Abstract
OBJECTIVES: (1) To assess prognostic factors for patient-reported outcome measures (PROMs) and physical activity 2 to 10 years after anterior cruciate ligament reconstruction (ACLR) or anterior cruciate ligament (ACL) injury, and (2) to assess differences in prognostic factors between patients treated with ACLR and with rehabilitation alone.
DESIGN: Prognosis systematic review.
LITERATURE SEARCH: Systematic searches were performed in PubMed, Web of Science, and SPORTDiscus.
STUDY SELECTION CRITERIA: We selected prospective cohort studies and randomized clinical trials that included adults or adolescents undergoing either ACLR or rehabilitation alone after ACL rupture. Studies had to assess the statistical association between potential prognostic factors (factors related to patient characteristics, injury, or knee symptoms/function measured at baseline or within 1 year) and outcomes (PROMs and physical activity).
DATA SYNTHESIS: Our search yielded 997 references. Twenty studies met the inclusion criteria. Seven studies with low or moderate risk of bias remained for data synthesis.
RESULTS: Moderate-certainty evidence indicated that concomitant meniscus and cartilage injuries were prognostic factors for worse PROMs 2 to 10 years after ACLR. Very low-certainty evidence suggested that body mass index, smoking, and baseline PROMs were prognostic factors for worse outcome. Very low-certainty evidence suggested that female sex and a worse baseline Marx Activity Rating Scale score were prognostic factors for a worse Marx Activity Rating Scale score 2 to 10 years after ACLR. There was a lack of studies on prognostic factors after rehabilitation alone.
CONCLUSION: Concomitant meniscus and cartilage injuries were prognostic factors for worse long-term PROMs after ACLR. The certainty was very low for other prognostic factors. J Orthop Sports Phys Ther 2020;50(9):490-502. Epub 1 Aug 2020. doi:10.2519/jospt.2020.9451.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 490-502 |
| Number of pages | 13 |
| Journal | Journal of Orthopaedic and Sports Physical Therapy |
| Volume | 50 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2020 |
Bibliographical note
Funding Information:1Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway. 2Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, DE. 3Department of Physical Therapy, University of Delaware, Newark, DE. 4Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway. 5Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 6Department of Clinical Sciences, Lund, Faculty of Medicine, Lund University, Lund, Sweden. 7National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. 8Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway. Our study protocol was published in PROSPERO (CRD42018095602) on June 7, 2018. The project was funded by the National Institutes of Health through grant R37HD37985. The authors certify that they have no affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article. Address correspondence to Marie Pedersen, Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806 Oslo, Norway. E-mail: [email protected] U Copyright ©2020 Journal of Orthopaedic & Sports Physical Therapy®
Publisher Copyright:
© 2020 Journal of Orthopaedic & Sports Physical Therapy.
Keywords
- Knee surgery
- Ligament
- Prognosis
- Sporting injuries