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Relationship Between Sports Participation After Revision Anterior Cruciate Ligament Reconstruction and 2-Year Patient-Reported Outcome Measures.

Publication ,  Journal Article
MARS Group; Bigouette, JP; Owen, EC; Lantz, BBA; Hoellrich, RG; Huston, LJ; Haas, AK; Allen, CR; Anderson, AF; Cooper, DE; DeBerardino, TM ...
Published in: Am J Sports Med
July 2019

BACKGROUND: Anterior cruciate ligament (ACL) revision cohorts continually report lower outcome scores on validated knee questionnaires than primary ACL cohorts at similar time points after surgery. It is unclear how these outcomes are associated with physical activity after physician clearance for return to recreational or competitive sports after ACL revision surgery. HYPOTHESES: Participants who return to either multiple sports or a singular sport after revision ACL surgery will report decreased knee symptoms, increased activity level, and improved knee function as measured by validated patient-reported outcome measures (PROMs) and compared with no sports participation. Multisport participation as compared with singular sport participation will result in similar increased PROMs and activity level. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A total of 1205 patients who underwent revision ACL reconstruction were enrolled by 83 surgeons at 52 clinical sites. At the time of revision, baseline data collected included the following: demographics, surgical characteristics, previous knee treatment and PROMs, the International Knee Documentation Committee (IKDC) questionnaire, Marx activity score, Knee injury and Osteoarthritis Outcome Score (KOOS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). A series of multivariate regression models were used to evaluate the association of IKDC, KOOS, WOMAC, and Marx Activity Rating Scale scores at 2 years after revision surgery by sports participation category, controlling for known significant covariates. RESULTS: Two-year follow-up was obtained on 82% (986 of 1205) of the original cohort. Patients who reported not participating in sports after revision surgery had lower median PROMs both at baseline and at 2 years as compared with patients who participated in either a single sport or multiple sports. Significant differences were found in the change of scores among groups on the IKDC (P < .0001), KOOS-Symptoms (P = .01), KOOS-Sports and Recreation (P = .04), and KOOS-Quality of Life (P < .0001). Patients with no sports participation were 2.0 to 5.7 times more likely than multiple-sport participants to report significantly lower PROMs, depending on the specific outcome measure assessed, and 1.8 to 3.8 times more likely than single-sport participants (except for WOMAC-Stiffness, P = .18), after controlling for known covariates. CONCLUSION: Participation in either a single sport or multiple sports in the 2 years after ACL revision surgery was found to be significantly associated with higher PROMs across multiple validated self-reported assessment tools. During follow-up appointments, surgeons should continue to expect that patients who report returning to physical activity after surgery will self-report better functional outcomes, regardless of baseline activity levels.

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Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

July 2019

Volume

47

Issue

9

Start / End Page

2056 / 2066

Location

United States

Related Subject Headings

  • Young Adult
  • Surveys and Questionnaires
  • Self Report
  • Return to Sport
  • Reoperation
  • Quality of Life
  • Patient Reported Outcome Measures
  • Orthopedics
  • Middle Aged
  • Male
 

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MARS Group, Bigouette, J. P., Owen, E. C., Lantz, B. B. A., Hoellrich, R. G., Huston, L. J., … York, J. J. (2019). Relationship Between Sports Participation After Revision Anterior Cruciate Ligament Reconstruction and 2-Year Patient-Reported Outcome Measures. Am J Sports Med, 47(9), 2056–2066. https://doi.org/10.1177/0363546519856348
MARS Group, John P. Bigouette, Erin C. Owen, Brett Brick A. Lantz, Rudolf G. Hoellrich, Laura J. Huston, Amanda K. Haas, et al. “Relationship Between Sports Participation After Revision Anterior Cruciate Ligament Reconstruction and 2-Year Patient-Reported Outcome Measures.Am J Sports Med 47, no. 9 (July 2019): 2056–66. https://doi.org/10.1177/0363546519856348.
MARS Group, Bigouette JP, Owen EC, Lantz BBA, Hoellrich RG, Huston LJ, et al. Relationship Between Sports Participation After Revision Anterior Cruciate Ligament Reconstruction and 2-Year Patient-Reported Outcome Measures. Am J Sports Med. 2019 Jul;47(9):2056–66.
MARS Group, et al. “Relationship Between Sports Participation After Revision Anterior Cruciate Ligament Reconstruction and 2-Year Patient-Reported Outcome Measures.Am J Sports Med, vol. 47, no. 9, July 2019, pp. 2056–66. Pubmed, doi:10.1177/0363546519856348.
MARS Group, Bigouette JP, Owen EC, Lantz BBA, Hoellrich RG, Huston LJ, Haas AK, Allen CR, Anderson AF, Cooper DE, DeBerardino TM, Dunn WR, Mann B, Spindler KP, Stuart MJ, Wright RW, Albright JP, Amendola AN, Andrish JT, Annunziata CC, Arciero RA, Bach BR, Baker CL, Bartolozzi AR, Baumgarten KM, Bechler JR, Berg JH, Bernas GA, Brockmeier SF, Brophy RH, Bush-Joseph CA, Butler JB, Campbell JD, Carey JL, Carpenter JE, Cole BJ, Cooper JM, Cox CL, Creighton RA, Dahm DL, David TS, Flanigan DC, Frederick RW, Ganley TJ, Garofoli EA, Gatt CJ, Gecha SR, Giffin JR, Hame SL, Hannafin JA, Harner CD, Harris NL, Hechtman KS, Hershman EB, Hosea TM, Johnson DC, Johnson TS, Jones MH, Kaeding CC, Kamath GV, Klootwyk TE, Levy BA, Ma CB, Maiers GP, Marx RG, Matava MJ, Mathien GM, McAllister DR, McCarty EC, McCormack RG, Miller BS, Nissen CW, O’Neill DF, Owens BD, Parker RD, Purnell ML, Ramappa AJ, Rauh MA, Rettig AC, Sekiya JK, Shea KG, Sherman OH, Slauterbeck JR, Smith MV, Spang JT, Svoboda SJ, Taft TN, Tenuta JJ, Tingstad EM, Vidal AF, Viskontas DG, White RA, Williams JS, Wolcott ML, Wolf BR, York JJ. Relationship Between Sports Participation After Revision Anterior Cruciate Ligament Reconstruction and 2-Year Patient-Reported Outcome Measures. Am J Sports Med. 2019 Jul;47(9):2056–2066.
Journal cover image

Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

July 2019

Volume

47

Issue

9

Start / End Page

2056 / 2066

Location

United States

Related Subject Headings

  • Young Adult
  • Surveys and Questionnaires
  • Self Report
  • Return to Sport
  • Reoperation
  • Quality of Life
  • Patient Reported Outcome Measures
  • Orthopedics
  • Middle Aged
  • Male