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Review
. 2024 Jul 15;16(7):e64546.
doi: 10.7759/cureus.64546. eCollection 2024 Jul.

Patient-Reported Outcome Measures Used on Patients With Anterior Cruciate Ligament Injury

Apostolos D Prodromidis  1 , Georgios C Thivaios  2 , Anastasios Mourikis  3 , Ioannis D Erginousakis  4 , Vasileios S Nikolaou  1   5 , John Vlamis  1   3 , Efstathios Chronopoulos  1   6
Affiliations
Review

Patient-Reported Outcome Measures Used on Patients With Anterior Cruciate Ligament Injury

Apostolos D Prodromidis et al. Cureus. .

Abstract

Patient-reported knee-related rating scores and scales are widely used in reporting the clinical outcomes of anterior cruciate ligament (ACL) surgery. Understanding the psychometric properties of such measures is vital to recognizing the limitations that such measures may confer. The aim of this study was to review the available evidence as to the psychometric properties of patient-reported outcome measures (PROMs) used in ACL surgery. Eleven studies were identified, the majority being prospective cohort studies. Eight English, ACL-specific patient-reported outcome measures were identified and evaluated: Lysholm score, Tegner Activity Scale (TAS), Cincinnati score, ACL-Quality of Life (QOL) score, International Knee Documentation Committee (IKDC) Subjective Knee Form (SKF), Knee Injury and Osteoarthritis Outcome Score (KOOS)-ACL score, and ACL-Return to Sport Injury (RSI) scale. Only the Lysholm score, ACL-QOL, IKDC SKF, and ACL-RSI were evaluated for internal consistency, having an acceptable Cronbach's α (α>0.70). Most of the scoring systems were assessed for test-retest reliability, with four of them (Lysholm score, TAS, Cincinnati score, and IKDC SKF) having acceptable intraclass correlation coefficient (ICC) values (ICC > 0.70). Criterion validity was assessed for most measures with a good correlation with the IKDC. Effect sizes and standardized response means were large for three instruments that measured responsiveness (Lysholm score, TAS, and Cincinnati score) and moderate for one (ACL-QOL). Evidence is stronger and more robust for the Lysholm score, TAS, ACL-QOL, and IKDC SKF. However, there is variation in their psychometric properties as well as the aspect of knee-related health they are assessing. Hence, none can be universally applicable to all patients with ACL injuries. Recognizing these parameters is vital when choosing which instrument to use in reporting the outcomes of ACL injury or ACL surgery studies.

Keywords: acl injury; acl surgery; knee scores; outcome measures; patient-reported outcome (pro); patient-reported outcome measures; patient-reported outcomes; proms; quality of life.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. A PRISMA flow diagram of the included studies
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; MEDLINE: Medical Literature Analysis and Retrieval System Online; CINAHL: Cumulative Index to Nursing and Allied Health Literature [27]
See this image and copyright information in PMC

References

    1. Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study. Gianotti SM, Marshall SW, Hume PA, Bunt L. J Sci Med Sport. 2009;12:622–627. - PubMed
    1. Use of the International Knee Documentation Committee guidelines to assess outcome following anterior cruciate ligament reconstruction. Irrgang JJ, Ho H, Harner CD, Fu FH. Knee Surg Sports Traumatol Arthrosc. 1998;6:107–114. - PubMed
    1. Outcome measurement in the ACL deficient knee-what's the score? Johnson DS, Smith RB. Knee. 2001;8:51–57. - PubMed
    1. Knee Injury and Osteoarthritis Outcome Score (KOOS)-development of a self-administered outcome measure. Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. J Orthop Sports Phys Ther. 1998;28:88–96. - PubMed
    1. Portney LG, Watkins MP. Upper Saddle River, NJ: Pearson/Prentice Hall; 2009. Foundations of Clinical Research: Applications to Practice.

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