Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky, USA.
Department of Orthopaedics, Henry Ford Hospital, Detroit, Michigan, USA.
Am J Sports Med. 2024 Oct;52(12):3161-3166. doi: 10.1177/03635465231219966. Epub 2024 Feb 14.
There have been a large number of patient-reported outcome measures (PROMs) used to assess outcomes after anterior cruciate ligament (ACL) reconstruction (ACLR).
PURPOSE/HYPOTHESIS: The purpose was to determine which PROMs are being commonly used in randomized clinical trials (RCTs) to assess patients undergoing ACLR and to compare the responsiveness between them. It was hypothesized that the International Knee Documentation Committee (IKDC) score would be the most commonly used and responsive PROM among patients undergoing ACLR.
Meta-analysis. Level of evidence, 2.
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed, and relevant studies were extracted from the PubMed/MEDLINE and Web of Science databases. The inclusion criteria were English-language RCTs reporting on PROMs after ACLR. For articles meeting our inclusion criteria for responsiveness analysis (≥2 PROMs reported, 1 year minimum follow-up, and reported pre- and postoperative PROM means and standard deviations), the responsiveness between PROMs was compared using effect size (ES) and relative efficiency (RE).
A total of 108 articles met the inclusion criteria, comprising 9034 patients (mean age, 29.9 years; mean body mass index, 24.3; mean follow-up time, 36.1 months). There were 34 PROMs identified. The top 3 most commonly reported PROMs were the IKDC (n = 68; 63.0%), Lysholm (n = 65; 60.2%), and Tegner (n = 47; 43.5%) scores. The 2 PROMs with the highest ES were the ACL-Quality of Life (QoL) (3.37) and Knee Injury and Osteoarthritis Outcome Score (KOOS) QoL (2.07) scores. Compared with other PROMs, Lysholm and KOOS QoL scores had the greatest RE values. The Lysholm score had a greater RE than the KOOS Pain (RE, 1.17), KOOS Symptoms (RE, 1.22), KOOS Activities of Daily Living (ADL) (RE, 1.42), KOOS Sport/Recreation (RE, 1.55), KOOS QoL (RE, 1.41), and Tegner (RE, 2.89) scores. KOOS QoL had a greater RE than the IKDC (RE, 1.32), KOOS Pain (RE, 1.60), KOOS Symptoms (RE, 2.12), KOOS ADL (RE, 3.03), KOOS Sport/Recreation (RE, 1.27), and Tegner (RE, 2.06) scores.
The IKDC score is the most commonly reported PROM in RCTs after ACLR; however, the Lysholm and KOOS QoL scores demonstrated the highest responsiveness in patients undergoing ACLR compared with other PROMs.
有大量的患者报告结局测量（PROMs）被用于评估前交叉韧带（ACL）重建（ACLR）后的结果。
目的/假设：目的是确定在评估 ACLR 患者时最常使用的 PROM，并比较它们之间的反应性。假设国际膝关节文献委员会（IKDC）评分将是 ACLR 患者中最常用和最敏感的 PROM。
荟萃分析。证据水平，2 级。
遵循 PRISMA（系统评价和荟萃分析的首选报告项目）指南，从 PubMed/MEDLINE 和 Web of Science 数据库中提取相关研究。纳入标准为报告 ACLR 后 PROM 的英语随机对照试验（RCT）。对于符合我们反应性分析纳入标准的文章（≥2 个 PROM 报告，至少 1 年随访，报告术前和术后 PROM 均值和标准差），使用效应大小（ES）和相对效率（RE）比较 PROM 之间的反应性。
共有 108 篇文章符合纳入标准，共纳入 9034 名患者（平均年龄 29.9 岁；平均体重指数 24.3；平均随访时间 36.1 个月）。共确定了 34 个 PROM。报告最多的前 3 个 PROM 是 IKDC（n=68；63.0%）、Lysholm（n=65；60.2%）和 Tegner（n=47；43.5%）评分。ES 最高的 2 个 PROM 是 ACL-生活质量（QoL）（3.37）和膝关节损伤和骨关节炎结果评分（KOOS）QoL（2.07）评分。与其他 PROM 相比，Lysholm 和 KOOS QoL 评分具有最大的 RE 值。Lysholm 评分的 RE 大于 KOOS 疼痛（RE，1.17）、KOOS 症状（RE，1.22）、KOOS 日常生活活动（ADL）（RE，1.42）、KOOS 运动/娱乐（RE，1.55）、KOOS QoL（RE，1.41）和 Tegner（RE，2.89）评分。KOOS QoL 的 RE 大于 IKDC（RE，1.32）、KOOS 疼痛（RE，1.60）、KOOS 症状（RE，2.12）、KOOS ADL（RE，3.03）、KOOS 运动/娱乐（RE，1.27）和 Tegner（RE，2.06）评分。
IKDC 评分是 ACLR 后 RCT 中最常报告的 PROM；然而，与其他 PROM 相比，Lysholm 和 KOOS QoL 评分在 ACLR 患者中表现出最高的反应性。
