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Not All Patient Reported Outcome Measures are Equivalent at Two- Compared to One-Year After Anterior Cruciate Ligament Reconstruction Based on a Retrospective Analysis

J ISAKOS. 2024 Mar 14:S2059-7754(24)00055-5. doi: 10.1016/j.jisako.2024.03.010. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess for clinically important differences in patient reported outcome measures (PROMs) at one- and two-years post anterior cruciate ligament reconstruction (ACLR).

METHODS: A retrospective comparison of prospectively collected PROMs for a single cohort who underwent a primary ACLR with or without associated meniscal surgery from 2016 to 2020 was assessed. Six externally validated PROMs were collected pre-operatively and at standardized times post-operatively. Descriptive statistics and paired equivalence testing of PROMs at one- and two-years after surgery was completed using previously published or calculated minimal clinically important differences as upper and lower equivalence limits. A repeated measures analysis of PROMs that were not clinically equivalent at one- and two-years after surgery was completed to assess for a clinically significant difference. Subgroup analyses based on sex, age and associated meniscal injury were completed.

RESULTS: One-hundred and forty-five participants with a mean age of 28.7 years (standard deviation: 9.9 years) were included in the final analysis. All PROMs were clinically equivalent at two- compared to one-year after ACLR except the Quality of Life and Sport and Recreation domains of the Knee Injury and Osteoarthritis Outcome Score (KOOS). The Quality of Life (mean difference (MD):12.3, P < 0.01, effect size (η2): 0.65) and Sport and Recreation (MD: 8.78, P < 0.01, η2: 0.50) domains of the KOOS were clinically different at two- compared to one-year post-operatively. No major differences were found in the subgroup analyses compared to the entire included sample.

CONCLUSION: While most PROMs were equivalent at two- compared to one-year after ACLR, the Quality of Life and Sport and Recreation domains of the KOOS, which reflect knee performance during higher demand activities exhibited a clinically significant difference.

LEVEL OF EVIDENCE: IV.

PMID:38492849 | DOI:10.1016/j.jisako.2024.03.010

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