Comparative assessment of the quality of life and the effectiveness of treatment in patients after early and delayed anterior cruciate ligament reconstruction

Abstract

Background. In modern medical practice, a significant interest in the study of quality of life is manifested in the biopsychosocial approach, which indicates the concept of a holistic view of the course of the disease and the effectiveness of treatment.
 Aim. To give a comparative assessment of the quality of life and the effectiveness of treatment of patients after early and delayed reconstruction of an isolated injury of the anterior cruciate ligament.
 Material and methods. The results of a survey of 782 patients aged 1854 years according to the international standardized questionnaire of the quality of life (SF-36 Short Form-36 Health Survey Questionnaire) before and after arthroscopic reconstruction of an isolated injury of the anterior cruciate ligament using a free autograft from the tendons of the semitendinosus and tender muscles are presented. All patients were divided into two groups. The first group included 403 patients (232 males and 171 females), anterior cruciate ligament plasty was performed at an early stage, from the 1st to the 6th week after the injury. The second group included 379 patients (211 males and 168 females) who were operated on late, from the 7th week to 1 year after the injury. Statistical analysis was performed using the Statistica 12.0 program (Stat Soft, Inc.). The significance of differences between independent samples was determined using nonparametric tests: the MannWhitney U test and the Wilcoxon T test.
 Results. It was found that 1 year after the operation, in patients of the first group, the values of the treatment effectiveness indicator in terms of the total indicator of physical and mental components of health are significantly higher compared to the second group (p 0.0001, MannWhitney U-test). A high correlation between the indicators of treatment effectiveness according to the assessment scales of the physical component of health and the mental component of health in groups depending on the timing of the reconstruction of the anterior cruciate ligament was found. Thus, the Spearman's rank correlation coefficient in the first group between the indicators of treatment effectiveness in terms of the total indicator of the physical and mental components of health was r=0.79 (p=0.001), and in the second group r=0.71 (p=0.001).
 Conclusion. The long-term results of assessing the quality of life of patients indicate the predominant effectiveness of the treatment of patients operated on in the early stages after injury, compared with delayed surgery.