Long-term Follow-up of Anterior Cruciate Ligament Injury

Study Overview
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Brief Summary
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Anterior cruciate ligament (ACL) rupture is one of the most common sports-related knee injuries. Because it is such a significant injury - requiring a long period of rehabilitation before the injured person is ready to return to physical activity, the burden of injury is high. This can help to explain why so much of orthopaedic research is devoted to evaluating the outcomes of ACL injury. However, while there has been extensive study of short-term (up to 5 years after injury) outcomes, few studies have followed patients beyond 15 years after their ACL injury. This is important because long-term follow-up can provide key insights to guide the information provided to newly injured patients (e.g. to help set realistic expectations of what the injured person can expect of their knee function in the future), and help us evaluate the efficacy of previous treatments. The primary aim is to assess the influence of an acute ACL injury on knee function and quality of life, 32-37 years after the index injury. Approximately 300 patients injured between 1980 and 1985 will be invited to participate in the study. Patient- and clinician-reported outcomes, and radiographic osteoarthritis will be evaluated.

Detailed Description
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Patients injuring their ACL between 1980 and 1985 have periodically been followed since the injury. Now, we plan to contact all patients and invite them to participate. The patients will be asked to complete a questionnaire battery visit the movement laboratory at Linköping University for an objective assessment of knee function and have an x-ray of both knee joints. Baseline information including associated injuries, treatment and activity level exist for all the patients. At that time, rehabilitation was normally completed after 4-6 months for non-operatively treated patients, and nine months after ACL surgery.

Official Title
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Long-term Follow-up of Anterior Cruciate Ligament Injury

Conditions
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Anterior Cruciate Ligament Injury

Intervention / Treatment
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* Procedure: Surgically treatment of the ACL
* Other: Non surgical initial ACL treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: primary ACL injury between 1980 and 1985, age between 15 and 40 at injury Exclusion Criteria: all patients from the initial cohort will be invited for participation

Ages Eligible for Study
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Minimum Age: 47 Years
Maximum Age: 77 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Non surgery<br>Patients were not treated with surgery initially | Other: Non surgical initial ACL treatment<br>* Non surgical initial ACL treatment<br>|
| Surgery<br>Patients had an initial surgical treatment | Procedure: Surgically treatment of the ACL<br>* Surgical initial ACL treatment<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self reported knee function | Knee Injury and Osteoarthritis Outcome Score, KOOS 4 (Pain, Symptoms, Sport/Rec, QOL subscales) | 32-37 years after ACL injury | 
| Osteoarthritis | Development of osteoarthritis examined with tibiofemoral and patellofemoral radiographs | 32-37 years after ACL injury | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of life | ACL-Quality of Life scale (ACL-QoL) | 32-37 years after ACL injury | 
| Physical activity | Total time over the previous week spent doing moderate, and vigorous activity AND accelerometer measures | 32-37 years after ACL injury | 
| Objective assessment of knee function | Concentric isokinetic muscle strength | 32-37 years after ACL injury | 
| Objective assessment of knee function | Functional testing; stand-up test | 32-37 years after ACL injury | 
| Objective assessment of knee function | Functional testing; hopping performance in one leg hop for distance | 32-37 years after ACL injury | 
| Objective assessment of knee function | Postural control (one leg stand test) | 32-37 years after ACL injury | 
| Associated injuries and additional surgery | Patient reported | 32-37 years after ACL injury |