Anterior cruciate ligament injury after more than 20 years: I. Physical activity level and knee function

Scand J Med Sci Sports. 2014 Dec;24(6):e491-500. doi: 10.1111/sms.12212. Epub 2014 Mar 27.


Little is known about physical activity level and knee function including jump capacity and fear of movement/reinjury more than 20 years after injury of the anterior cruciate ligament (ACL). Seventy persons with unilateral ACL injury participated (23 ± 2 years post-injury): 33 treated with physiotherapy in combination with surgical reconstruction (ACLR ), and 37 treated with physiotherapy alone (ACLPT ). These were compared with 33 age- and gender-matched controls. Assessment included knee-specific and general physical activity level [Tegner activity scale, International Physical Activity Questionnaire (IPAQ)], knee function [Lysholm score, Knee injury and Osteoarthritis Outcome Score (KOOS)], jump capacity (one-leg hop, vertical jump, side hops), and fear of movement/reinjury [Tampa Scale for Kinesiophobia (TSK)]. Outcomes were related to degree of osteoarthritis (OA). ACL-injured had lower Lysholm, KOOS, and Tegner scores than controls (P < 0.001), while IPAQ score was similar. ACL-injured demonstrated inferior jump capacity in injured compared with noninjured leg (6-25%, P < 0.001-P = 0.010 in the different jumps), while noninjured leg had equal jump capacity as controls. ACL groups scored 33 ± 7 and 32 ± 7 of 68 on TSK. Lower scores on Lysholm and KOOS symptom were seen for persons with moderate-to-high OA than for no-or-low OA, while there were no differences for physical activity and jump capacity. Regardless of treatment, there are still negative knee-related effects of ACL injury more than 20 years later.

Keywords: International Physical Activity Questionnaire; cross-sectional design; jump; limb symmetry index; movement fear.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anterior Cruciate Ligament Injuries*
  • Anterior Cruciate Ligament Reconstruction / rehabilitation
  • Case-Control Studies
  • Cross-Sectional Studies
  • Exercise Test
  • Fear*
  • Female
  • Humans
  • Knee Injuries / psychology
  • Knee Injuries / therapy
  • Knee Joint / physiopathology*
  • Male
  • Middle Aged
  • Motor Activity*
  • Osteoarthritis, Knee / diagnostic imaging
  • Physical Therapy Modalities
  • Radiography
  • Surveys and Questionnaires
  • Time Factors