title: Comorbidity-related quality of life in anterior cruciate ligament insufficiency: a cross-sectional study involving 282 candidates for arthroscopic reconstruction.
abstract: OBJECTIVE
  Comorbidity-adjusted health-related quality of life (HRQoL) in anterior cruciate ligament insufficiency (ACLI) has not been assessed to date. A cross-sectional study was conducted to test the hypothesis that HRQoL in ACLI is comorbidity-related and differs from the Italian norm.
  
  
  METHODS
  282 chronically ACL-insufficient candidates for arthroscopic reconstruction with or without meniscal and/or focal chondral lesions were studied. Knee function was evaluated with IKDC form, HRQoL with SF-36, and associated medical comorbidities with a self-administered questionnaire allowing calculation of a comorbidity index (CI). Patients were stratified according to CI into subgroup A (CI = 0) and subgroup B (CI > 0). The SF-36 profiles in the whole sample and in subgroups A and B were compared with the Italian norm.
  
  
  RESULTS
  Of the 282 patients, 82 had associated comorbidity and 200 did not. Patients with comorbidity were older and had a higher degree of knee laxity than patients without comorbidity. Distinctive SF-36 profiles were obtained after stratification by comorbidity and comparison with the age- and sex-matched norm. The SF-36 profile in subgroup A showed statistically significantly lower scores on the PF, RP, BP, and SF domains while the GH and MH domains were statistically significantly higher than the norm. Subgroup B showed statistically significantly lower scores than the norm for the PF, RP, BP, VT, SF and RE domains.
  
  
  CONCLUSIONS
  Comorbidity-related HRQoL in ACL-insufficient candidates for arthroscopic reconstruction showed statistically significant differences from the norm. Comorbid illness acting as confounder should thus be controlled for when reporting SF-36 profiles, in order to avoid selection bias. Our findings may also be used as benchmark data for researchers investigating SF-36 profiles in ACLI.
authors.affiliation: University of L'Aquila, L'Aquila, Italy. calvisiv@libero.it
authors.forename: Vittorio
authors.initials: V
authors.lastname: Calvisi
authors.forename: Stefano
authors.initials: S
authors.lastname: Lupparelli
authors.forename: Barbara
authors.initials: B
authors.lastname: De Vincentiis
authors.forename: Gustavo
authors.initials: G
authors.lastname: Zanoli