Measurement of patient perception of ACL injury and management

ACL injury has both short and long term effects on the knee itself and the person as a whole.

Another interesting point of discussion with Dr Steph Filbay in London was appropriate questionnaires to assess the patient's perception of the impact of ACL injury and management, on their knee quality of life.

We discussed the Mohtadi Quality of Life (QOL) Assessment in Anterior Cruciate Ligament Deficiency (sometimes referred to as the ACL- QOL). This was developed by Nick Mohtadi and published in The American Journal of Sports Medicine in 1998.

This has been compared to other knee specific quality of Life instruments in a trial  published by Tanner et al, in The American Journal of Sports Medicine, Vol. 35, No. 9 , 2007 You can access the full article including the ACL-QOL questionnaire here.

They found the Mohtadi QOL scored highest as endorsed by patients with an ACL injury as compared to IKDC, KOOS, HSS, Cincinnati, Lysholm, VAS, ADL and AAOS.

La Fave et al, 2017 found the ACL–QOL was valid, reliable and responsive and completed 8 of the 9 COSMIN criteria. (La Fave et al, Clin J Sport Med Volume 27, Number 1, January 2017.)

Watch out also for Steph Filbay et al publication coming soon in JOSPT looking at long term Quality of Life outcomes after ACL injury.

The Clinical Translator (my notes): Sometimes as clinicians we focus primarily on objective clinical testing rather than combining this with the patients perception of their injury experience or management progress. The ACL- QOL (which is a patient completed questionnaire) is a simple valid, reliable and responsive tool ( Lafave et al, 2017). It can allow us to have greater insights into the impact an ACL injury is having on that individual person and their life including symptoms and physical complaints, work-related concerns, recreational activities and sport participation or competition, lifestyle and social and emotional effects. This information is very relevant in a shared decision making model utilising a biopsychosocial approach and can be used to monitor management progress.  


This is intended as an aid to the clinician to translate research findings into clinical practice but is my own opinion based on the available current research evidence and my clinical expertise and experience. Clinicians should consider if this advice is appropriate for them and use their own reasoning processes considering the individual patient in question