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Study Design Clinical measurement, cross-sectional. Background ACL-reconstructed individuals commonly experience impaired longer-term quality of life (QOL) which may be related to persistent knee symptoms or radiographic osteoarthritis (ROA). Understanding the impact of knee symptoms and ROA on QOL after ACL-reconstruction may assist in developing appropriate management strategies. Objectives 1. Compare QOL between ACL-reconstructed groups: i) symptomatic with ROA, ii) symptomatic without ROA, iii) asymptomatic (unknown ROA status); 2. Identify specific aspects of QOL impairment in symptomatic ACL-reconstructed individuals with and without ROA. Methods 113 participants completed QOL measures (KOOS-QOL, ACL-QOL, AQoL-8D) 5-20 years after ACL reconstruction. 81 symptomatic individuals underwent radiographs and 32 asymptomatic individuals formed a comparison group. ROA was defined as Kellgren & Lawrence ≥2 for the tibiofemoral and/or patellofemoral joint. Mann-Whitney U tests compared outcomes between groups. Individual ACL-QOL items were used to explore specific aspects of QOL. Results In symptomatic ACL-reconstructed individuals, ROA was related to worse knee-related QOL (KOOS-QOL: median(IQR) 50(38, 69) vs. 69(56, 81), p<0.001; ACL-QOL: 51 (38, 71) vs. 66 (50, 82), p=0.04). Health-related QOL (AQoL-8D) was impaired in both symptomatic groups compared to the asymptomatic group. ACL-QOL item scores revealed greater limitations and concern surrounding sport and exercise, and social/emotional difficulties in the symptomatic group with ROA. Conclusions Osteoarthritis is associated with worse knee-related QOL in symptomatic ACL-reconstructed individuals. Diagnosing ROA in symptomatic ACL-reconstructed individuals may be valuable since these individuals may require unique management. Targeted strategies to facilitate participation in satisfying activities has potential to improve QOL in symptomatic ACL-reconstructed people with ROA. J Orthop Sports Phys Ther, Epub 18 Apr 2018. doi:10.2519/jospt.2018.7830.

Original publication




Journal article


J Orthop Sports Phys Ther

Publication Date



1 - 37


pain, physical activity, psychological, radiology/medical imaging, sport