Self-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: An Internal Health Locus of Control Score Comparison

Purpose: The purpose of this study was to evaluate the influence of high or low internal health locus of control (HLOC) scores on knee function and sports activity self-reports. Methods: The Multidimensional HLOC Scale, the Knee Outcome Survey (KOS) Activities of Daily Living Scale (ADLS) and Sports Activity Scale (SAS), and the 2000 International Knee Documentation Committee (IKDC) Subjective Knee Evaluation and Current Health Assessment surveys were mailed to 335 subjects at a minimum of 2 years after anterior cruciate ligament reconstruction. Results: Of the subjects, 198 returned completed surveys at 5.1 ± 2.9 years after surgery. Compared with the group with low internal HLOC scores, the group with high internal HLOC scores had better KOS-ADLS scores (89.6 ± 13.7 v 77.4 ± 23.9, P < .0001), KOS-SAS scores (85.2 ± 18 v 70 ± 29, P < .0001), global ADLS ratings (90.7 ± 12.8 v 77.4 ± 23.9, P < .0001), global SAS ratings (81.8 ± 20.6 v 70 ± 29.4, P < .0001), 2000 IKDC Subjective Knee Evaluation scores (80.9 ± 17.7 v 68.3 ± 25.2, P < .0001), and 2000 IKDC Current Health Assessment scores for physical function (90.2 ± 14 v 80.5 ± 24.6, P = .001), social function (92.6 ± 14.8 v 85.8 ± 21.1, P = .014), bodily pain (80.7 ± 17.7 v 68.7 ± 24.6, P < .001), mental health (77.9 ± 14.2 v 70.6 ± 19.2, P = .005), and vitality (65.1 ± 19 v 58.8 ± 21, P = .04). Current knee function scores (8.7 ± 1.8 v 7.1 ± 2.9, P < .0001) and KOS-SAS sports activity level scores (χ2 = 11.2, P = .01) were also higher in the group with high internal HLOC scores compared with the group with low scores. Conclusions: Patients with high internal HLOC scores were more satisfied with knee function. Level of Evidence: Level IV, prognostic case series.