Kinesiophobia and Self-Reported Outcome Measures Are Not Related to Knee Function And Muscle Strength 5 Years After Anterior Cruciate Ligament Reconstruction

subscales Pain, Symptoms, Sports/Recreation and Quality of Life), presented as the odds ratio (OR) with a 95% confidence interval (CI).Revision rates within two years were examined for the surgeon/clinic groups, and an adjusted Cox regression analysis was conducted to determine the hazard ratio (HR) with 95% CI of ACL revision surgery.Results 16,317 out of 35,371 patients completed the two-year KOOS.Surgeons and clinics with high total caseload/annual volume operated their patients earlier (time from injury to surgery), and with a decreased operating time (all p<0.001).The rates of perioperative complications, use of thromboprophylaxis and non-recommended perioperative antibiotics were lower among patients operated by surgeons with high caseload/annual volume (all p<0.001).Similar trends were seen for the clinics (all p<0.001).Significantly decreased odds of achieving MIC-KOOS4 (OR 0.74, 95% CI 0.62-0.88)and PASS-KOOS4 (OR 0.71, 95% CI 0.60-0.84)(but not TF-KOOS4) were found for ACLRs performed by inexperienced surgeons (low caseload/annual volume) compared to experienced (high caseload/annual volume) ones at two-year follow-up.Clinic volume did not influence MIC-KOOS4, PASS-KOOS4 or TF-KOOS4.There were 804 patients (2.2%) having a subsequent ACL revision surgery within two years from primary ACLR.ACL revision rates were higher among patients operated at high volume clinics (p<0.001).However, when adjusting for potential confounders (age, sex, time from injury to surgery, activity at time of injury and preoperative KOOS4) in the Cox regression analysis, surgeon and clinic experience had no influence on the subsequent risk of revision surgery.Conclusion Patients having primary ACLR by high volume surgeons experienced an increased improvement and satisfaction regarding subjective knee function, compared to patients operated by low volume surgeons.