Matthew P Ithurburn1, Mark V Paterno2, Staci Thomas3, Michael L Pennell4, Kevin D Evans5, Robert A Magnussen6, Laura C Schmitt7. 1. Department of Physical Therapy and Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA; Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: mpi@uab.edu. 2. Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Electronic address: mark.paterno@cchmc.org. 3. Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Electronic address: staci.thomas@cchmc.org. 4. Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA. Electronic address: pennell.28@osu.edu. 5. School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA. Electronic address: kevin.evans@osumc.edu. 6. Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: robert.magnussen@osumc.edu. 7. School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA; Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Division of Physical Therapy, The Ohio State University, Columbus, OH, USA. Electronic address: laura.schmitt@osumc.edu.
Abstract
PURPOSE: The purpose of this study was to investigate how patient-reported knee function changed over a two-year period in young athletes after anterior cruciate ligament reconstruction (ACLR) and return-to-sport (RTS), and to determine the impact of clinical measures, after controlling for demographic and surgical covariates. METHODS: At the time of RTS after primary, unilateral ACLR, the following data were collected in 67 young athletes: Quadriceps (QF), hamstring (HS), and hip abduction (HA) strength; knee range-of-motion, effusion, and anterior laxity; and patient-reported function using the Knee injury and Osteoarthritis Outcome Score (KOOS). At two years post-RTS, patient-reported function was reevaluated using the KOOS. Absolute KOOS scores and proportions of participants meeting functional recovery cutoffs were compared between time-points. Multivariable linear regression was used to determine clinical measures at RTS associated with two-year post-RTS KOOS scores. RESULTS: KOOS scores for all subscales were higher at two years post-RTS (all p < 0.003), and the proportions of participants demonstrating functional recovery were higher at two years post-RTS for the KOOS-Symptoms, KOOS-Sport, KOOS-QOL, and all KOOS subscales combined (all p < 0.03). After controlling for graft type, clinical measures at RTS associated with higher two-year post-RTS KOOS scores were: KOOS-Pain (lower HA peak torque); KOOS-Symptoms (higher QF strength symmetry and higher QF peak torque); and KOOS-ADL (lower HA peak torque). CONCLUSIONS: In this cohort, after controlling for graft type, higher QF strength symmetry, higher involved-limb QF peak torque, and lower involved-limb HA peak torque from the time of RTS were associated with higher function at two years post-RTS.
PURPOSE: The purpose of this study was to investigate how patient-reported knee function changed over a two-year period in young athletes after anterior cruciate ligament reconstruction (ACLR) and return-to-sport (RTS), and to determine the impact of clinical measures, after controlling for demographic and surgical covariates. METHODS: At the time of RTS after primary, unilateral ACLR, the following data were collected in 67 young athletes: Quadriceps (QF), hamstring (HS), and hip abduction (HA) strength; knee range-of-motion, effusion, and anterior laxity; and patient-reported function using the Knee injury and Osteoarthritis Outcome Score (KOOS). At two years post-RTS, patient-reported function was reevaluated using the KOOS. Absolute KOOS scores and proportions of participants meeting functional recovery cutoffs were compared between time-points. Multivariable linear regression was used to determine clinical measures at RTS associated with two-year post-RTS KOOS scores. RESULTS: KOOS scores for all subscales were higher at two years post-RTS (all p < 0.003), and the proportions of participants demonstrating functional recovery were higher at two years post-RTS for the KOOS-Symptoms, KOOS-Sport, KOOS-QOL, and all KOOS subscales combined (all p < 0.03). After controlling for graft type, clinical measures at RTS associated with higher two-year post-RTS KOOS scores were: KOOS-Pain (lower HA peak torque); KOOS-Symptoms (higher QF strength symmetry and higher QF peak torque); and KOOS-ADL (lower HA peak torque). CONCLUSIONS: In this cohort, after controlling for graft type, higher QF strength symmetry, higher involved-limb QF peak torque, and lower involved-limb HA peak torque from the time of RTS were associated with higher function at two years post-RTS.
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