Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India.
University Hospitals of Morecambe Bay NHS Trust-Royal Lancaster Infirmary, Ashton Road, Lancaster, LA1 4RP, UK.
Eur J Orthop Surg Traumatol. 2023 May;33(4):819-827. doi: 10.1007/s00590-022-03208-z. Epub 2022 Feb 4.
The outcome of arthroscopic anterior cruciate ligament reconstruction (ACLR) in the non-athlete population is under-reported. The study aimed to compare the functional outcomes of ACLR in the non-athlete and athlete population by patient reported outcome measures (PROMs)- International Knee Documentation Committee score (IKDC), Lysholm knee scoring scale, Forgotten joint score (FJS-12) and return to pre-injury activity level. The study also correlated the FJS-12 score with other commonly used PROM's (IKDC and Lysholm).
This was a prospective comparative study including patients undergoing ACLR. Patients were divided into two groups. Group-1 (non-athletes) and Group-2 (athletes, defined as those with pre-injury Tegner activity level > 5). Demographic profile, management of associated meniscal injury, perioperative and midterm complications were noted. All patients had 24 months follow-up. Knee laxity assessment by pivot shift test, functional outcome scores (Lysholm and IKDC) and FJS-12 were assessed preoperatively and postoperatively at 12 and 24 months.
Group 1 and 2 included 69 and 47 participants, respectively, (total 116 patients). The mean age of group 1 was significantly higher than group 2 (33.1 ± 8.0 vs 25.0 ± 4.9 years; p < 0.005). There was no statistically significant difference in PROMs and FJS-12 scores between the groups at any follow-up. Return to pre-injury Tegner activity level post-ACLR was 88.4% (n = 61) and 46.8% (n = 22) in group 1 and 2, respectively (p). The ceiling effect in FJS-12, IKDC, and Lysholm scores were achieved by 9.3%, 19.5%, and 34.7% of patients (n = 116), respectively, at 2-year follow-up. The ceiling effect of FJS-12, Lysholm, and IKDC scores between the groups at final follow-up was not statistically significant (p = 1, p = .524, p = .09, respectively).
The functional outcome of ACLR was comparable between athletes and non-athletes. FJS-12 has a lower ceiling effect and better discriminatory power than Lysholm and IKDC scores. FJS-12 score can be satisfactorily used in ACLR to observe and monitor changes in patient satisfaction and outcome.
II, Prospective comparative study.
非运动员人群的关节镜前交叉韧带重建（ACLR）的结果报道较少。本研究旨在通过患者报告的结果测量（PROM）-国际膝关节文献委员会评分（IKDC）、Lysholm 膝关节评分、遗忘关节评分（FJS-12）和恢复到受伤前的活动水平，比较非运动员和运动员人群中 ACLR 的功能结果。本研究还将 FJS-12 评分与其他常用的 PROM（IKDC 和 Lysholm）进行了相关性分析。
这是一项前瞻性的比较研究，包括接受 ACLR 的患者。患者分为两组。组 1（非运动员）和组 2（运动员，定义为受伤前 Tegner 活动水平>5）。记录人口统计学特征、伴发半月板损伤的处理、围手术期和中期并发症。所有患者均随访 24 个月。术前、术后 12 个月和 24 个月通过髌股关节试验评估膝关节松弛度、功能评分（Lysholm 和 IKDC）和 FJS-12。
组 1 和组 2 分别包括 69 名和 47 名参与者（共 116 名患者）。组 1 的平均年龄明显高于组 2（33.1±8.0 岁比 25.0±4.9 岁；p<0.005）。在任何随访中，两组之间的 PROM 和 FJS-12 评分均无统计学差异。ACL 重建后恢复到受伤前的 Tegner 活动水平分别为组 1 中的 88.4%（n=61）和组 2 中的 46.8%（n=22）（p<0.001）。在 2 年随访时，FJS-12、IKDC 和 Lysholm 评分的天花板效应分别达到 9.3%、19.5%和 34.7%（n=116）。在最终随访时，组间 FJS-12、Lysholm 和 IKDC 评分的天花板效应无统计学意义（p=1、p=0.524、p=0.09）。
运动员和非运动员 ACLR 的功能结果相当。FJS-12 比 Lysholm 和 IKDC 评分具有更低的天花板效应和更好的区分能力。FJS-12 评分可满意地用于 ACLR，以观察和监测患者满意度和结果的变化。
II 级，前瞻性比较研究。
