Structural severity versus clinical reality: Are we measuring the right endpoints?

Patient-reported outcome measures are well established in sports medicine as a standard tool for assessing treatment success. Despite efforts to define clinically meaningful thresholds, studies often report improved clinical outcomes alongside suboptimal structural, biological or imaging findings. This evidence highlights a persistent gap between patient-reported improvement and objective changes, underscoring the limitations of current outcome metrics. These findings challenge the assumption that better clinical outcomes translate into improved structural results. Reliance on subjective measures alone seems insufficient to define true success. A more comprehensive approach is needed to better align clinical assessment with biological and biomechanical realities and to more accurately define meaningful patient benefit. Level of Evidence: N/A.