Male sex, Younger age, Lower BMI, Athletes, Shorter Time from Injury to Surgery and Non-Contact Injury Are Associated with Achieving the Substantial Clinical Benefits for Patient-Reported Outcome Measures after Primary ACL Reconstruction.

Objective: To determine the substantial clinical benefits (SCBs) for patient-reported outcome measures (PROMs) and to identify potential factors associated with achieving the SCBs after primary anterior cruciate ligament (ACL) reconstruction.

Methods: Patients who underwent primary single-bundle ACL reconstruction using hamstring tendon autografts at our institute were included. The collected PROMs include the Visual Analogue Scale for Pain (VAS), Tegner Activity Score (Tegner score), modified Lysholm Knee Scoring Scale (Lysholm score), and International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC score). The SCBs for PROM improvements and raw postoperative PROMs were determined based on patient responses to an anchor question. Multivariable logistic regression analyses were performed to identify factors associated with achieving the SCBs.

Results: A total of 382 patients with a minimum of 4-year follow-up were included in this study. The SCBs for PROM improvements and raw postoperative PROMs were determined as 2 and 1.5 for VAS, 3 and 3.5 for Tegner score, 24.2 and 81.5 for Lysholm score, and 27.2 and 77.6 for IKDC score, respectively. Male sex (p=0.0050 for raw postoperative), younger age (p=0.0249 for improvement, p=0.0075 for raw postoperative), athletes (p=0.0001 for improvement) and non-contact injury (p=0.0034 for raw postoperative) were associated with increased odds of achieving the SCBs for Tegner score. Higher BMI was associated with decreased odds of achieving the SCBs for both raw postoperative Lysholm score (p = 0.0009) and its improvement (p = 0.0036). A longer time from injury to surgery was associated with decreased odds of achieving the SCB for IKDC score improvement (p = 0.0006).

Conclusions: The SCBs for PROM improvements and raw postoperative PROMs were determined after primary ACL reconstruction. Male sex, younger age, lower BMI, athletes, shorter time from injury to surgery and non-contact injury were associated with increased odds of achieving the SCBs.