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Activity Level and Subjective Knee Function 15 Years After Anterior Cruciate Ligament Injury: A Prospective, Longitudinal Study of Nonreconstructed Patients.

Kostogiannis, Ioannis LU ; Ageberg, Eva LU ; Neuman, Paul LU ; Dahlberg, Leif LU ; Fridén, Thomas LU and Roos, Harald LU (2007) In American Journal of Sports Medicine 35(7). p.1135-1143
Abstract
Background: The activity level and subjective knee function after an anterior cruciate ligament (ACL) injury treated without reconstruction have not been well elucidated. Hypothesis: Patients with ACL injury can achieve good knee function and satisfactory long-term activity level when treated by early activity modification combined with rehabilitation. Study Design: Cohort study (prognosis); Level of evidence, 2. Materials and Methods: One hundred patients with an acute total ACL injury were observed for 15 years. All patients initially underwent arthroscopic surgery and a rehabilitation program. They were advised to modify their activity level, especially by avoiding contact sports. Patients with recurrent giving-way episodes and/or... (More)
Background: The activity level and subjective knee function after an anterior cruciate ligament (ACL) injury treated without reconstruction have not been well elucidated. Hypothesis: Patients with ACL injury can achieve good knee function and satisfactory long-term activity level when treated by early activity modification combined with rehabilitation. Study Design: Cohort study (prognosis); Level of evidence, 2. Materials and Methods: One hundred patients with an acute total ACL injury were observed for 15 years. All patients initially underwent arthroscopic surgery and a rehabilitation program. They were advised to modify their activity level, especially by avoiding contact sports. Patients with recurrent giving-way episodes and/or secondary meniscal injuries that required fixation (n = 6) were subsequently excluded and underwent reconstruction (n = 22). Sixty-seven patients with unilateral nonreconstructed ACL injury remained at the 15-year follow-up. The Lysholm knee score, Tegner activity level, and a visual analog score for global knee function were recorded at regular intervals. At the final follow-up, patients were further evaluated with the Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) subjective knee evaluation form. Results: Forty patients resumed their preinjury activity level or higher within 3 years. The median activity level 15 years after injury had decreased from 7 to 4 according to Tegner activity scale (P < .001). The mean Lysholm knee score was 96 and 95, 1 and 3 years after injury, respectively, but declined to 86 after 15 years (P < .001). Forty-nine patients had good/excellent results, and 14 had fair (n = 6) or poor function (n = 8) at 15 years. Patients injured in contact sports scored lower in the quality of life subscale of KOOS than those injured in noncontact sports (P < .05). Thirteen of the 67 patients (19%) were reoperated with an arthroscopic procedure because of knee symptoms. Conclusion: Early activity modification and neuromuscular rehabilitation resulted in a good knee function and an acceptable activity level in the majority of the non reconstructed patients. The decline in activity level of patients engaged in contact sports at the time of injury affected their subjective quality of life more than patients involved in noncontact sports. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
activity level, knee, ACL, long-term follow-up, nonoperative treatment
in
American Journal of Sports Medicine
volume
35
issue
7
pages
1135 - 1143
publisher
American Orthopaedic Society for Sports Medicine
external identifiers
  • wos:000247813200013
  • scopus:34250799239
ISSN
1552-3365
DOI
10.1177/0363546507299238
language
English
LU publication?
yes
id
36b7af99-1d7d-471b-baac-7c99daabeeb8 (old id 166687)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17351121&dopt=Abstract
date added to LUP
2007-07-12 12:16:47
date last changed
2017-11-19 04:03:35
@article{36b7af99-1d7d-471b-baac-7c99daabeeb8,
  abstract     = {Background: The activity level and subjective knee function after an anterior cruciate ligament (ACL) injury treated without reconstruction have not been well elucidated. Hypothesis: Patients with ACL injury can achieve good knee function and satisfactory long-term activity level when treated by early activity modification combined with rehabilitation. Study Design: Cohort study (prognosis); Level of evidence, 2. Materials and Methods: One hundred patients with an acute total ACL injury were observed for 15 years. All patients initially underwent arthroscopic surgery and a rehabilitation program. They were advised to modify their activity level, especially by avoiding contact sports. Patients with recurrent giving-way episodes and/or secondary meniscal injuries that required fixation (n = 6) were subsequently excluded and underwent reconstruction (n = 22). Sixty-seven patients with unilateral nonreconstructed ACL injury remained at the 15-year follow-up. The Lysholm knee score, Tegner activity level, and a visual analog score for global knee function were recorded at regular intervals. At the final follow-up, patients were further evaluated with the Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) subjective knee evaluation form. Results: Forty patients resumed their preinjury activity level or higher within 3 years. The median activity level 15 years after injury had decreased from 7 to 4 according to Tegner activity scale (P &lt; .001). The mean Lysholm knee score was 96 and 95, 1 and 3 years after injury, respectively, but declined to 86 after 15 years (P &lt; .001). Forty-nine patients had good/excellent results, and 14 had fair (n = 6) or poor function (n = 8) at 15 years. Patients injured in contact sports scored lower in the quality of life subscale of KOOS than those injured in noncontact sports (P &lt; .05). Thirteen of the 67 patients (19%) were reoperated with an arthroscopic procedure because of knee symptoms. Conclusion: Early activity modification and neuromuscular rehabilitation resulted in a good knee function and an acceptable activity level in the majority of the non reconstructed patients. The decline in activity level of patients engaged in contact sports at the time of injury affected their subjective quality of life more than patients involved in noncontact sports.},
  author       = {Kostogiannis, Ioannis and Ageberg, Eva and Neuman, Paul and Dahlberg, Leif and Fridén, Thomas and Roos, Harald},
  issn         = {1552-3365},
  keyword      = {activity level,knee,ACL,long-term follow-up,nonoperative treatment},
  language     = {eng},
  number       = {7},
  pages        = {1135--1143},
  publisher    = {American Orthopaedic Society for Sports Medicine},
  series       = {American Journal of Sports Medicine},
  title        = {Activity Level and Subjective Knee Function 15 Years After Anterior Cruciate Ligament Injury: A Prospective, Longitudinal Study of Nonreconstructed Patients.},
  url          = {http://dx.doi.org/10.1177/0363546507299238},
  volume       = {35},
  year         = {2007},
}