Patient-Reported Outcomes and Factors Associated with Achieving the Minimal Clinically Important Difference After ACL Reconstruction

Background:. Analyzing outcomes and the minimal clinically important difference (MCID) after anterior cruciate ligament reconstruction (ACLR) is of increased interest in the orthopaedic literature. The purposes of this study were to report outcomes after ACLR at medium to long-term follow-up, identi...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Benedict U. Nwachukwu, MD, MBA, Spencer W. Sullivan, BS, Ryan C. Rauck, MD, Evan W. James, MD, Joost A. Burger, MD, David W. Altchek, MD, Answorth A. Allen, MD, Riley J. Williams, III, MD, the HSS ACL Registry Group
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/b20fe19b699a46c98fd73bac845d4902
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b20fe19b699a46c98fd73bac845d4902
record_format	dspace
spelling	oai:doaj.org-article:b20fe19b699a46c98fd73bac845d49022021-11-25T07:59:02ZPatient-Reported Outcomes and Factors Associated with Achieving the Minimal Clinically Important Difference After ACL Reconstruction2472-724510.2106/JBJS.OA.21.00056https://doaj.org/article/b20fe19b699a46c98fd73bac845d49022021-12-01T00:00:00Zhttp://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.21.00056https://doaj.org/toc/2472-7245Background:. Analyzing outcomes and the minimal clinically important difference (MCID) after anterior cruciate ligament reconstruction (ACLR) is of increased interest in the orthopaedic literature. The purposes of this study were to report outcomes after ACLR at medium to long-term follow-up, identify the threshold preoperative outcome values that would be predictive of achieving the MCID postoperatively, and analyze outcome maintenance at medium to long-term follow-up after ACLR. Methods:. Active athletes who underwent ACLR were identified in an institutional ACL registry. Patient-reported outcome measures (PROMs) were administered preoperatively and at the 2-year and >5-year postoperative follow-up; measures included the International Knee Documentation Committee (IKDC) form, the 12-item Short Form Health Survey (SF-12) Physical Component Summary (PCS) and Mental Component Summary (MCS), and Lysholm scale. We calculated the MCID from baseline to each of the 2 follow-up periods (2-year and mean 7.7-year). Logistic regression was performed to investigate factors associated with achievement of the MCID. Results:. A total of 142 patients (mean follow-up, 7.7 years [range, 6.6 to 9.1 years]) underwent ACLR. The mean age and body mass index at the time of surgery were 27.2 ± 13.0 years and 23.2 ± 3.0 kg/m2, respectively. Final postoperative outcome scores improved significantly from baseline for the IKDC (50.9 ± 14.7 to 87.9 ± 11.2), SF-12 PCS (41.6 ± 8.9 to 55.6 ± 3.2), and Lysholm scale (62.2 ± 17.6 to 90.5 ± 10.3) (p < 0.0001), while the SF-12 MCS did not improve significantly (54.2 ± 8.0 to 54.4 ± 6.0) (p = 0.763). Between 2- and >5-year follow-up, the SF-12 PCS showed significant improvement (54.6 ± 4.5 to 55.6 ± 3.2; p = 0.036), while no change was noted in the IKDC (87.6 ± 11.1 to 87.9 ± 11.2), SF-12 MCS (55.5 ± 5.3 to 54.4 ± 6.0), and Lysholm scale (89.8 ± 10.6 to 90.5 ± 10.3) (p ≥ 0.09). At the time of final follow-up, the MCID was achieved by 94.7% of patients for the IKDC, 80.8% for the Lysholm, 79.0% for the SF-12 PCS, and 28.2% for the SF-12 MCS. At 2-year follow-up, 95.3% of patients were either “very” or “somewhat” satisfied with their surgery, compared with 88.6% at the time of final follow-up. Conclusions:. We found a high level of maintained function following ACLR. The IKDC, SF-12 PCS, and Lysholm scores improved significantly after ACLR at the time of final follow-up and were not significantly different between follow-up periods. Approximately 95% and 89% of patients reported being satisfied with the outcome of surgery at the 2-year and final follow-up, respectively. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.Benedict U. Nwachukwu, MD, MBASpencer W. Sullivan, BSRyan C. Rauck, MDEvan W. James, MDJoost A. Burger, MDDavid W. Altchek, MDAnsworth A. Allen, MDRiley J. Williams, III, MDthe HSS ACL Registry GroupWolters KluwerarticleOrthopedic surgeryRD701-811ENJBJS Open Access, Vol 6, Iss 4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 Benedict U. Nwachukwu, MD, MBA Spencer W. Sullivan, BS Ryan C. Rauck, MD Evan W. James, MD Joost A. Burger, MD David W. Altchek, MD Answorth A. Allen, MD Riley J. Williams, III, MD the HSS ACL Registry Group Patient-Reported Outcomes and Factors Associated with Achieving the Minimal Clinically Important Difference After ACL Reconstruction
