Impact of Knee Injury History on Health-Related Quality of Life in Adolescent
KC & Markbreiter JG. J Sport Rehab.
2017; Online Ahead of Print September 19, 2017.  
Take Home Message: Adolescent athletes with a previous knee
injury history report poor quality of life scores that effect their physical
functioning as well as their social and school functioning. 
Many college athletes and military
cadets with a knee-injury history often report poor patient-reported outcomes (e.g.,
impaired health-related quality of life) after returning to physical
activity.  It remains unclear if this is
true among younger athletes. Hence, the researchers completed a cross-sectional
study to see if knee-injury history was associated with lower quality of life
among adolescent athletes who were cleared to participate in sports.  The researchers asked 183 interscholastic athletes
to complete a health history questionnaire, pediatric International Knee Documentation Form (IKDC; overall quality of life), and Pediatric Quality of Life (emotional, physical, social, and
school functioning scales) during pre-season assessments.  Thirty-six athletes reported a previous knee-injury
history, with ligament sprains being the most common.  Athletes with a previous knee injury history had
lower quality of life, physical function, social function, and school function
as well as lower IKDC scores.  The
researchers observed no differences for emotional functioning or when accounting
for gender.     
These authors showed that adolescent
athletes, who were medically cleared for sports, are reporting poorer quality-of-life
related outcomes if they have a knee-injury history.  It would have been interesting to see if
athletes with a history of major knee injury (surgical) versus chronic injury
responded differently.  However, these
findings seem consistent with what has been found in other populations.  Patients across multiple levels of sport are
still reporting problems despite being medically cleared to return to physical
activity and/or sport.  With knee-injury
history being a risk factor for long-term problems such as osteoarthritis, we
should be paying more attention to this as it seems our patients are trying to
tell us something is wrong.  A interesting
finding in this study was that adolescents with a knee-injury history are
reporting problems in the classroom and socially with peers.  Pain and quality of life are known to lead to
long-term problems, but this is one of the first studies to find very early
effects in young athletes.  This could be
very problematic for their future mental and physical health and development.  It would be very interesting to follow these
athletes long-term.  As clinicians, our
patients are trying to tell us that they don’t feel normal and that it effects
many areas of their life – not just their physical function.  We need to be more attentive to this, and see
if there are interventions that might help our patients with a knee-injury
for Discussion
:  Are you currently using
any patient reported outcomes after knee injury?  Are there any strategies that you have used
to try to address poor quality of life after knee injury?
by: Nicole Cattano
by: Jeffrey Driban