Anterior Cruciate Ligament Reconstruction: Clinical and Functional Outcomes

Anterior cruciate ligament reconstruction (ACLR) is one of the most commonly performed procedures in the world. As such, functional and clinical outcomes following ACLR are a very well-studied topic in the orthopedic literature. The most widely used measures to assess ACLR outcomes are validated patient reported outcome measurements (PROMs) such as the Lysholm, International Knee Documentation Committee (IKDC), Tegner, and Knee injury and Osteoarthritis Outcome Scores (KOOS). Despite their subjective nature, they do provide valuable insight into the functional outcomes of ACLR. Other important clinical outcomes following ACLR are return to sport (RTS), graft failure (or rerupture), and postoperative complications.As PROMs are based on patient perception, they are inherently subjective. Other outcome measurements of ACL laxity such as the anterior drawer, Lachman, and pivot-shift – which have their own standardized grading schemes – may offer more objectivity in a clinical setting. However, they may only display moderate levels of interrater reliability. More truly objective methods of ACL laxity measurement are available such as the KT-1000 arthrometer, but they are not widely used in a clinical setting.The focus of this chapter will be to describe factors that influence clinical and functional outcomes after primary ACL reconstruction. To do so, several patient and surgical factors have been selected and categorized into three perioperative time points – preoperative, intraoperative, and postoperative factors.