I am in the habit of using PROMs routinely now. Before clinic starts I open the dashboard to check new results – sometimes the unexpected turns up!
Josie is a 23 year old soccer player who injured her ACL 11 months prior and was very keen to try non-operative management. She had been diligent with her physiotherapy and had progressively returned to training then match play. I hadn’t seen her for a couple of months (she was being supervised by a very capable physio), but she was still tracking her IKDC, so I was able to indirectly monitor her progress.
And there it was…..
Josie’s IKDC had taken a downturn!
I gave her a call.
She had injured her knee at soccer and had interpreted this (perhaps in denial) as a medial ligament sprain. I was not so optimistic. Returning to the pitch is, of course, the end game following ACL injury, surgery or no surgery.
Remote monitoring of a patient’s condition is one of the great benefits of a routine PROMs strategy.
She popped back into the clinic for a consultation and it was clear she had experienced an instability episode, confirmed on MRI with a fresh bone oedema impaction pattern indicating recent instability and the old, existing ACL rupture.
We know from the KANON trial that around 50% of people can return to sport without ACL reconstruction, we just don’t know which 50%! Josie’s story is a very disappointing outcome – that someone progresses with rehabilitation for 12 months before it becomes apparent surgery may be required to better meet the expectations of returning to soccer.
Josie underwent ACL reconstruction. There was no chondral or meniscal injury but she now faces a further 12 months of rehab.
By using myscoreit to automatically track PROMs, I was able to see a change in Josie’s condition that prompted me to contact her. Remote monitoring of a patient’s condition is one of the great benefits of a routine PROMs strategy. It keeps you in touch, builds trust and supports an ongoing therapeutic relationship regardless of how long ago the last appointment was.