Use of the short form health surveys as an outcome measure for anterior cruciate ligament reconstruction

PURPOSE: The purpose of the study was to report SF-36 data from a large cohort with anterior cruciate ligament (ACL) reconstruction surgery and compare between the SF-36 and SF-12. METHODS: 1,500 patients completed the SF-36 at a minimum 12 months following ACL reconstruction surgery. The items which make up the SF-12 were selected and subscale scores were calculated and compared with the SF-36. The physical and mental component summary scores were calculated for both versions and correlated with disease-specific outcomes and were compared between different patient groups. In addition, the percentage of patients with below average, average, or above average general health was tabulated. RESULTS: Over 90% of the cohort scored in the average or above average range for both physical and mental health component summary scores. Correlations between SF-36 and SF-12 scores were above 0.8 for all subscales except general health. Mean differences between the two versions were small except for the bodily pain subscale for which the SF-12 was 8.17 points higher than the SF-36 (0-100 scoring). For both versions, disease-specific measures were more highly correlated with the physical component score than the mental component score. Both versions were able to similarly distinguish between primary and revision procedures and groups that were and were not participating in sports. CONCLUSIONS: Following ACL reconstruction, patients generally have excellent health. The SF-12 provides a simple health outcome assessment following ACL reconstruction surgery and is an adequate alternative for the SF-36 for measures made at a single time point. The bodily pain subscale for the SF-12 may lack sensitivity, and disease-specific measures of pain should therefore also be included. LEVEL OF EVIDENCE: I.