Greater changes in self-reported activity level are associated with decreased quality of life in patients following an anterior cruciate ligament reconstruction

Objective

To determine the association between change in physical activity level, as defined as the change from pre-to post-operative Tegner Activity Scale, and quality of life (QOL) after anterior cruciate ligament reconstruction (ACLR), before patients are cleared for return to sport.

Participants

1198 participants (42.9% male; 18.7 ± 3.6 years; 7.1 ± 3.7 months post-ACLR).

Main outcome measures

Surveys included Knee Injury and Osteoarthritis Outcome Score QOL (KOOS-QOL) subscale and Tegner Activity Scale. KOOS-QOL score ≥62.5 is considered as meeting a previously established patient acceptable symptom state.

Results

The acceptable KOOS-QOL group reported a significantly smaller decrease in activity level from pre-injury to time of data collection (median: 2.00, IQR: 2.00) than the unacceptable KOOS-QOL group (median: 3.00, IQR: 3.00). Across the full cohort, for every one-point larger decrease in Tegner score from pre-to post-ACLR, there is a 52% increase in the odds of having an unacceptable KOOS-QOL score. For adolescents, the odds increase to 60% while the odds for adults were lower at 39%.

Conclusions

Following ACLR, greater decreases in physical activity level are associated with poorer QOL for both adolescents and adults at short-term follow-up, and this effect is larger amongst adolescents.