January 03, 2017
1 min read

Patients satisfied after ACL reconstruction had significantly higher outcome scores

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Recently published results showed patients who were satisfied with their previously injured knee 1 year to 5 years after ACL reconstruction had significantly higher outcome scores compared with patients who were not satisfied.

Overall, 250 patients (55.4% were women) who underwent ACL reconstruction completed a comprehensive questionnaire that included self-reported demographic data, responses with regard to re-injury and level of sports participation, IKDC-subjective knee form (IKDC-SKF), KOOS and a question to assess the patient-acceptable symptom state (PASS). Researchers assessed the achievement of PASS by a “yes” or “no” response to the question, “Taking into account all the activity you have during you daily life, your level of pain and also your activity limitations and participation restrictions, do you consider the current state of your knee satisfactory?”

Results showed a high test-retest reliability of the PASS question in patients after ACL reconstruction. Researchers found 89.2% of patients responded “yes” to the PASS question, and more women responded “no” to the PASS question. Compared with patients who achieved the acceptable symptom state, patients who were not in an acceptable symptom state had re-injured their knee more often and more often underwent additional surgery.

Researchers noted patients who achieved the PASS had significantly greater mean IKDC-SKF and KOOS subscales. Compared with chance, the IKDC-SKF and each of the KOOS subscales were significantly better identifiers of patients who were in an acceptable symptom state, according to an analysis of the receiver operating characteristic curve. Results showed a PASS threshold of 75.9 for the IKDC-SKF score, of 88.9 for the KOOS pain score, of 57.1 for the KOOS symptom score, of 100 for the KOOS activities of daily living score, of 75 for the KOOS sport/rec score and of 62.5 for the KOOS quality of life score. – by Casey Tingle


Disclosures: One or more of the authors has declared the following potential conflict of interest or source funding: Reliability assessment of the PASS question was performed as part of a study titled “Knee CAT study – Validity of the PROMIS pain interference and physical function CATs” that was funded by the National Institutes of Arthritis, Musculoskeletal and Skin Diseases.