title: Functional recovery after anterior cruciate ligament reconstruction, a study of health-related quality of life based on the Swedish National Knee Ligament Register.
abstract: OBJECTIVE
  To restore functional stability of the knee joint and to prevent secondary injuries to the cartilage and menisci are the main goals of an anterior cruciate ligament (ACL) reconstruction. Functional stability can be assessed by health-related quality of life questionnaires, but characterising differences between a satisfactory and non-satisfactory result can be challenging.
  
  
  METHODS
  The aim of this study based on the Swedish National Knee Ligament Register was to find predictors for a satisfactory result defined as functional recovery (FR) or a non-satisfactory result defined as treatment failure (TF), with special emphasis on waiting time before surgery and additional injuries. FR was defined as a Knee Osteoarthritis Outcome Score (KOOS) above: 90 for Pain, 84 for Symptoms, 91 for ADL, 80 for Sport/Rec and 81 for quality of life (QoL). TF was defined as a KOOS, QoL < 44.
  
  
  RESULTS
  A complete KOOS was available for 41.4 % of a cohort of 8,584 patients 2 years after the ACL reconstruction. Of all patients, 19.7 % were FR and 28.9 % were TF. Male gender was a predictor for FR. Previous surgery of the menisci and a patella graft was predictors for TF and negative predictors for FR. A medial meniscus suture or resection at the time of reconstruction was a predictor for TF. Waiting time was a predictor for medial meniscus and cartilage injury at the time of reconstruction.
  
  
  CONCLUSIONS
  Functional recovery after an ACL reconstruction can be achieved; gender and additional injuries are important predictors for a functional recovery. To time surgery early, that is, before recurring giving ways has occurred is essential to decrease additional injuries and increase the chance of functional recovery.
authors.affiliation: Section of Orthopaedics, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 11883, Stockholm, Sweden. bjorn.barenius@sodersjukhuset.se
authors.forename: Björn
authors.initials: B
authors.lastname: Barenius
authors.forename: Magnus
authors.initials: M
authors.lastname: Forssblad
authors.forename: Björn
authors.initials: B
authors.lastname: Engström
authors.forename: Karl
authors.initials: K
authors.lastname: Eriksson
mesh_terms: D000293:Adolescent; D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology*; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D013548:Sweden; D013710:Tendons / Q000637:transplantation; D061665:Time-to-Treatment; D055815:Young Adult