[Current state of evaluation of knee ligament lesions. The new IKDC knee evaluation form]

Abstract

Various scoring systems have been proposed for quantification of the disability caused by knee ligament injuries and to evaluation of the results of their treatment. None of them was found worldwide acceptance, mainly because all scoring systems attribute numerical values to factors that are not quantifiable, after which the arbitrary scores for parameters that are not comparable with each other are added together. For these reasons a group of knee surgeons from Europe and America met in 1987 and founded the International Knee Documentation Committee. A common terminology and an evaluation form were created. This form is the standard form for use in all publications on results of treatment of knee ligament injuries. It is a concise one-page form and includes a documentation section, a qualification section and a evaluation section. For evaluation there are four problem areas (subjective assessment, symptoms, range of motion and ligament examination). These are supplemented by four additional areas that are documented but are not included in the evaluation (compartmental findings, donor site pathology, X-ray findings and functional tests). The form can be used pre- and postoperatively and at follow-up. The Committee also laid down that in a publication the minimum follow-up time for short-term results should be 2 years, for medium-term results, 5 years, and for long-term results, 10 years. Most of the sheet is devoted to the qualification section. It is called "qualification" and not "scoring" section because no scores are given. Each parameter is qualified as "normal", "nearly normal", "abnormal" or "severely abnormal". This qualification is less subjective and emotional than "very good", "good", "fair" and "poor". No knee and no knee function can be better than normal, and it is rather doubtful whether any knee that has been operated on can ever be "normal" again. For evaluation, the parameters of the four problem areas "subjective assessment", "symptoms", "range of motion" and "ligament examination" are qualified for the group qualification. The worst qualification within the group is taken as the group qualification. The worst group qualification is taken as the final evaluation. If the knee is abnormal in any of the problem areas it cannot be entered as normal knee. For knees with chronic pathology it is also possible to evaluate the sum of levels of improvement or deterioration of all groups compared with the preoperative evaluation. The committee also recommends that terms describing knee ligament problems should be used according to the definitions published by Noyes et al.(ABSTRACT TRUNCATED AT 400 WORDS)