PMID- 35297390
OWN - NLM
STAT- MEDLINE
DCOM- 20220608
LR  - 20230829
IS  - 1539-2570 (Electronic)
IS  - 0271-6798 (Linking)
VI  - 42
IP  - 6
DP  - 2022 Jul 1
TI  - Establishing Clinically Significant Outcomes After Anterior Cruciate Ligament 
      Reconstruction in Pediatric Patients.
PG  - e641-e648
LID - 10.1097/BPO.0000000000002143 [doi]
AB  - PURPOSE: The purpose of this study was to establish clinically significant 
      outcome values for the minimal clinically important difference (MCID) and patient 
      acceptable symptomatic state (PASS) after anterior cruciate ligament 
      reconstruction (ACLR) in the pediatric and adolescent populations and to assess 
      factors that were associated with achieving these outcomes. METHODS: Patients 
      between the age of 10 to 21 who underwent ACLR between 2016 and 2018 were 
      identified and patient-reported outcomes (PROs) were collected preoperatively and 
      postoperatively. Intraoperative variables collected included graft choice, graft 
      size (diameter), graft fixation method, and concomitant procedures. PROs 
      collected for analysis were the International Knee Documentation Committee Score 
      (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS). MCID and PASS 
      were calculated using receiver operating characteristic with area under the curve 
      analyses for delta (ie, baseline-to-postoperative change) and absolute 
      postoperative PRO scores, respectively. RESULTS: A total of 59 patients were 
      included in the analysis. Of the entire study population, 53 (89.8%) reported 
      satisfaction with their surgical outcome. The established MCID threshold values 
      based on the study population were 33.3 for IKDC, 28.6 for (KOOS) Symptoms, 19.4 
      for Pain, 2.9 for activities of daily living (ADL), 45.0 for Sport, and 25.0 for 
      Quality of Life (QoL). Postoperative scores greater than the following values 
      corresponded to the PASS: 80.5 for IKDC, 75.0 (KOOS) Symptoms, 88.9 for Pain, 
      98.5 for ADL, 75.0 for Sport, and 68.8 for QoL. CONCLUSION: Clinically meaningful 
      outcomes including MCID and PASS were established for pediatric ACLR surgery 
      using selected PRO measures, IKDC, and KOOS. Patient age, sex, graft type, and 
      graft size were not associated with greater achievement of these outcomes. In 
      contrast, collision sports, fixed-object high-impact rotational landing sports, 
      and concomitant meniscectomy surgery were associated with a decreased likelihood 
      of achieving clinically significant improvement. However, findings must be 
      interpreted with caution due to limitations in follow-up and sample size. LEVEL 
      OF EVIDENCE: Level IV: case series.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Maheshwer, Bhargavi
AU  - Maheshwer B
AD  - University Hospitals Cleveland Medical Center, Case Western Reserve University 
      School of Medicine, OH.
FAU - Polce, Evan M
AU  - Polce EM
AD  - University of Wisconsin College of Medicine, Madison, WI.
FAU - Parvaresh, Kevin C
AU  - Parvaresh KC
AD  - Orthopaedic Specialty Institute, Orange, CA.
FAU - Paul, Katlynn
AU  - Paul K
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Yanke, Adam B
AU  - Yanke AB
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Forsythe, Brian
AU  - Forsythe B
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Bush-Joseph, Charles A
AU  - Bush-Joseph CA
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Bach, Bernard R
AU  - Bach BR
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Cole, Brian J
AU  - Cole BJ
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Verma, Nikhil N
AU  - Verma NN
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Kogan, Monica
AU  - Kogan M
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Chahla, Jorge
AU  - Chahla J
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.
LA  - eng
PT  - Journal Article
DEP - 20220317
PL  - United States
TA  - J Pediatr Orthop
JT  - Journal of pediatric orthopedics
JID - 8109053
SB  - IM
MH  - Activities of Daily Living
MH  - Adolescent
MH  - *Anterior Cruciate Ligament Injuries/surgery
MH  - *Anterior Cruciate Ligament Reconstruction
MH  - Child
MH  - Humans
MH  - Knee Joint/surgery
MH  - Minimal Clinically Important Difference
MH  - Pain/surgery
MH  - Quality of Life
MH  - Treatment Outcome
COIS- The authors declare no conflicts of interest.
EDAT- 2022/03/18 06:00
MHDA- 2022/06/09 06:00
CRDT- 2022/03/17 08:54
PHST- 2022/03/18 06:00 [pubmed]
PHST- 2022/06/09 06:00 [medline]
PHST- 2022/03/17 08:54 [entrez]
AID - 01241398-202207000-00023 [pii]
AID - 10.1097/BPO.0000000000002143 [doi]
PST - ppublish
SO  - J Pediatr Orthop. 2022 Jul 1;42(6):e641-e648. doi: 10.1097/BPO.0000000000002143. 
      Epub 2022 Mar 17.