PMID- 29733680 OWN - NLM STAT- MEDLINE DCOM- 20190923 LR - 20190923 IS - 1552-3365 (Electronic) IS - 0363-5465 (Linking) VI - 46 IP - 7 DP - 2018 Jun TI - Change in KOOS and WOMAC Scores in a Young Athletic Population With and Without Anterior Cruciate Ligament Injury. PG - 1606-1616 LID - 10.1177/0363546518768753 [doi] AB - BACKGROUND: Several studies have examined changes in patient-reported outcome measures (PROMs) after anterior cruciate ligament (ACL) injury, but no studies to date have prospectively evaluated changes from preinjury baseline through injury and follow-up among ACL-injured patients compared to the baseline and follow-up changes of uninjured patients. PURPOSE: To examine changes in PROMs over time from preinjury baseline to at least 2 years after ACL reconstruction and to compare these changes with those of an uninjured control group having similar physical activity requirements. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: The authors conducted a prospective cohort study with a nested case-control analysis at a US service academy. All incoming first year students were recruited to participate in this study. Consenting participants completed a baseline questionnaire that included the KOOS (Knee injury and Osteoarthritis Outcome Score), WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and MARS (Marx Activity Rating Scale). Participants who sustained a subsequent ACL injury completed assessments at the time of surgery and at 6, 12, and 24 months after surgery. Healthy participants were recruited to repeat the baseline assessments within 1 year of graduation. Inter- and intragroup differences at these time points were evaluated with dependent and independent t tests, respectively. We also compared these results with established minimum clinically important difference (MCID) values. RESULTS: Of 1268 first year students entering the academy, 1005 with no previous injuries consented to participate in this study (82% male, mean +/- SD age 19 +/- 1 years). Of those enrolled, 30 suffered an ACL injury and met the inclusion criteria for this study. Ninety uninjured control students who met the inclusion criteria completed follow-up assessments. There were statistically significant differences across all KOOS and WOMAC subscales between ACL-injured group and uninjured group at the time of the final follow-up assessment. Four KOOS subscales (Pain, Symptoms, Sports and Recreation Function, and Knee-Related Quality of Life) and the WOMAC Stiffness subscale demonstrated >8-point differences between groups, which exceeded the established MCID for these instruments. There were no significant differences between the ACL-injured group and uninjured groups noted for the MARS ( P = .635). At the time of final follow-up, the ACL-injured group also reported significant deficits on the WOMAC Stiffness subscale ( P = .032), the MARS ( P = .030), and all KOOS subscales, with the exception of Functional Activities of Daily Living, as compared with their preinjury baseline scores. These deficits exceeded the established MCID values for 3 KOOS subscales and the MARS. CONCLUSION: Patients with ACL injuries reported significant deficits on PROMs at least 2 years after surgical reconstruction in relation to preinjury baseline scores and an uninjured control group. Many of these deficits exceeded established MCID values. FAU - Antosh, Ivan J AU - Antosh IJ AD - Dwight D. Eisenhower Army Medical Center, Ft Gordon, Georgia, USA. FAU - Svoboda, Steven J AU - Svoboda SJ AD - John A. Feagin Jr Orthopaedic Sports Medicine Fellowship, United States Military Academy, West Point, New York, USA. FAU - Peck, Karen Y AU - Peck KY AD - John A. Feagin Jr Orthopaedic Sports Medicine Fellowship, United States Military Academy, West Point, New York, USA. FAU - Garcia, E'Stephan J AU - Garcia EJ AD - William Beaumont Army Medical Center, El Paso, Texas, USA. FAU - Cameron, Kenneth L AU - Cameron KL AD - John A. Feagin Jr Orthopaedic Sports Medicine Fellowship, United States Military Academy, West Point, New York, USA. LA - eng PT - Journal Article DEP - 20180507 PL - United States TA - Am J Sports Med JT - The American journal of sports medicine JID - 7609541 SB - IM MH - Adolescent MH - Anterior Cruciate Ligament Injuries/*surgery MH - Anterior Cruciate Ligament Reconstruction MH - Athletes MH - Case-Control Studies MH - Female MH - Humans MH - Knee Injuries/surgery MH - Knee Joint/surgery MH - Male MH - Military Personnel MH - Osteoarthritis/surgery MH - *Patient Reported Outcome Measures MH - Prospective Studies MH - Quality of Life MH - Surveys and Questionnaires MH - Young Adult OTO - NOTNLM OT - ACL injury OT - knee OT - patient-reported outcome measures OT - posttraumatic osteoarthritis EDAT- 2018/05/08 06:00 MHDA- 2019/09/24 06:00 CRDT- 2018/05/08 06:00 PHST- 2018/05/08 06:00 [pubmed] PHST- 2019/09/24 06:00 [medline] PHST- 2018/05/08 06:00 [entrez] AID - 10.1177/0363546518768753 [doi] PST - ppublish SO - Am J Sports Med. 2018 Jun;46(7):1606-1616. doi: 10.1177/0363546518768753. Epub 2018 May 7.