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Orthop J Sports Med. 2018 Mar 7;6(3):2325967118758602. doi: 10.1177/2325967118758602. eCollection 2018 Mar.

Male Sex, Decreased Activity Level, and Higher BMI Associated With Lower Completion of Patient-Reported Outcome Measures Following ACL Reconstruction.

Author information

Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.



Patient-reported outcome (PRO) surveys have become increasingly important in both improving patient care and assessing outcomes.


The purpose of this study was to evaluate which variables are associated with compliance with completing PRO surveys in patients who have undergone anterior cruciate ligament reconstruction (ACLR). The authors hypothesized that older patient age and longer time since ACLR would be associated with lower completion rates of PRO surveys preoperatively and at postoperative time points.

Study Design:

Case series; Level of evidence, 4.


All patients who underwent ACLR by a sports medicine fellowship-trained orthopaedic surgeon at a single institution and were electronically assigned PRO surveys through a data collection system preoperatively between December 2013 and March 2015 were included. Postoperatively, PRO surveys were sent to patients' email addresses at 6, 12, and 24 months. Demographics, history, and operative and postoperative information were evaluated for an association with survey completion rates.


A total of 256 patients met the inclusion criteria. There were 140 (54.7%) male and 116 (45.3%) female patients, with an overall mean age of 28.6 ± 11.9 years. Only 19 (7.4%) patients completed all preoperative and postoperative surveys at all time points. Less than half of the patients (n = 104; 40.6%) completed both the preoperative survey and at least 1 postoperative survey. There was a steady decrease in the completion rate of PRO surveys postoperatively over time (Pearson r = -0.995, P = .005). Male patients had significantly worse compliance with completing PRO surveys preoperatively and at a minimum of 1 time point postoperatively (P = .044). Patients who did not identify as athletes or report frequent exercise (≥3 times/wk) had significantly worse compliance with completing any PRO surveys (P = .046). Lower body mass index was associated with greater odds of compliance with completing the preoperative survey and 24-month postoperative survey (odds ratio, 0.902; P = .029).


An inverse relationship was found between the surgery-to-survey period and percentage of those completing PRO surveys, with poor overall compliance. Male sex and not self-identifying as an athlete or performing frequent physical exercise were associated with lower completion rates of PRO surveys, while lower body mass index was associated with a greater rate of completion.


ACL; ACL reconstruction; electronic data collection system; patient-reported outcome surveys

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: N.N.V. receives research support from Arthrex, Arthrosurface, Athletico, Conmed Linvatec, DJ Orthopedics, Miomed, Mitek, Ossur, and Smith & Nephew; receives publishing royalties from Arthroscopy and Vindico Medical–Orthopedics Hyperguide; has stock/stock options in CyMedica, Minivasive, and Omeros; is a paid consultant for Minivasive, OrthoSpace, and Smith & Nephew; and receives royalties from Smith & Nephew. B.J.C. receives research support from Aesculap/B. Braun, Arthrex, Medipost, and the National Institutes of Health (National Institute of Arthritis and Musculoskeletal and Skin Diseases and National Institute of Child Health and Human Development); receives royalties from Arthrex and DJ Orthopedics; is a paid consultant for Arthrex and Regentis; has stock/stock options in Carticept and Regentis; receives publishing royalties from Elsevier, Saunders/Mosby-Elsevier, and SLACK; and receives other financial support from Athletico, Ossur, Smith & Nephew, and Tornier.

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