International Knee Documentation Committee (IKDC) Is the Most Responsive Patient Reported Outcome Measure After Meniscal Surgery
- Authors:
- Shephard, L., Abed, V., Nichols, M., Kennedy, A., Khalily, C., Conley, C., Jacobs, C., and Stone, A. V.
- Abstract:
- PURPOSE: To report the variability in outcome measures after meniscal surgery and to compare responsiveness between patient-reported outcome measures (PROMs).
METHODS: A systematic search of the PubMed/MEDLINE and Web of Science databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A total of 257 studies met inclusion criteria. Patient and study attributes were extracted, including pre- and postoperative means for PROMs. Of the studies that met inclusion criteria for responsiveness analysis (2+ PROMs reported, 1-year minimum follow-up; n = 172), we compared the responsiveness between PROM instruments using effect size and relative efficiency (RE) if a PROM could be compared with another in at least 10 articles.
RESULTS: In total, 18,612 patients (18,690 menisci, mean age = 38.6 years, mean body mass index = 26.3) were included in this study. Radiographic measures were reported in 167 (65.0%) studies, range of motion was reported in 53 (20.6%) studies, and 35 different PROM instruments were identified. The mean number of PROMs in each article was 3.6 and 83.8% reported 2 or more PROMs. The most used PROMs were Lysholm (74.5%) and IKDC (51.0%). IKDC was found to be more responsive than other PROMs, which include Lysholm (RE = 1.03), Tegner (RE = 3.90), and Knee Injury and Osteoarthritis Outcome Score (KOOS) Activities of Daily Living (ADL) (RE = 1.12). KOOS Quality of Life (QoL) was also more responsive than other PROMs, such as IKDC (RE = 1.45) and KOOS ADL (RE = 1.48). Lysholm was more responsive compared with KOOS QoL (RE = 1.14), KOOS ADL (RE = 1.96), and Tegner (RE = 3.53).
CONCLUSIONS: Our study found that IKDC, KOOS QoL, and Lysholm were the most responsive PROMs. However, because of the previously reported risks of either floor effects (KOOS QoL) or ceiling effects (Lysholm), the IKDC may offer a more complete psychometric profile when quantifying outcomes after meniscus procedures.
CLINICAL RELEVANCE: To improve clinical outcomes, surgical decision-making, and research methodology, it is important to determine which PROMs are the most responsive after meniscal surgery. - DOI:
- 10.1016/j.asmr.2023.02.005
- Journal:
- Arthrosc Sports Med Rehabil
- issn:
- 2666-061x
- Publication year:
- 2023
- pages:
- e859-e865
- Symptom status:
- Physical state
- Functional status:
- Physical functioning
- General health perceptions / HRQoL:
- Health-related quality of life
- Age:
- Adults (18-65)
Children (0-18)
Seniors (65+) - Disease:
- Diseases of and symptoms related to the musculoskeletal system and connective tissue
- PRO / non-PRO:
- Non-patient Reported Outcome
Patient Reported Outcome - Type of measurement instrument:
- 1 - Questionnaires
6 - Clinical rating scales - Instrument:
- CKRS - Cincinnati Knee Rating System (versions: Noyes-CKRS)
Hospital for Special Surgery Knee-Rating Scale
IKDC-SKF - International Knee Documentation Committee-Subjective Knee Form (versions: IKDC-9; knee ligament standard evaluation form; Pediatric IKDC-SKF; Pediatric IKDC-SKF-e-version)
KOOS - Knee injury and Osteoarthritis Outcome Score (versions: KOOS-Child; KOOS-JR - KOOS-Joint Replacement; KOOS-12; KOOS-PF - KOOS PatelloFemoral pain and osteoarthritis)|
LKS - Lysholm (Knee) Score (versions: LKS-M)|
SF-12 - 12-item Short Form Health Survey [alias: RAND-12] (versions: SF-12v2; VR-12 - Veterans SF-12; SF-12 MCS; SF-12 PCS)
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: MOS SF-36]] (versions: VSF-36 LoA - Visual Version of the SF-36 Limitations of Physical Activities domain; VR-36 - Veterans SF-36)|
| also see: database.cosmin.nl
TAS - Tegner Activity Score (also: TAS - Tegner Activity Level Scale) (versions: TAS-e-version)
VAS pain - Visual Analogue Scale pain (versions: VAS pain-parental)
WOMAC - Western Ontario and McMaster Universities Osteoarthritis Index (versions: Individualized WOMAC; WOMAC-Likert Scale; WOMACsf; WOMAC-12; WOMACv3, foot and ankle; R-WOMAC - Reduced WOMAC; ShortMAC; Modified WOMAC)|
WOMET - Western Ontario Meniscal Evaluation Tool