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- W3124334789 abstract "Outcomes after anterior cruciate ligament reconstruction (ACLR) have traditionally been examined by measuring differences in patient-reported outcome scores. However, recent literature has underlined the importance of utilizing clinically significant outcomes such as the patient acceptable symptomatic state (PASS). Accordingly, the purpose of this study is to use an anchor-based methodology to define the absolute score threshold for PASS in patients undergoing isolated ACLR. A prospective clinical registry was queried for primary ACLR patients between January 2014 to April 2017 with serial PROM completion at 6-, 12- and 24-months. Exclusion criteria included revision procedures, significant concomitant procedures (i.e. bony, ligamentous, meniscal, biological augmentation), or lack of consecutive follow-up time points. PROMs collected include the International Knee Documentation Committee score (IKDC), and all Knee Injury and Osteoarthritis Outcome Score (KOOS) sub scores. PASS threshold values were calculated using receiver operating curves (ROC) with area under the curve (AUC) analysis. A stepwise multivariate regression identified predictors of PASS achievement. A total of 126 APM patients (46.9±13.6 years, BMI 25.9±6.1, 57.1% male) and 144 ACLR patients (30.9±12.8 years, BMI 25.5±4.6, 41.0% male) were included. PASS achievement rates in the ACLR cohort ranged from 50.8% to 69.3% across PROMs, while being >95.1% across IKDC and KOOS domains at 24 months (p<0.001). Factors impacting odds of PASS achievement in the ACLR cohort included pre-operative exercises (OR: 2.95-4.74, p=0.003-0.038), worker’s compensation status (OR: 0.25-0.28, p=0.014-0.033), pre-operative scores (OR:1.03-1.07, p=0.005- < 0.001), iliotibial band (ITB) tenodesis (OR: 11.08, p=0.010), and anteromedial approach (OR: 18.03-37.05, p<0.001). The current study establishes PASS threshold values for IKDC and KOOS subscales in patients undergoing ACLR. These patients are more likely to achieve PASS on IKDC and KOOS subscales than those receiving APM. Additionally, preoperative exercise, worker’s compensation status, tunneling technique (i.e. anteromedial), ITB tenodesis, and pre-operative scores impact the odds of PASS achievement." @default.
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- W3124334789 date "2021-01-01" @default.
- W3124334789 modified "2023-09-23" @default.
- W3124334789 title "Defining the Patient Acceptable Symptomatic State in Anterior Cruciate Ligament Reconstruction" @default.
- W3124334789 doi "https://doi.org/10.1016/j.arthro.2020.12.071" @default.
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