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Predictors of activity level 2 years after anterior cruciate ligament reconstruction (ACLR): a Multicenter Orthopaedic Outcomes Network (MOON) ACLR cohort study.

Publication ,  Journal Article
Dunn, WR; Spindler, KP; MOON Consortium
Published in: Am J Sports Med
October 2010

OBJECTIVE: The study was conducted to quantify activity level 2 years after anterior cruciate ligament reconstruction and identify explanatory variables measured at baseline (demographics, concomitant meniscal/articular cartilage injuries and their treatment) associated with activity level at short-term follow-up (2 years). STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: In 2002, the Multicenter Orthopaedic Outcomes Network (MOON) consortium began enrolling patients undergoing anterior cruciate ligament reconstruction at 6 recruitment sites. The current study reports 2-year follow-up of patients enrolled in 2002. Participants completed a series of validated, patient-oriented questionnaires that included activity level assessment. Measurement of intra-articular pathology, techniques of anterior cruciate ligament reconstruction, and secondary procedures were recorded at baseline by participating surgeons. Multivariable proportional odds ordinal logistic regression was used to assess predictors of activity level after adjusting for baseline patient characteristics. Interquartile range (IQR) odds ratios (ORs) are given for continuous variables. The fitted model that used ORs to specify predicted probabilities of exceeding any activity level was translated into predicted mean activity level. RESULTS: Of the 446 patients who underwent unilateral anterior cruciate ligament reconstruction, follow-up was obtained on 393 (88%). Male patients comprise 56% of the cohort, with a median age of 23 years. The median and IQR International Knee Documentation Committee subjective score was 53 (range, 40-65) preoperatively and increased to 84 (range, 74-92) 2 years postoperatively. Median and IQR activity level was 12 (range, 8-16) at baseline, and declined to 9 (range, 3-13) at follow-up. The proportion of participants returning to the same or higher level of activity 2 years after anterior cruciate ligament reconstruction was 45%. After controlling for other baseline factors such as age, marital and student status, contralateral knee status, sport and competition level, and articular cartilage/meniscal injuries, factors associated with higher activity levels at 2 years were higher baseline activity (IQROR = 3.84; 95% confidence interval [CI], 1.98-7.43; P < .0001) and lower baseline body mass index (IQROR = 1.37; 95% CI, 1.04-1.82; P = .027). The following baseline factors were associated with lower activity: female sex (OR = 0.60; 95% CI, 0.39-0.91; P = .015), smoking within 6 months prior to surgery (OR = 0.55; 95% CI, 0.33-0.92; P = 0.023), and revision anterior cruciate ligament reconstruction (OR = 0.41; 95% CI, 0.20-0.83; P = .014). Factors presumably related to functional status of the knee such as the condition of the articular cartilage and menisci, as well as normalcy of the contralateral knee, were not predictive of activity level at 2 years. CONCLUSION: (1) Evaluation of posttreatment activity levels should control for patients' preoperative activity because this is a strong predictor of future activity. (2) Assuming physical activity is an important component of a healthy person, investigation of potential interventions to improve future activity could target modifiable exposures such as weight. (3) Further evaluation is needed to explore the association of sex and revision surgery on activity level following anterior cruciate ligament reconstruction.

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Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

October 2010

Volume

38

Issue

10

Start / End Page

2040 / 2050

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Reoperation
  • Prospective Studies
  • Outcome Assessment, Health Care
  • Orthopedics
  • Orthopedic Procedures
  • Middle Aged
  • Male
  • Knee Joint
 

Citation

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Dunn, W. R., Spindler, K. P., & MOON Consortium. (2010). Predictors of activity level 2 years after anterior cruciate ligament reconstruction (ACLR): a Multicenter Orthopaedic Outcomes Network (MOON) ACLR cohort study. Am J Sports Med, 38(10), 2040–2050. https://doi.org/10.1177/0363546510370280
Dunn, Warren R., Kurt P. Spindler, and MOON Consortium. “Predictors of activity level 2 years after anterior cruciate ligament reconstruction (ACLR): a Multicenter Orthopaedic Outcomes Network (MOON) ACLR cohort study.Am J Sports Med 38, no. 10 (October 2010): 2040–50. https://doi.org/10.1177/0363546510370280.
Dunn, Warren R., et al. “Predictors of activity level 2 years after anterior cruciate ligament reconstruction (ACLR): a Multicenter Orthopaedic Outcomes Network (MOON) ACLR cohort study.Am J Sports Med, vol. 38, no. 10, Oct. 2010, pp. 2040–50. Pubmed, doi:10.1177/0363546510370280.
Journal cover image

Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

October 2010

Volume

38

Issue

10

Start / End Page

2040 / 2050

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Reoperation
  • Prospective Studies
  • Outcome Assessment, Health Care
  • Orthopedics
  • Orthopedic Procedures
  • Middle Aged
  • Male
  • Knee Joint