Outcomes of anterior cruciate ligament reconstruction in patients with Workers' Compensation claims

A general perception exists that outcomes of orthopaedic procedures in pati ent's with Workers' Compensation claims fare worse than those of patients w ithout such claims. We retrospectively reviewed the outcomes of anterior cr uciate ligament (ACL) reconstruction in patients who have Workers' Compensa tion claims. This minimum 2-year follow-up study analyzed the occupational, functional, and objective results of patients who underwent arthroscopic-a ssisted anterior cruciate ligament (ACL) reconstruction. Twenty-two patient s with Workers' Compensation claims representing 5% of patients who underwe nt ACL reconstruction at our institution between 1987 and 1995 were include d in the current study. All reconstructions were performed by the senior au thor (B.R.B.) using arthroscopic-assisted techniques (single and double-inc ision) with bone-patellar tendon-bone autografts followed by an accelerated rehabilitation protocol. Postoperative follow-up physical examinations rev ealed a negative anterior drawer in 19 patients (91%), a negative Lachman i n 15 patients (68%), and a negative pivot shift in 21 patients (96%). The K T-1000 arthrometric evaluation at follow-up showed a mean maximum manual di fference of 1.9 mm with 15 patients (68%) having a maximum manual differenc e of less than or equal to 3 mm and 7 patients (32%) from 3 to 5 mm. The me an postoperative scores for the Hospital for Special Surgery scoring scale was 86, Noyes Sports activity scale 81, Noyes ADL score 36, Noyes Problem w ith Sports 75, Noyes Sports Function score 87, Lysholm score 82, and the Te gner score 5.9. The Noyes Occupational rating system increased from preoper ative 48 to 60 postoperatively and the Noyes Job Title rating system score remained at 5 after surgery. Functional testing revealed mean deficits of n o more than 9% between the reconstructed and normal knees. SF-36 testing re vealed significantly higher scores in the Role Physical and General Health categories and a significantly lower score in the Mental Health category wh en compared with United States norms. Subjective evaluation revealed that 9 5% of the patients would undergo a similar procedure if faced with a simila r injury to the contralateral knee in the future. The results of the curren t study show that ACL reconstruction leads to predictable functional and oc cupational results in those patients with work-related injuries. All of our patients were able to return to work. The hypothesis that Workers' Compens ation compromises the results of ACL reconstruction was not observed in thi s study.