Evaluation of clinical outcomes in anterior cruciate ligament surgery

In the past several decades, there have been many advances in the diagnosis, surgical care, and rehabilitation of anterior cruciate ligament (ACL) injuries. However, there are few data in the literature as to whether these advances have successfully improved clinical outcomes following anterior cruciate ligament reconstruction. Thus, future research efforts should focus on the valid evaluation of clinical outcomes after ACL reconstruction. This article reviews the relevant clinical outcome measures for the evaluation of patients with anterior cruciate ligament injuries. The outcome evaluation of anterior cruciate ligament injuries should include measures of structure and function of the knee as well as measures of activity and participation of the individual. Measures of structure and function of the knee most directly related to injury of the ACL include measures of laxity and degeneration of the joint over time. Activity and participation can be measured by observing performance of the individual during a variety of activities or through the use of general and knee-specific a patient-reported measures of health related quality of life. When evaluating clinical outcomes following ACL injury, validated measures with established reliability and responsiveness must be used.