Greater changes in self-reported activity level are associated with decreased quality of life in patients following an anterior cruciate ligament reconstruction.

Objective: To determine the association between change in physical activity level, as defined as the change from pre-to post-operative Tegner Activity Scale, and quality of life (QOL) after anterior cruciate ligament reconstruction (ACLR), before patients are cleared for return to sport.

Participants: 1198 participants (42.9% male; 18.7 ± 3.6 years; 7.1 ± 3.7 months post-ACLR).

Main Outcome Measures: Surveys included Knee Injury and Osteoarthritis Outcome Score QOL (KOOS-QOL) subscale and Tegner Activity Scale. KOOS-QOL score ≥62.5 is considered as meeting a previously established patient acceptable symptom state.

Results: The acceptable KOOS-QOL group reported a significantly smaller decrease in activity level from pre-injury to time of data collection (median: 2.00, IQR: 2.00) than the unacceptable KOOS-QOL group (median: 3.00, IQR: 3.00). Across the full cohort, for every one-point larger decrease in Tegner score from pre-to post-ACLR, there is a 52% increase in the odds of having an unacceptable KOOS-QOL score. For adolescents, the odds increase to 60% while the odds for adults were lower at 39%.

Conclusions: Following ACLR, greater decreases in physical activity level are associated with poorer QOL for both adolescents and adults at short-term follow-up, and this effect is larger amongst adolescents.