The role of the Short Form 36 Health Survey in autologous chondrocyte implantation

The purpose of this study was to examine the use of the Short Form 36 Health Survey (SF-36) in the preoperative assessment and postoperative review of patients undergoing autologous chondrocyte implantation (ACI) of the knee. We used the SF-36, a validated health related quality of life survey, and The Modified Cincinnati Knee score, a commonly used knee function scoring system, to evaluate 25 consecutive patients preoperatively and 1 year following surgery. Before surgery, patients scored lower for all aspects of general health and level of functioning compared to a normalised general population. We demonstrated significant increases of overall SF-36 scores following surgery, reflecting improvements to perceived general health. Most significant improvements were seen in the physical categories of “Physical Functioning” (44.8 to 56.2, p=0.014), “Role Physical”(35.0 to 52.2, p=0.044) and “Bodily Pain”(33.6 to 50.9, p=0.001). Higher preoperative SF-36 scores were found to correlate significantly with greater increases of Modified Cincinnati Knee scores. Postoperative knee function scores correlated well with physical categories of the SF-36. However, we found poor correlation between postoperative Modified Cincinnati Knee scores and SF-36 scores for vitality, social functioning and emotional domains. This suggests that knee function scores alone do not incorporate all the benefits to patient health following ACI surgery. We recommend using a knee function scoring system and the SF-36 for both the preoperative assessment and postoperative review of ACI patients.