description	Background:. Analyzing outcomes and the minimal clinically important difference (MCID) after anterior cruciate ligament reconstruction (ACLR) is of increased interest in the orthopaedic literature. The purposes of this study were to report outcomes after ACLR at medium to long-term follow-up, identify the threshold preoperative outcome values that would be predictive of achieving the MCID postoperatively, and analyze outcome maintenance at medium to long-term follow-up after ACLR. Methods:. Active athletes who underwent ACLR were identified in an institutional ACL registry. Patient-reported outcome measures (PROMs) were administered preoperatively and at the 2-year and >5-year postoperative follow-up; measures included the International Knee Documentation Committee (IKDC) form, the 12-item Short Form Health Survey (SF-12) Physical Component Summary (PCS) and Mental Component Summary (MCS), and Lysholm scale. We calculated the MCID from baseline to each of the 2 follow-up periods (2-year and mean 7.7-year). Logistic regression was performed to investigate factors associated with achievement of the MCID. Results:. A total of 142 patients (mean follow-up, 7.7 years [range, 6.6 to 9.1 years]) underwent ACLR. The mean age and body mass index at the time of surgery were 27.2 ± 13.0 years and 23.2 ± 3.0 kg/m2, respectively. Final postoperative outcome scores improved significantly from baseline for the IKDC (50.9 ± 14.7 to 87.9 ± 11.2), SF-12 PCS (41.6 ± 8.9 to 55.6 ± 3.2), and Lysholm scale (62.2 ± 17.6 to 90.5 ± 10.3) (p < 0.0001), while the SF-12 MCS did not improve significantly (54.2 ± 8.0 to 54.4 ± 6.0) (p = 0.763). Between 2- and >5-year follow-up, the SF-12 PCS showed significant improvement (54.6 ± 4.5 to 55.6 ± 3.2; p = 0.036), while no change was noted in the IKDC (87.6 ± 11.1 to 87.9 ± 11.2), SF-12 MCS (55.5 ± 5.3 to 54.4 ± 6.0), and Lysholm scale (89.8 ± 10.6 to 90.5 ± 10.3) (p ≥ 0.09). At the time of final follow-up, the MCID was achieved by 94.7% of patients for the IKDC, 80.8% for the Lysholm, 79.0% for the SF-12 PCS, and 28.2% for the SF-12 MCS. At 2-year follow-up, 95.3% of patients were either “very” or “somewhat” satisfied with their surgery, compared with 88.6% at the time of final follow-up. Conclusions:. We found a high level of maintained function following ACLR. The IKDC, SF-12 PCS, and Lysholm scores improved significantly after ACLR at the time of final follow-up and were not significantly different between follow-up periods. Approximately 95% and 89% of patients reported being satisfied with the outcome of surgery at the 2-year and final follow-up, respectively. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
format	article
author	Benedict U. Nwachukwu, MD, MBA Spencer W. Sullivan, BS Ryan C. Rauck, MD Evan W. James, MD Joost A. Burger, MD David W. Altchek, MD Answorth A. Allen, MD Riley J. Williams, III, MD the HSS ACL Registry Group
author_facet	Benedict U. Nwachukwu, MD, MBA Spencer W. Sullivan, BS Ryan C. Rauck, MD Evan W. James, MD Joost A. Burger, MD David W. Altchek, MD Answorth A. Allen, MD Riley J. Williams, III, MD the HSS ACL Registry Group
author_sort	Benedict U. Nwachukwu, MD, MBA
title	Patient-Reported Outcomes and Factors Associated with Achieving the Minimal Clinically Important Difference After ACL Reconstruction
title_short	Patient-Reported Outcomes and Factors Associated with Achieving the Minimal Clinically Important Difference After ACL Reconstruction
title_full	Patient-Reported Outcomes and Factors Associated with Achieving the Minimal Clinically Important Difference After ACL Reconstruction
title_fullStr	Patient-Reported Outcomes and Factors Associated with Achieving the Minimal Clinically Important Difference After ACL Reconstruction
title_full_unstemmed	Patient-Reported Outcomes and Factors Associated with Achieving the Minimal Clinically Important Difference After ACL Reconstruction
title_sort	patient-reported outcomes and factors associated with achieving the minimal clinically important difference after acl reconstruction
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/b20fe19b699a46c98fd73bac845d4902
work_keys_str_mv	AT benedictunwachukwumdmba patientreportedoutcomesandfactorsassociatedwithachievingtheminimalclinicallyimportantdifferenceafteraclreconstruction AT spencerwsullivanbs patientreportedoutcomesandfactorsassociatedwithachievingtheminimalclinicallyimportantdifferenceafteraclreconstruction AT ryancrauckmd patientreportedoutcomesandfactorsassociatedwithachievingtheminimalclinicallyimportantdifferenceafteraclreconstruction AT evanwjamesmd patientreportedoutcomesandfactorsassociatedwithachievingtheminimalclinicallyimportantdifferenceafteraclreconstruction AT joostaburgermd patientreportedoutcomesandfactorsassociatedwithachievingtheminimalclinicallyimportantdifferenceafteraclreconstruction AT davidwaltchekmd patientreportedoutcomesandfactorsassociatedwithachievingtheminimalclinicallyimportantdifferenceafteraclreconstruction AT answorthaallenmd patientreportedoutcomesandfactorsassociatedwithachievingtheminimalclinicallyimportantdifferenceafteraclreconstruction AT rileyjwilliamsiiimd patientreportedoutcomesandfactorsassociatedwithachievingtheminimalclinicallyimportantdifferenceafteraclreconstruction AT thehssaclregistrygroup patientreportedoutcomesandfactorsassociatedwithachievingtheminimalclinicallyimportantdifferenceafteraclreconstruction
_version_	1718413580012879872

Patient-Reported Outcomes and Factors Associated with Achieving the Minimal Clinically Important Difference After ACL Reconstruction

Ejemplares similares