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Knee Surg Sports Traumatol Arthrosc. 2015 Apr;23(4):1135-40. doi: 10.1007/s00167-014-2925-5. Epub 2014 Mar 12.

Associations between inadequate knee function detected by KOOS and prospective graft failure in an anterior cruciate ligament-reconstructed knee.

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Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway,



First, to evaluate whether the 2 year post-operative Knee injury and Osteoarthritis Outcome Score (KOOS) in primary anterior cruciate ligament reconstructions (ACLRs) was significantly different between patients that did not go on to have a subsequent revision after the 2 year post-operative control and the ones that did. Second, to test whether the "clinically failure" value of KOOS quality of life (QoL) < 44 was indicative of a clinically relevant difference in the risk of subsequent revision ACLR.


ACLRs reported to the Norwegian Knee Ligament Registry between June 2004 and December 2009. 5,517 primary ACLRs with at least 2-year follow-up with KOOS QoL before revision surgery.


There were clinically significant differences, adjusted and unadjusted, in both the KOOS Sport and Recreation and QoL subscales in patients with a later revision surgery compared to those that did not have a revision surgery. In adjusted models, the risk of later ACLR revision was 3.7 (95 % CI 2.2-6.0) higher in patients with a 2-year KOOS QoL < 44 compared to patients with a KOOS QoL ≥ 44. For every 10-point reduction in the KOOS QoL, a 33.6 % (95 % CI 21.2-47.5 %) higher risk for later ACLR revision was observed.


This study reveals an association between inadequate knee function, as measured by KOOS, and a prospective ACL-reconstructed graft failure.


Prognostic study (prospective cohort study), Level II.

[Indexed for MEDLINE]

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