Patient-Reported Outcome Measures Used on Patients With Anterior Cruciate Ligament Injury

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation Science

Background:

• Patient-reported outcome measures (PROMs) are crucial for evaluating anterior cruciate ligament (ACL) surgery outcomes.
• Understanding the psychometric properties of these PROMs is essential for accurate clinical interpretation and research.
• Existing PROMs for ACL surgery vary in their reliability, validity, and responsiveness.

Purpose of the Study:

• To systematically review the psychometric properties of English, ACL-specific PROMs.
• To evaluate the internal consistency, test-retest reliability, criterion validity, and responsiveness of commonly used ACL outcome measures.
• To identify the strengths and limitations of different PROMs for ACL surgery research.

Main Methods:

• A literature search identified eleven studies evaluating ACL-specific PROMs.
• Eight PROMs were assessed: Lysholm score, Tegner Activity Scale (TAS), Cincinnati score, ACL-Quality of Life (QOL) score, International Knee Documentation Committee (IKDC) Subjective Knee Form (SKF), Knee Injury and Osteoarthritis Outcome Score (KOOS)-ACL score, and ACL-Return to Sport Injury (RSI) scale.
• Psychometric properties including internal consistency (Cronbach's α), test-retest reliability (ICC), criterion validity, and responsiveness were evaluated.

Main Results:

• Only Lysholm, ACL-QOL, IKDC SKF, and ACL-RSI demonstrated acceptable internal consistency (Cronbach's α > 0.70).
• Lysholm, TAS, Cincinnati score, and IKDC SKF showed acceptable test-retest reliability (ICC > 0.70).
• Lysholm, TAS, and Cincinnati score exhibited large effect sizes for responsiveness, while ACL-QOL showed moderate responsiveness.

Conclusions:

• The Lysholm score, TAS, ACL-QOL, and IKDC SKF have the most robust evidence supporting their use in ACL surgery outcomes.
• Significant variations exist in the psychometric properties and assessed domains of these PROMs.
• No single PROM is universally applicable for all ACL injury patients; careful selection based on study objectives and patient characteristics is vital.