Comorbidity‐related quality of life in anterior cruciate ligament insufficiency: A cross‐sectional study involving 282 candidates for arthroscopic reconstruction

Abstract

Background and purpose Comorbidity‐adjusted health‐related quality of life (HRQoL) in anterior cruciate ligament insufficiency (ACLI) has not been assessed to date. A cross‐sectional study was conducted to test the hypothesis that HRQoL in ACLI is comorbidity‐related and differs from the Italian norm.

Methods 282 chronically ACL‐insufficient candidates for arthroscopic reconstruction with or without meniscal and/or focal chondral lesions were studied. Knee function was evaluated with IKDC form, HRQoL with SF‐36, and associated medical comorbidities with a self‐administered questionnaire allowing calculation of a comorbidity index (CI). Patients were stratified according to CI into subgroup A (CI = 0) and subgroup B (CI > 0). The SF‐36 profiles in the whole sample and in subgroups A and B were compared with the Italian norm.

Results Of the 282 patients, 82 had associated comorbidity and 200 did not. Patients with comorbidity were older and had a higher degree of knee laxity than patients without comorbidity. Distinctive SF‐36 profiles were obtained after stratification by comorbidity and comparison with the age‐ and sex‐matched norm. The SF‐36 profile in subgroup A showed statistically significantly lower scores on the PF, RP, BP, and SF domains while the GH and MH domains were statistically significantly higher than the norm. Subgroup B showed statistically significantly lower scores than the norm for the PF, RP, BP, VT, SF and RE domains.

Interpretation Comorbidity‐related HRQoL in ACL‐insufficient candidates for arthroscopic reconstruction showed statistically significant differences from the norm. Comorbid illness acting as confounder should thus be controlled for when reporting SF‐36 profiles, in order to avoid selection bias. Our findings may also be used as benchmark data for researchers investigating SF‐36 profiles in ACLI.