H Grindem1, L P Granan2, M A Risberg3, L Engebretsen4, L Snyder-Mackler5, I Eitzen6. 1. Norwegian Research Center for Active Rehabilitation, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway. 2. Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway. 3. Norwegian Research Center for Active Rehabilitation, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway Norwegian Research Center for Active Rehabilitation, Department of Orthopaedics, Oslo University Hospital, Oslo, Norway. 4. Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway Department of Orthopaedics, Oslo University Hospital, Oslo, Norway. 5. Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, Delaware, USA. 6. Norwegian Research Center for Active Rehabilitation, Department of Orthopaedics, Oslo University Hospital, Oslo, Norway.
Abstract
BACKGROUND: Preoperative knee function is associated with successful postoperative outcome after anterior cruciate ligament reconstruction (ACLR). However, there are few longer term studies of patients who underwent progressive preoperative and postoperative rehabilitation compared to usual care. OBJECTIVES: To compare preoperative and 2 year postoperative patient-reported outcomes (PROs) in patients undergoing progressive preoperative and postoperative rehabilitation at a sports medicine clinic compared with usual care. METHODS: We included patients aged 16-40 years undergoing primary unilateral ACLR. The preoperative and 2 year postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) of 84 patients undergoing progressive preoperative and postoperative rehabilitation at a sports medicine clinic (Norwegian Research Center for Active Rehabilitation (NAR) cohort) were compared with the scores of 2690 patients from the Norwegian National Knee Ligament Registry (NKLR). The analyses were adjusted for sex, age, months from injury to surgery and cartilage/meniscus injury at ACLR. RESULTS: The NAR cohort had significantly better preoperative KOOS in all subscales, with clinically relevant differences (>10 points) observed in KOOS Pain, activities of daily living (ADL), Sports and Quality of Life. At 2 years, the NAR cohort still had significantly better KOOS with clinically relevant differences in KOOS Symptoms, Sports and Quality of Life. At 2 years, 85.7-94% of the patients in the NAR cohort scored within the normative range of the different KOOS subscales, compared to 51.4-75.8% of the patients in the NKLR. CONCLUSIONS: Patients in a prospective cohort who underwent progressive preoperative and postoperative rehabilitation at a sports medicine clinic showed superior patient-reported outcomes both preoperatively and 2 years postoperatively compared to patients in the NKLR who received usual care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: Preoperative knee function is associated with successful postoperative outcome after anterior cruciate ligament reconstruction (ACLR). However, there are few longer term studies of patients who underwent progressive preoperative and postoperative rehabilitation compared to usual care. OBJECTIVES: To compare preoperative and 2 year postoperative patient-reported outcomes (PROs) in patients undergoing progressive preoperative and postoperative rehabilitation at a sports medicine clinic compared with usual care. METHODS: We included patients aged 16-40 years undergoing primary unilateral ACLR. The preoperative and 2 year postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) of 84 patients undergoing progressive preoperative and postoperative rehabilitation at a sports medicine clinic (Norwegian Research Center for Active Rehabilitation (NAR) cohort) were compared with the scores of 2690 patients from the Norwegian National Knee Ligament Registry (NKLR). The analyses were adjusted for sex, age, months from injury to surgery and cartilage/meniscus injury at ACLR. RESULTS: The NAR cohort had significantly better preoperative KOOS in all subscales, with clinically relevant differences (>10 points) observed in KOOS Pain, activities of daily living (ADL), Sports and Quality of Life. At 2 years, the NAR cohort still had significantly better KOOS with clinically relevant differences in KOOS Symptoms, Sports and Quality of Life. At 2 years, 85.7-94% of the patients in the NAR cohort scored within the normative range of the different KOOS subscales, compared to 51.4-75.8% of the patients in the NKLR. CONCLUSIONS:Patients in a prospective cohort who underwent progressive preoperative and postoperative rehabilitation at a sports medicine clinic showed superior patient-reported outcomes both preoperatively and 2 years postoperatively compared to patients in the NKLR who received usual care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Gregory B Maletis; Lars-Petter Granan; Maria C S Inacio; Tadashi T Funahashi; Lars Engebretsen Journal: J Bone Joint Surg Am Date: 2011-12-21 Impact factor: 5.284
Authors: Hege Grindem; David Logerstedt; Ingrid Eitzen; Håvard Moksnes; Michael J Axe; Lynn Snyder-Mackler; Lars Engebretsen; May Arna Risberg Journal: Am J Sports Med Date: 2011-08-09 Impact factor: 6.202
Authors: Mathew J Failla; David S Logerstedt; Hege Grindem; Michael J Axe; May Arna Risberg; Lars Engebretsen; Laura J Huston; Kurt P Spindler; Lynn Snyder-Mackler Journal: Am J Sports Med Date: 2016-07-14 Impact factor: 6.202
Authors: Jay R Ebert; Peter Edwards; Luke Yi; Brendan Joss; Timothy Ackland; Richard Carey-Smith; Jens-Ulrich Buelow; Ben Hewitt Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-09-15 Impact factor: 4.342
Authors: Louise M Thoma; Hege Grindem; David Logerstedt; Michael Axe; Lars Engebretsen; May Arna Risberg; Lynn Snyder-Mackler Journal: Am J Sports Med Date: 2019-02-21 Impact factor: 6.202