School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia.
Am J Sports Med. 2022 Jul;50(8):2119-2124. doi: 10.1177/03635465221099459. Epub 2022 May 23.
Patient-reported outcome measures (PROMs) have become increasingly popular for assessing subjective elements of a patient's condition. Two frequently used knee-related PROMs after anterior cruciate ligament reconstruction (ACLR) surgery are the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) and the Knee injury and Osteoarthritis Outcome Score (KOOS). However, completing the full versions of both measures represents a considerable responder burden.
To compare a variety of KOOS short forms with each other as well as the IKDC-SKF in a large sample of ACLR patients between 2 and 6 years after surgery.
Cohort study (Diagnosis); Level of evidence, 2.
The KOOS and IKDC-SKF were administered between 2 and 6 years (mean, 3 years) after ACLR surgery to a cohort of 832 patients (men, n = 489; women, n = 343). Two single-item assessment numerical evaluations were also completed for knee function and satisfaction. The following short form versions were calculated from the full KOOS: the KOOS-12 short form, KOOS-Physical Function Short form (KOOS-PS), KOOS-Joint Replacement Short form (KOOS-JR), and KOOS-Global. Descriptive statistics were calculated for all PROMs and associations between measures were explored using nonparametric (Spearman rho) correlations. Floor or ceiling effects were considered present if >15% of patients reported the worst (floor effect) or best (ceiling effect) possible score. Age and sex comparisons were also made for each PROM.
Ceiling effects were present for all KOOS short form versions. They were highly evident for the KOOS-JR and KOOS-PS (37%-44%), but they were only marginally above the threshold for the KOOS-12 and KOOS-Global (16%). The KOOS-12 and KOOS-Global had the highest correlation with the IKDC-SKF but only explained 58% to 59% of the variance in scores. The KOOS-12 and KOOS-Global were very highly correlated (ρ = 0.98). Only moderate correlations were seen between the single-item assessments and the IKDC-SKF or various KOOS short forms. There was a negligible association between patient age and PROM scores, but there was no significant sex difference for any of the PROMs.
The IKDC-SKF together with either the KOOS-Global or KOOS-12 may provide a comprehensive range of knee-related PROMs with minimized responder burden at 2 to 6 years after ACLR.
患者报告的结局测量（PROMs）已越来越多地用于评估患者病情的主观因素。前交叉韧带重建（ACLR）术后常用的两种膝关节相关 PROM 是国际膝关节文献委员会主观膝关节评分（IKDC-SKF）和膝关节损伤和骨关节炎结果评分（KOOS）。然而，完成这两种测量的完整版本代表着相当大的应答者负担。
在 ACLR 手术后 2 至 6 年（平均 3 年）的大量 ACLR 患者中，比较各种 KOOS 短表与 IKDC-SKF。
队列研究（诊断）；证据水平，2 级。
对 832 例 ACLR 术后 2 至 6 年（平均 3 年）的患者进行 KOOS 和 IKDC-SKF 评估。还完成了膝关节功能和满意度的两项单项评估数值评估。从完整的 KOOS 中计算出以下短表版本：KOOS-12 短表、KOOS 躯体功能短表（KOOS-PS）、KOOS 关节置换短表（KOOS-JR）和 KOOS 全局短表。计算了所有 PROM 的描述性统计数据，并使用非参数（Spearman rho）相关性探讨了各测量值之间的相关性。如果 >15%的患者报告了最差（地板效应）或最佳（天花板效应）可能的评分，则认为存在地板或天花板效应。还对每个 PROM 进行了年龄和性别比较。
所有 KOOS 短表版本均存在天花板效应。对于 KOOS-JR 和 KOOS-PS（37%-44%），它们非常明显，但对于 KOOS-12 和 KOOS-全局（16%），它们仅略微超过阈值。KOOS-12 和 KOOS-全局与 IKDC-SKF 的相关性最高，但仅解释了 58%至 59%的分数差异。KOOS-12 和 KOOS-全局高度相关（ρ=0.98）。单项评估与 IKDC-SKF 或各种 KOOS 短表之间仅存在中度相关性。患者年龄与 PROM 评分之间几乎没有关联，但在任何 PROM 中，性别差异均无统计学意义。
在 ACLR 后 2 至 6 年，IKDC-SKF 联合 KOOS-全局或 KOOS-12 可能提供综合的膝关节相关 PROM，应答者负担最小。
