PMID- 34841188
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240124
IS  - 2472-7245 (Electronic)
IS  - 2472-7245 (Linking)
VI  - 6
IP  - 4
DP  - 2021 Oct-Dec
TI  - Patient-Reported Outcomes and Factors Associated with Achieving the Minimal 
      Clinically Important Difference After ACL Reconstruction: Results at a Mean 
      7.7-Year Follow-up.
LID - 10.2106/JBJS.OA.21.00056 [doi]
LID - e21.00056
AB  - 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/m(2), 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.
CI  - Copyright (c) 2021 The Authors. Published by The Journal of Bone and Joint Surgery, 
      Incorporated. All rights reserved.
FAU - Nwachukwu, Benedict U
AU  - Nwachukwu BU
AUID- ORCID: 0000-0002-6170-7769
AD  - Sports Medicine Institute, Hospital for Special Surgery, New York, NY.
FAU - Sullivan, Spencer W
AU  - Sullivan SW
AUID- ORCID: 0000-0002-8220-3404
AD  - Sports Medicine Institute, Hospital for Special Surgery, New York, NY.
FAU - Rauck, Ryan C
AU  - Rauck RC
AUID- ORCID: 0000-0002-2129-8649
AD  - Department of Orthopaedics, The Ohio State University Wexner Medical Center, 
      Columbus, Ohio.
FAU - James, Evan W
AU  - James EW
AD  - Sports Medicine Institute, Hospital for Special Surgery, New York, NY.
FAU - Burger, Joost A
AU  - Burger JA
AUID- ORCID: 0000-0001-9360-2884
AD  - Sports Medicine Institute, Hospital for Special Surgery, New York, NY.
FAU - Altchek, David W
AU  - Altchek DW
AUID- ORCID: 0000-0002-7964-3513
AD  - Sports Medicine Institute, Hospital for Special Surgery, New York, NY.
FAU - Allen, Answorth A
AU  - Allen AA
AUID- ORCID: 0000-0003-0346-4735
AD  - Sports Medicine Institute, Hospital for Special Surgery, New York, NY.
FAU - Williams, Riley J 3rd
AU  - Williams RJ 3rd
AUID- ORCID: 0000-0003-2991-7173
AD  - Sports Medicine Institute, Hospital for Special Surgery, New York, NY.
LA  - eng
PT  - Journal Article
DEP - 20211111
PL  - United States
TA  - JB JS Open Access
JT  - JB & JS open access
JID - 101726219
PMC - PMC8613365
COIS- Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided 
      with the online version of the article (http://links.lww.com/JBJSOA/A337).
EDAT- 2021/11/30 06:00
MHDA- 2021/11/30 06:01
PMCR- 2021/11/11
CRDT- 2021/11/29 06:35
PHST- 2021/11/30 06:00 [pubmed]
PHST- 2021/11/30 06:01 [medline]
PHST- 2021/11/29 06:35 [entrez]
PHST- 2021/11/11 00:00 [pmc-release]
AID - JBJSOA-D-21-00056 [pii]
AID - 10.2106/JBJS.OA.21.00056 [doi]
PST - epublish
SO  - JB JS Open Access. 2021 Nov 11;6(4):e21.00056. doi: 10.2106/JBJS.OA.21.00056. 
      eCollection 2021 Oct-Dec.