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Related Experiment Video

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Defining Minimal Clinically Important Difference Thresholds for Pediatric Knee Surgeries.

Amith Umesh1, Joshua T Bram1, Patrick P Nian1

  • 1Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.

Orthopaedic Journal of Sports Medicine
|March 16, 2026
PubMed
Summary
This summary is machine-generated.

This study establishes minimal clinically important differences (MCIDs) for pediatric patient-reported outcome instruments following anterior cruciate ligament reconstruction (ACLR) and medial patellofemoral ligament reconstruction (MPFLR). These findings aid in interpreting outcomes for pediatric knee surgery patients.

Keywords:
MCIDPROpediatric knee

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Rehabilitation Medicine

Background:

  • Minimal clinically important difference (MCID) is established for adult PROs post-pediatric ACLR and MPFLR.
  • MCID remains unquantified for pediatric-specific PRO instruments.

Purpose of the Study:

  • Establish MCIDs for HSS Pedi-FABS, Pedi-IKDC, and pediatric/parent-proxy PROMIS PI, mobility, and physical activity scores.
  • Target population: pediatric patients undergoing ACLR and MPFLR.

Main Methods:

  • Retrospective review of 18 years or younger patients undergoing ACLR or MPFLR (2016-2023).
  • Collected preoperative HSS Pedi-FABS, Pedi-IKDC, and PROMIS scores (pain interference, physical activity, mobility).
  • MCID defined as one-half the standard deviation of preoperative scores.

Main Results:

  • ACLR group (505 patients): MCIDs established for HSS Pedi-FABS (-5.0), Pedi-IKDC (8.7), PROMIS PI (-5.2), mobility (2.2), physical activity (5.6) (pediatric); and PROMIS PI (-4.3), mobility (4.3), physical activity (5.0) (parent-proxy).
  • MPFLR group (253 patients): MCIDs established for HSS Pedi-FABS (-5.1), Pedi-IKDC (9.1), PROMIS PI (-5.7), mobility (4.9), physical activity (5.6) (pediatric); and PROMIS PI (-4.3), mobility (4.5), physical activity (5.9) (parent-proxy).
  • Negative MCIDs indicate thresholds for improved pain and decreased activity levels.

Conclusions:

  • This study establishes novel MCIDs for key PRO instruments in pediatric ACLR and MPFLR.
  • These MCIDs are crucial for interpreting patient outcomes in pediatric knee surgery.
  • Provides benchmarks for assessing treatment effectiveness and patient recovery.