Webster Kate E, Klemm Haydn J, Whitehead Timothy S, Norsworthy Cameron J, Feller Julian A
School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia.
Orthop J Sports Med. 2024 Mar 22;12(3):23259671241236513. doi: 10.1177/23259671241236513. eCollection 2024 Mar.
Various short-form versions of the Knee injury and Osteoarthritis Outcome Score (KOOS) have been developed in an attempt to minimize responder burden. However, the responsiveness of these short-form measures in patients who have undergone anterior cruciate ligament (ACL) reconstruction has not been compared at midterm follow-up.
To determine the responsiveness of 3 short-form versions of the KOOS (KOOS-12, KOOS-Global, and KOOS-ACL) in patients who have undergone ACL reconstruction.
Cohort study (diagnosis); Level of evidence, 3.
In 276 patients (149 male, 127 female), we administered the KOOS and a measure of overall knee function at both 2 and 5 years after ACL reconstruction. From the full KOOS, the following short-form versions were calculated: KOOS-12, KOOS-Global, and KOOS-ACL. Responsiveness was assessed using several distribution and anchor-based methods for each of the short-form versions. From distribution statistics the standardized response mean (SRM) and smallest detectable change (SDC) were calculated. Using the anchor-based method, the minimally important change (MIC) that was associated with an improvement in knee function was determined using receiver operating characteristic (ROC) analysis.
High ceiling effects were present for all measures. KOOS-Global scores increased significantly over time, whereas KOOS-12 and KOOS-ACL did not change. The KOOS-Quality of Life (QOL) subscale, which can be derived from both KOOS-Global and KOOS-12, also increased significantly between assessments. Both these increases were associated with a small (0.2-0.3) SRM. The MIC was smallest for KOOS-Global (3.2 points) and largest for KOOS-QOL (9.4 points), and, for all measures, the MIC was larger than the SDC at a group level. KOOS-Global was the only measure for which the mean difference between the 2- and 5-year assessments exceeded both the SDC (group level) and the MIC.
Of the 3 short-form versions of the KOOS currently available, the KOOS-Global had the greatest responsiveness to change between the 2- and 5-year assessments after ACL reconstruction. High ceiling effects were present for all versions.
为尽量减轻应答者负担，已开发出多种膝关节损伤和骨关节炎疗效评分（KOOS）的简版。然而，这些简版量表在接受前交叉韧带（ACL）重建的患者中期随访中的反应性尚未得到比较。
确定3种KOOS简版量表（KOOS - 12、KOOS - Global和KOOS - ACL）在接受ACL重建患者中的反应性。
队列研究（诊断）；证据等级，3级。
对276例患者（149例男性，127例女性）在ACL重建术后2年和5年时进行KOOS及一项膝关节整体功能测量。从完整的KOOS中计算出以下简版量表：KOOS - 12、KOOS - Global和KOOS - ACL。使用几种基于分布和锚定的方法对每个简版量表的反应性进行评估。从分布统计中计算标准化反应均值（SRM）和最小可检测变化（SDC）。使用基于锚定的方法，通过接受者操作特征（ROC）分析确定与膝关节功能改善相关的最小重要变化（MIC）。
所有测量指标均存在较高的天花板效应。KOOS - Global评分随时间显著增加，而KOOS - 12和KOOS - ACL没有变化。可从KOOS - Global和KOOS - 12得出的KOOS生活质量（QOL）子量表在两次评估之间也显著增加。这两种增加均与较小的（0.2 - 0.3）SRM相关。KOOS - Global的MIC最小（3.2分），KOOS - QOL的最大（9.4分），并且对于所有测量指标，在组水平上MIC均大于SDC。KOOS - Global是唯一在2年和5年评估之间的平均差异超过SDC（组水平）和MIC的测量指标。
在目前可用的3种KOOS简版量表中，KOOS - Global在ACL重建术后2年和5年评估之间对变化的反应性最大。所有版本均存在较高的天花板效应。
