PMID- 37419222 OWN - NLM STAT- MEDLINE DCOM- 20231222 LR - 20240226 IS - 1526-3231 (Electronic) IS - 0749-8063 (Linking) VI - 40 IP - 1 DP - 2024 Jan TI - The Value of Minimal Clinically Important Difference, Substantial Clinical Benefit, and Patient-Acceptable Symptomatic State for Commonly Used Patient-Reported Outcomes in Recurrent Patellar Instability Patients After Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Transfer. PG - 115-123 LID - S0749-8063(23)00532-7 [pii] LID - 10.1016/j.arthro.2023.06.042 [doi] AB - PURPOSE: To identify the minimal clinically important difference (MCID), substantial clinical benefit (SCB) and patient-acceptable symptomatic state (PASS) for commonly used patient-reported outcomes (PROs) in recurrent patellar instability patients after medial patellofemoral ligament reconstruction (MPFLR) and tibial tubercle transfer (TTT), and to determine the impact of potential prognostic factors on the likelihood of achieving these values. METHODS: From April 2015 to February 2021, patients who underwent MPFLR and TTT were retrospectively reviewed. PROs included Kujala, Knee Injury and Osteoarthritis Outcome (KOOS), Lysholm, International Knee Documentation Committee (IKDC), and Tegner score. Relevant anchor questions were provided. A distribution- or anchor-based method was adopted to determine the MCID, SCB, and PASS. Minimal detectable change (MDC) was included to confirm the validity. Univariate regression analyses were conducted to determine the potential prognostic factors. RESULTS: One hundred forty-two patients were included. The MCID were 9.1 (Kujala), 11.1 (Lysholm), 0.9 (Tegner), 9.9 (IKDC), 9.0 (KOOS-Pain), 10.8 (KOOS-Symptoms), 10.0 (KOOS-Activities of Daily Living [ADL]), 17.8 (KOOS-Sports and Recreation [Sports/Rec]), and 12.7 (KOOS-Quality of Life [QoL]). The SCB were 14.5 (Kujala), 12.5 (Lysholm), 1.5 (Tegner), 14.5 (IKDC), 13.9 (KOOS-Pain), 14.3 (KOOS-Symptoms), 18.4 (KOOS-ADL), 47.5 (KOOS-Sports/Rec), and 15.0 (KOOS-QoL). The PASSs were 85.5 (Kujala), 75.5 (Lysholm), 3.5 (Tegner), 73.2 (IKDC), 87.5 (KOOS-Pain), 73.2 (KOOS-Symptoms), 92.0 (KOOS-ADL), 77.5 (KOOS-Sports/Rec), and 53.1 (KOOS-QoL). All SCBs were valid except KOOS-QoL. All MCIDs were valid at the 95% confidence interval (CI) except KOOS scores, the majority of which were valid at the 90% CI. A younger age was an independent prognostic factor of reaching PASS for Lysholm, IKDC, Tegner, and KOOS-ADL score. A higher baseline score was a negative prognostic factor for achieving MCID or SCB but had a slightly positive influence on the achievement of PASS. CONCLUSIONS: This study established the MCID, SCB, and PASS for commonly used PROs and confirmed their validity in recurrent patellar instability patients after MPFLR and TTT. Younger age and lower baseline scores were prognostic factors of achieving MCID and SCB, whereas patients with higher baseline scores were more likely to report satisfaction. LEVEL OF EVIDENCE: Level III, retrospective comparative prognostic trial. CI - Copyright (c) 2023 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. FAU - Qiao, Yi AU - Qiao Y AD - Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Wu, Chenliang AU - Wu C AD - Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Wu, Xiulin AU - Wu X AD - Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Li, Ziyun AU - Li Z AD - Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Chen, Jiebo AU - Chen J AD - Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Xu, Caiqi AU - Xu C AD - Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Zhao, Song AU - Zhao S AD - Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Zhao, Jinzhong AU - Zhao J AD - Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: jzzhao@sjtu.edu.cn. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230705 PL - United States TA - Arthroscopy JT - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JID - 8506498 SB - IM MH - Humans MH - Retrospective Studies MH - Quality of Life MH - *Joint Instability/surgery MH - Activities of Daily Living MH - Minimal Clinically Important Difference MH - *Patellofemoral Joint/surgery MH - Ligaments, Articular/surgery MH - *Osteoarthritis, Knee MH - *Knee Injuries MH - Pain MH - Patient Reported Outcome Measures MH - Treatment Outcome EDAT- 2023/07/08 10:42 MHDA- 2023/12/22 06:42 CRDT- 2023/07/07 19:24 PHST- 2023/02/09 00:00 [received] PHST- 2023/05/28 00:00 [revised] PHST- 2023/06/21 00:00 [accepted] PHST- 2023/12/22 06:42 [medline] PHST- 2023/07/08 10:42 [pubmed] PHST- 2023/07/07 19:24 [entrez] AID - S0749-8063(23)00532-7 [pii] AID - 10.1016/j.arthro.2023.06.042 [doi] PST - ppublish SO - Arthroscopy. 2024 Jan;40(1):115-123. doi: 10.1016/j.arthro.2023.06.042. Epub 2023 Jul 5.