Females Age ≥25 Show Slower Recovery During the First 2-Years After ACL Reconstruction But Similar Outcome Compared to Those That Are Younger.

Purpose: The purpose of this study was to determine if patient reported outcome measures(PROMs), following anterior cruciate ligament reconstruction(ACLR) differ between female patients younger(<) than 25 versus patients 25 years of age(yo) and older(>).

Methods: A retrospective cohort study was conducted using data collected between October 2012 and November 2022. Inclusion criteria encompassed patients undergoing a primary ACLR using a soft tissue graft with 2-year follow up. Demographic information and PROMs were collected preoperatively and 3, 6, 12, and 24 months postoperatively and included: Pain Visual Analog Scale(VAS), Marx Activity Rating Scale(MARS), and the Knee Injury and Osteoarthritis Outcome Score(KOOS) including Pain, Symptoms, Activity of Daily Living(ADL), Sports and Recreation, and Quality of Life(QoL) subscales. PROMs were compared between the two age groups using 2x5 mixed model ANOVAs(Group x Time).

Results: 81 female patients who met inclusion criteria were included in the analysis. At mean follow-up of 2 years, PROMs improved over time regardless of age group (p<0.001) and the proportion of patients that achieved minimal clinically important differences in VAS or KOOS scores did not differ between age groups (p-values ranging from 0.28 to 0.99). KOOS ADL and Marx were worse at every time-point for the >25yo group, but the change in scores did not differ between the two age groups. Those <25yo recovered more quickly demonstrating better scores at 3, 6, and 12 months, but then tended to plateau between 1 and 2 years. On the contrary, the >25yo group improved more slowly and more linearly over the 2 years with outcome scores similar to the <25yo group.

Conclusion: At 2 years after ACLR, KOOS Pain, KOOS Symptom, and KOOS Sport scores were similar in female patients regardless of age but patients >25 yo take longer to achieve these outcomes.

Level Of Evidence: Level III: Retrospective Comparative Study.