Clinical measures associated with knee function over two years in young athletes after ACL reconstruction.

Objective: The purpose of this study was to investigate how patient-reported knee function changed over a two-year period in young athletes after anterior cruciate ligament reconstruction (ACLR) and return-to-sport (RTS), and to determine the impact of clinical measures, after controlling for demographic and surgical covariates.

Methods: At the time of RTS after primary, unilateral ACLR, the following data were collected in 67 young athletes: Quadriceps (QF), hamstring (HS), and hip abduction (HA) strength; knee range-of-motion, effusion, and anterior laxity; and patient-reported function using the Knee injury and Osteoarthritis Outcome Score (KOOS). At two years post-RTS, patient-reported function was reevaluated using the KOOS. Absolute KOOS scores and proportions of participants meeting functional recovery cutoffs were compared between time-points. Multivariable linear regression was used to determine clinical measures at RTS associated with two-year post-RTS KOOS scores.

Results: KOOS scores for all subscales were higher at two years post-RTS (all p < 0.003), and the proportions of participants demonstrating functional recovery were higher at two years post-RTS for the KOOS-Symptoms, KOOS-Sport, KOOS-QOL, and all KOOS subscales combined (all p < 0.03). After controlling for graft type, clinical measures at RTS associated with higher two-year post-RTS KOOS scores were: KOOS-Pain (lower HA peak torque); KOOS-Symptoms (higher QF strength symmetry and higher QF peak torque); and KOOS-ADL (lower HA peak torque).

Conclusions: In this cohort, after controlling for graft type, higher QF strength symmetry, higher involved-limb QF peak torque, and lower involved-limb HA peak torque from the time of RTS were associated with higher function at two years post-RTS.