Liew Ignatius, Low Wen Xian, Ikram Adeel, McDonnell Stephen, Marson Ben Arthur, Ikram Adeel, Memarzadeh Arman, Marson Ben A, Gompels Benjamin, Hing Caroline, Manoukian Dimitrios, Grace Faye, Liew Ignatius, Ebert Jay, Ng Jimmy, Thomas Joanna, Patel Neeraj M, Nicolaou Nicolas, D'Alessandro Peter, Buddhdev Pranai, Basheer Sheba, McDonnell Stephen, Smith Toby, Low Wen Xian, Boddy Hannah
Queen Mary University of London, London, UK.
Department of Academic Orthopaedics, Trauma and Sports Medicine. Academic Unit of Injury, Recovery and Inflammation Sciences, The University of Nottingham, Nottingham, UK.
Bone Jt Open. 2025 Aug 21;6(8):971-982. doi: 10.1302/2633-1462.68.BJO-2025-0005.R1.
To systematically review published evidence of outcomes reported in trials of knee injuries in children and adolescents.
We searched the following databases from inception to 29 July 2024: OVID MEDLINE, Embase, Cochrane CENTRAL, Clinicaltrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). In total, 13,146 studies were identified; after removing duplicates, 9,796 studies were yielded for screening following PRISMA guidelines. Data extraction was performed by two researchers, and 15 trials were included in the final analysis. Outcomes reported by trials were mapped to the domains within the WHO International Classification of Function framework (ICF), comprising four main categories: Body functions (b), Activities and participation (d), Environmental factors (e), and Body structure (s).
A total of 83 outcomes were identified from 15 trials, representing 35 WHO domains. The most common domain reported mapped to the ICF framework was structure of the lower limb (s750; 93.3%), followed by sensation of pain (b280; 86.7%), mobility of joint function (b710; 86.7%), and function of the joints and bones (b729; 86.7%). Patient satisfaction was reported in two trials (13.3%) trials. Primary outcomes were not reported in seven trials (46.6%). Pedi-International Knee Documentation Committee (IKDC) was the most common patient-reported outcome measure in seven trials (46.6%).
Outcome measure tools reported in children and adolescent knee injuries are highly variable and inconsistent. Currently, there are no core outcome sets (COS) for these injuries, highlighting an urgent need to improve standardization and consistency in trial reporting. A key recommendation for the COS development is accounting for pathology-specific subcategories, given the difference in emphasis on WHO ICF domains across various knee injuries. In the future, these approaches will ensure the COS has comprehensive yet unique priorities for each condition.
系统回顾已发表的关于儿童和青少年膝关节损伤试验中报告的结果证据。
我们检索了以下数据库，检索时间从数据库创建至2024年7月29日：OVID MEDLINE、Embase、Cochrane CENTRAL、Clinicaltrials.gov以及世界卫生组织（WHO）国际临床试验注册平台（ICTRP）。总共识别出13146项研究；去除重复项后，根据PRISMA指南筛选出9796项研究进行进一步筛选。由两名研究人员进行数据提取，最终分析纳入了15项试验。试验报告的结果被映射到WHO国际功能分类框架（ICF）内的领域，该框架包括四个主要类别：身体功能（b）、活动与参与（d）、环境因素（e）和身体结构（s）。
从15项试验中总共识别出83项结果，代表35个WHO领域。报告的映射到ICF框架中最常见的领域是下肢结构（s750；93.3%），其次是疼痛感觉（b280；86.7%）、关节功能活动度（b710；86.7%）以及关节和骨骼功能（b729；86.7%）。两项试验（13.3%）报告了患者满意度。七项试验（46.6%）未报告主要结果。儿童国际膝关节文献委员会（Pedi-International Knee Documentation Committee，IKDC）是七项试验（46.6%）中最常见的患者报告结局指标。
儿童和青少年膝关节损伤试验中报告的结局测量工具高度可变且不一致。目前，这些损伤尚无核心结局集（COS），这凸显了迫切需要提高试验报告的标准化和一致性。鉴于不同膝关节损伤对WHO ICF领域的侧重点不同，COS开发的一项关键建议是考虑特定病理亚类。未来，这些方法将确保COS对每种情况都有全面且独特的优先级。
