Knee Surg Sports Traumatol Arthrosc. 2026 May 15. doi: 10.1002/ksa.70425. Online ahead of print.
ABSTRACT
PURPOSE: A growing emphasis on patient-centered care, paired with a steady rise in anterior cruciate ligament reconstructions (ACLRs), has led to greater interest in identifying predictors of patient-reported outcomes (PROs) after ACLR. Patient expectations are one factor previously identified as potentially impacting post-operative PROs in orthopaedic surgery; however, the association between preoperative expectations and PROs after ACLR has not been thoroughly investigated. Therefore, the present study aimed to examine the association between preoperative expectations and PROs 2 years after primary ACLR.
METHODS: Patients who underwent primary ACLR at an academic institution from July 2015 to May 2018 were retrospectively identified from a prospectively enroled registry. Surveys were administered at baseline and 2 years post-operatively. Outcomes included six Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT) domains, International Knee Documentation Committee (IKDC) Subjective Knee Form, Tegner Activity Scale (TAS), Marx Activity Rating Scale of the lower extremity (MARS LE) and numeric pain scale (NPS) of the operative knee and body. Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS) preoperative expectations domain assessed patient expectations.
RESULTS: Out of 184 patients, 129 patients (70.1%) with complete preoperative expectations completed 2-year PROs and were included for statistical analysis. The mean preoperative expectations score for our patient population was 88.1. On bivariate analysis, preoperative expectations were not associated with patient sociodemographics. Higher preoperative expectations correlated with improved 2-year surgical satisfaction (p = 0.005), greater 2-year improvement in PROMIS Social Satisfaction (p = 0.023) and improved PROMIS Pain Interference (p = 0.005). On regression analysis, preoperative expectations predicted 2-year PROMIS Pain Interference (p = 0.030) and Met Expectations (p = 0.038). Preoperative expectations were also a predictor of greater improvement in PROMIS Pain Interference (p = 0.014).
CONCLUSION: The current study found that preoperative expectations are predictive of improved 2-year pain-related outcomes and a greater sense that expectations were met after ACLR.
LEVEL OF EVIDENCE: Level IV, a retrospective cohort study.
PMID:42139673 | DOI:10.1002/ksa.70425
