Health-related quality of life in patients with anterior cruciate ligament insufficiency undergoing arthroscopic reconstruction: a practice-based Italian normative group in comorbid-free patients

• Published in: Journal of orthopaedics and traumatology Vol. 9; no. 4; pp. 233 - 238
• Main Authors: Calvisi, V., De Vincentiis, B., Palumbo, P., Padua, R., Lupparelli, S.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2008; Springer Nature B.V; Springer Milan
• Subjects: Anterior cruciate ligament; Comorbidity; Conservative Orthopedics; Criteria; Decision making; Domains; Evaluation; Evidence-Based Medicine Section; Fractures; Inflammatory diseases; Knee; Lesions; Ligaments; Medicine; Medicine & Public Health; Meniscus; Mental health; Orthopedics; Pain; Patients; Quality of life; Questionnaires; Rheumatology; Sports Medicine; Surgery; Surgical Orthopedics; Traumatic Surgery; Reconstruction; Normative group; Anterior cruciate ligament; SF-36; Quality of life
• ISSN: 1590-9921; 1590-9999
• DOI: 10.1007/s10195-008-0034-2

Background Health-related quality of life (HRQoL) in anterior cruciate ligament (ACL) insufficiency has not been assessed in comorbid-free patients to date. An observational study was therefore conducted on a practice-based sample to test the hypothesis that SF-36 scoring in patients with chronic ACL insufficiency differs from the age- and gender-matched Italian norm. Materials and methods Chronically ACL-insufficient patients with or without meniscal and/or focal chondral lesions were enrolled in the study. Exclusion criteria were acute ACL tear, severe and diffuse chondral lesions, concomitant knee major ligamentous injuries and/or fractures requiring surgery, previous ACL surgery and infectious, neoplastic and inflammatory disease. Knee function was evaluated by International Knee Documentation Committee (IKDC) form, HRQoL with the SF-36 questionnaire, and associated medical comorbidities by a Self-Administered Comorbidity Questionnaire (SCQ). Results A total of 316 consecutive patients, 265 males and 51 females (median age 25 years, range 15-22 years) met the inclusion/exclusion criteria. SF-36 norm-based scoring showed that the Physical Functioning, Role Physical, Bodily Pain, and Social Functioning domains were significantly lower than the Italian norm; the Role Emotional domain was also lower than the norm, but the difference was not significant. Conversely, the General Health and Mental Health domains scored significantly higher than the norm; the Vitality domain also exceeded, albeit not significantly, the norm. Conclusions The decision-making process leading to ACL reconstruction currently emphasises the evaluation of knee function and patients-level of activity. The findings in our study, by showing that chronic ACL insufficiency significantly affects HRQoL in otherwise healthy patients, suggest that a multidimensional evaluation including HRQoL in addition to knee function might be integrated into outcome assessment.