Defining Thresholds for the Patient Acceptable Symptom State for the IKDC Subjective Knee Form and KOOS for Patients Who Underwent ACL Reconstruction

Abstract

To our knowledge, this is the first study to identify the PASS thresholds for the IKDC-SKF and the KOOS subscales for individuals 1 to 5 years after ACL reconstruction. By identifying threshold values for the PASS, this study provides additional information to facilitate interpretation of the IKDC-SKF and KOOS in daily practice and clinical research related to ACL reconstruction.

Patient‐Reported Outcomes One to Five Years After Anterior Cruciate Ligament Reconstruction: The Effect of Combined Injury and Associations With Osteoarthritis Features Defined on Magnetic Resonance Imaging

“…At 5 years, n = 46 for the combined injury group and n = 35 for the isolated injury group. QoL = quality of life; * = median value at 1 year or 5 years is greater than or equal to the minimal detectable change below the general population (age‐matched, uninjured) normative medians for the KOOS and IKDC questionnaires; ** = statistically significant difference ( P < 0.05) between combined and isolated injury groups at 1 or 5 years; ~ = weighted average median values for KOOS and IKDC scores were calculated using respective data from healthy uninjured (no history of knee pain) participants , age‐ and sex‐matched data in the general population (may have history of knee pain) , and acceptable cutoff scores in ACLR patients .…”

“… Values are the number (%) of participants in the group with a raw score above acceptable cutoffs using previously published data for anterior cruciate ligament reconstruction (ACLR) patients and the Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) questionnaires. …”

“…Similarly, at 5 years, the presence of a patellofemoral cartilage defect or meniscal tear was associated with worse patient-reported outcomes, and tibiofemoral BMLs were associated with better patient-reported outcomes ( Table 3). Regression analysis was also (26,31) below the general population (age-matched, uninjured) normative medians for the KOOS (32) and IKDC (34) questionnaires; ** = statistically significant difference (P < 0.05) between combined and isolated injury groups at 1 or 5 years; ~ = weighted average median values for KOOS and IKDC scores were calculated using respective data from healthy uninjured (no history of knee pain) participants (32), age-and sex-matched data in the general population (may have history of knee pain) (33,34), and acceptable cutoff scores in ACLR patients (6,35…”

Preoperative knee laxity measurements predict the achievement of a patient-acceptable symptom state after ACL reconstruction: a prospective multicenter study

“…The form has been validated, and the responsiveness of the IKDC-SKF has been established 10 18 21. The PASS reference value was assessed by Muller et al 11 by considering patients’ response to the following question: ‘‘Taking into account all the activity you have during your daily life, your level of pain, and also your activity limitations and participation restrictions, do you consider the current state of your knee satisfactory?’’. Achievement of PASS was defined by a ‘yes’ on this question, while patients answering with a ‘no’ did not achieve PASS.…”

“…However, the interpretation of this score may not always be clear to clinicians since small differences may not be clinically relevant and reversely, that is, differences which affect the patient’s well-being may not always be detected. In an attempt to capture the state, where the patients perceive their symptoms as acceptable, the patient acceptable symptom state (PASS) has been established for the IKDC-SKF score 11. An IKDC-SKF score equal to or above the reference PASS value could function as an important indicator of a successful ACL reconstruction.…”