Mowers C C, Lack B T, Childers J T, Jackson G R
Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St, Suite 360, Chicago, IL, 60612, USA.
Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
Musculoskelet Surg. 2025 Feb 15. doi: 10.1007/s12306-025-00890-0.
To systematically review the variability of reporting of clinically significant outcomes (CSOs) including minimal clinically important difference (MCID), substantial clinical benefit (SCB) and patient acceptable symptom state (PASS), and threshold calculation methods following surgical treatments for cartilage defects of the knee. A systematic review was performed using the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A literature search was performed on August 12th, 2024, using the PubMed, Embase, and Scopus online databases for human clinical studies with publication dates ranging from 2010 to 2024 reporting on MCID, SCB, or PASS following surgical treatments for cartilage defects of the knee. Study demographics, patient-reported outcome measures (PROMs), CSO thresholds, and methods of CSO calculation were collected. A total of 19 studies (n = 3659 patients) with an average follow-up of 36.5 months were included. A total of 14 (93.3%) studies reported MCID, six (31.8%) studies reported SCB, and five (26.3%) studies reported PASS. Of the included studies, 16 (80%) referenced another study for calculating their CSO whereas three (20%) studies calculated their own CSO. A total of 16 different PROMs were reported among the included studies. Eight studies utilized the anchor-based method for CSO calculation, ten studies used both the anchor and the distribution-based methods for calculation, while only one study used the distribution-based method alone. There is considerable variation in the reporting and calculation methods of MCID, SCB, and PASS for different PROMs following surgical treatments for cartilage defects of the knee.Level of Evidence: IV, Systematic Review of Level I-IV studies.
系统评价膝关节软骨缺损手术治疗后临床显著结局（CSO）报告的变异性，包括最小临床重要差异（MCID）、显著临床获益（SCB）和患者可接受症状状态（PASS），以及阈值计算方法。使用2020年系统评价和Meta分析的首选报告项目（PRISMA）指南进行系统评价。于2024年8月12日使用PubMed、Embase和Scopus在线数据库进行文献检索，纳入2010年至2024年发表的关于膝关节软骨缺损手术治疗后MCID、SCB或PASS的人类临床研究。收集研究人口统计学、患者报告结局测量指标（PROMs）、CSO阈值和CSO计算方法。共纳入19项研究（n = 3659例患者），平均随访36.5个月。共有14项（93.3%）研究报告了MCID，6项（31.8%）研究报告了SCB，5项（26.3%）研究报告了PASS。在纳入的研究中，16项（80%）参考另一项研究来计算其CSO，而3项（20%）研究自行计算CSO。纳入研究中共报告了16种不同的PROMs。8项研究采用基于锚定的方法计算CSO，10项研究同时使用基于锚定和基于分布的方法进行计算，而只有1项研究单独使用基于分布的方法。膝关节软骨缺损手术治疗后，不同PROMs的MCID、SCB和PASS的报告和计算方法存在相当大的差异。证据级别：IV，I-IV级研究的系统评价。
