Anterior cruciate ligament (ACL) reconstruction is one of the most researched surgical procedures in orthopaedics and a prevalent problem for the sporting community. Debate continues regarding best management practice.
- Who needs surgical intervention?
- What graft or fixation to use?
- When can someone return to high level activities?
- What constitutes ideal rehabilitation?
- Who will return to their previous sporting activity?
- What are the results of non-operative versus operative management?
- What are the risk factors for poor outcomes?
To answer these questions, we need to know outcomes.
Outcomes in ACL injury – “chef’s selection” menu.
Objective measures
- Clinical assessment- symptoms and examination
- Strength – dynamometer
- Range of motion – goniometer
- Stability/ translation – KT100, GNRB
- Functional tests – including Y-balance test, hop tests
Patient Reported Outcome Measures – general
- Medical Outcome Study Short Form-12 (SF-36)
- EuroQol-5D (EQ 5D)
- Knee Injury & Osteoarthritis Outcome Score quality of life sub scale (KOOS QoL)
Patient Reported Outcome Measures – region specific
- International Knee Documentation Committee (IKDC) (subjective knee form)
- Lysholm / Tegner Activity Scale
- Knee Injury & Osteoarthritis Outcome Score (KOOS)
Patient Reported Outcome Measures – condition specific
- Knee Numeric Entity Evaluation (KNEE-ACL)
- Japanese ACL Injury Questionnaire-25 item (JACL-25)
Psychological Assessments
- Knee Self-Efficacy Scale (K-SES)
- ACL Return to Sport after Injury (ACL-RSI)
As you can see from this abbreviated selection, there is a lot to choose from!
In an ideal world, researchers and clinicians will use standardised PROMs or at least PROMs with known cross-walks, in order to compare like with like. In the meantime, here at myscoreit, we have selected validated knee PROMs we consider to have the most utility – IKDC and KOOS. We are pretty interested in psychological readiness as well, so watch this space!
This IKDC belongs to a patient who chose to delay surgery in order to go on a holiday. He thus had 3 months of “prehab” prior to his reconstruction.
Read more about PROM selection in ACL injury.
