL reconstruction was strongly associated with obesity, smoking, and severe chondrosis at the time of surgery. LEVEL OF EVIDENCE: Level III, prognostic case-control study.
Authors: J J Irrgang; A F Anderson; A L Boland; C D Harner; M Kurosaka; P Neyret; J C Richmond; K D Shelborne Journal: Am J Sports Med Date: 2001 Sep-Oct Impact factor: 6.202
Authors: David Logerstedt; Stephanie Di Stasi; Hege Grindem; Andrew Lynch; Ingrid Eitzen; Lars Engebretsen; May Arna Risberg; Michael J Axe; Lynn Snyder-Mackler Journal: J Orthop Sports Phys Ther Date: 2014-10-27 Impact factor: 4.751
Authors: Michael T Milone; Kartik Shenoy; Hien Pham; Laith M Jazrawi; Eric J Strauss Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-05-03 Impact factor: 4.342