Patient-Reported Outcomes and Their Predictors at Minimum 10 Years After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Prospectively Collected Data

BACKGROUND: Long-term results after anterior cruciate ligament (ACL) reconstruction are being reported with greater frequency, allowing a detailed analysis of long-term patient-reported outcomes and predictors. PURPOSE: To summarize expected patient-reported outcomes at a minimum 10 years following ACL reconstruction and to explore patient and surgical factors that affect these results. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: Prospective studies detailing patient-reported outcomes with a minimum follow-up of 10 years were identified. Average scores for each outcome measure were calculated. Factors identified in each paper as predictors of patient-reported outcomes were identified and described. RESULTS: Thirteen studies met inclusion and exclusion criteria. Lysholm scores were reported in 317 of 406 patients (78.1%) in 6 studies, with a mean score of 91.7 ± 11.2. Subjective International Knee Documentation Committee scores were reported in 1726 of 2611 patients (66.1%) in 5 studies, with a mean score of 84.2 ± 15.5. Cincinnati knee scores were reported in 1323 of 1801 patients (73.5%) in 3 studies, with a mean score of 87.4 ± 14.4. Tegner activity scores were reported in 728 of 914 patients (79.6%) in 8 studies, with a mean score of 5.1. There was mixed evidence that meniscectomy and articular cartilage damage were associated with poorer patient-reported outcomes. Patient sex and graft choice did not affect patient-reported outcomes. CONCLUSION: Patient-reported outcomes are generally good at a minimum of 10 tears following ACL reconstruction. Further large prospective studies with regression modeling and consistent outcome reporting will clarify predictors of outcomes.