Clinical outcomes after anterior cruciate ligament injury: panther symposium ACL injury clinical outcomes consensus group

Abstract

Purpose A stringent outcome assessment is a key aspect for establishing evidence-based clinical guidelines for anterior cruciate ligament (ACL) injury treatment. The aim of this consensus statement was to establish what data should be reported when conducting an ACL outcome study, what specific outcome measurements should be used and at what follow-up time those outcomes should be assessed. Methods To establish a standardized approach to assessment of clinical outcome after ACL treatment, a consensus meeting including a multidisciplinary group of ACL experts was held at the ACL Consensus Meeting Panther Symposium, Pittsburgh, PA; USA, in June 2019. The group reached consensus on nine statements by using a modified Delphi method. Results In general, outcomes after ACL treatment can be divided into four robust categories—early adverse events, patient-reported outcomes, ACL graft failure/recurrent ligament disruption and clinical measures of knee function and structure. A comprehensive assessment following ACL treatment should aim to provide a complete overview of the treatment result, optimally including the various aspects of outcome categories. For most research questions, a minimum follow-up of 2 years with an optimal follow-up rate of 80% is necessary to achieve a comprehensive assessment. This should include clinical examination, any sustained re-injuries, validated knee-specific PROs and Health-Related Quality of Life questionnaires. In the mid- to long-term follow-up, the presence of osteoarthritis should be evaluated. Conclusion This consensus paper provides practical guidelines for how the aforementioned entities of outcomes should be reported and suggests the preferred tools for a reliable and valid assessment of outcome after ACL treatment. Level of evidence V.

Knee function 30 years after ACL reconstruction: a case series of 60 patients

“…When interpreting patient-reported outcomes, it is essential to do so in a clinically meaningful manner. The measurement of the patient’s acceptable symptom state (PASS) is an accepted way of doing that (Svantesson et al 2020 ). Half of the patients in the group with intact ACL graft and one-third of the patients with ruptured ACL grafts scored KOOS Sport/Rec as 75 or more, which constitutes a previously identified threshold for the patient acceptable symptom state 1 to 6 years after ACL reconstruction (Muller et al 2016 ).…”

Identifying Clinical and MRI Characteristics Associated with Quality of Life in Patients with Anterior Cruciate Ligament Injury: Prognostic Factors for Long-Term

“…In addition, there are common injuries associated with ACL tears, such as meniscal, cartilage, and other ligament damage in the knee joint complex, and it is especially important that these injuries are also properly diagnosed [ 7 ]. However, symptomatic OA in these young patients remains a profound and largely unsolved treatment challenge [ 8 ]. The treatment of ACL injuries is still highly controversial, due to limited conclusive data based on comparative studies on the factors affecting the long-term outcome of these injuries, although recent prospective studies have defined short-term factors predicting rapid recovery [ 9 ].…”

Combined ACL and Segond Repair in Combined Acute Proximal ACL Tears and Segond Fracture

“…Anterior cruciate ligaments (ACL) tears are frequent sports-related injuries, and over the past few decades, ACL reconstruction has represented the gold standard technique to address the injured structure. 1 , 2 , 3 With the benefit of modern arthroscopic surgical techniques and devices, there has been a renewed curiosity in primary repair of ACL. 4 , 5 This procedure may be a surgical alternative for those patients presenting with functional impairment after acute proximal ACL injuries with potentially less morbidity, although clinical outcomes for ACL repair using modern techniques is still limited.…”