How Are We Measuring Patient Satisfaction After Anterior Cruciate Ligament Reconstruction?

Kahlenberg, Cynthia A.; Nwachukwu, Benedict U.; Ferraro, Richard; Schairer, William W.; Steinhaus, Michael E.; Allen, Answorth A.

doi:10.1177/2325967116673971

Cited by 26 publications

(18 citation statements)

References 45 publications

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“…The use of this scale to measure patient satisfaction is a concise, subjective representation of patient outcome and has been used after arthroscopy, including hip arthroscopy. 19,20 Complications and secondary hip surgeries were noted. These data were collected through patient questionnaires in clinic, by encrypted email, or by telephone at 3 months and annually postoperatively.…”

Section: Data Collectionmentioning

confidence: 99%

Arthroscopic Labral Treatment in Adolescents: Clinical Outcomes With Minimum 5-Year Follow-up

Litrenta

Chen

et al. 2019

Am J Sports Med

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Background: The success of hip arthroscopy has led to increased application in younger populations. However, hip arthroscopy remains a challenging procedure, and its safety and efficacy in the adolescent population have been controversial. Most existing literature on outcomes in such patients contains only short-term follow-up, and a paucity of evidence is available regarding long-term outcomes in adolescents. Purpose: To report on clinical outcomes at a minimum 5-year follow-up in patients younger than 18 years who underwent arthroscopic treatment of labral tears. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected and retrospectively reviewed on all patients younger than 18 years who underwent hip arthroscopy in a tertiary hip preservation setting at a single institution. Patients were excluded if they had previous ipsilateral hip conditions or surgery. All patients underwent either labral repair or debridement for treatment of a labral tear. Patient-reported outcome measures were recorded at 3 months and at 1, 2, or a minimum of 5 years. These included the modified Harris Hip Score (mHHS), Nonarthritic Hip Score, Hip Outcome Score–Sports Specific Subscale (HOS-SSS), visual analog scale, and patient satisfaction. Additionally, the abbreviated International Hip Outcome Tool and Short Form Health Survey were collected at latest follow-up. Results: The study included 44 hips in 32 patients that underwent arthroscopic labral repair (86.4%) or labral debridement (13.6%) between April 2008 and April 2011, with latest follow-up at a mean of 69.2 months (range, 60.0-89.9 months) postoperatively. The average age at surgery was 16.3 years (range, 14.2-17.9 years), and 39 hips from female patients. Statistically significant improvements were seen in all patient-reported outcome measures from preoperative to minimum 5-year follow-up. Improvements were noted at 1-year follow-up and maintained at minimum 5-year follow-up. At the latest follow-up, the Patient Acceptable Symptomatic State was achieved in 95.5% of patients for the mHHS and 72.7% for the HOS-SSS. Two patients subsequently underwent secondary arthroscopy on the ipsilateral hip; however, the survivorship of all hips was 100%. Conclusion: Hip arthroscopy for the treatment of labral tears in adolescents remains a technically challenging procedure that should be approached with appropriate caution. The results of the present study on a population treated in a specialized hip preservation center demonstrate that hip arthroscopy is a safe procedure with stable improvement in patient-reported outcome measures at 5 years.

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Section: Data Collectionmentioning

confidence: 99%

Arthroscopic Labral Treatment in Adolescents: Clinical Outcomes With Minimum 5-Year Follow-up

Litrenta

Chen

et al. 2019

Am J Sports Med

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“…Orthopaedic thought leaders have called for improvements in satisfaction reporting as a way of demonstrating the value of orthopedic procedures [5]. Prior reports of satisfaction in orthopaedic literature have demonstrated low methodological quality, with no uniform standard for determining patient satisfaction [9][10][11]. In the USA, government initiatives through the Centers for Medicare and Medicaid Services (CMS) and the Affordable Care Act have emphasized the importance of patient satisfaction and have suggested linking patient satisfaction reporting to reimbursement [5].…”

Section: Introductionmentioning

confidence: 99%

Patient Satisfaction After Total Knee Replacement: A Systematic Review

et al. 2018

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Background:The quality and state of satisfaction reporting after total knee replacement (TKR) is variable.Questions/Purposes:The purposes of this systematic review were (1) to examine the available literature on patient satisfaction after TKR, (2) to evaluate the quality of available evidence, and (3) to identify predictors of patient satisfaction after TKR.Methods:A systematic review of the MEDLINE database was performed. The initial search yielded 1219 studies. The inclusion criteria were English language, clinical outcome study with primary outcome related to TKR for osteoarthritis, and patient-reported satisfaction included as an outcome measure. Studies were assessed for demographics, methodology for reporting satisfaction, and factors influencing satisfaction.Results:Two hundred eight studies, including 95,560 patients who had undergone TKR, met all inclusion and exclusion criteria; 112 (53.8%) of these studies were published in the past 3 years. Satisfaction was most commonly measured using an ordinal scale. Twenty-seven studies (13%) used a validated satisfaction survey. Eighty-three percent of studies reported more than 80% satisfaction. The most commonly reported predictor of satisfaction was post-operative patient-reported functional outcome. Pre-operative anxiety/depression was the most common pre-operative predictor of dissatisfaction.Conclusion:There are numerous studies reporting patient satisfaction after TKR, and publication on the topic has been increasing over the past decade. However, the majority of studies represent lower levels of evidence and use heterogeneous methods for measuring satisfaction, and few studies use validated satisfaction instruments. In general, the majority of studies report satisfaction rates ranging from 80 to 100%, with post-operative functional outcome and relief of pain being paramount determinants for achieving satisfaction.Electronic supplementary materialThe online version of this article (10.1007/s11420-018-9614-8) contains supplementary material, which is available to authorized users.

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“…1 Improved function, return to play, and decreased pain are the most valued metrics by patients after ACL reconstruction. 21,32,40 The Lysholm scale, International Knee Documentation Committee (IKDC) questionnaire, and Knee injury and Osteoarthritis Outcome Score (KOOS) are outcome measures that assess patient symptomatology and function with knee-specific questions. However, Short Form Health Surveys are utilized to assess a patient's general health.…”

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confidence: 99%

Timeline for Maximal Subjective Outcome Improvement After Anterior Cruciate Ligament Reconstruction

et al. 2018

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Background: Anterior cruciate ligament (ACL) tears are one of the most common traumatic knee injuries experienced by athletes. Return to sport is considered the pinnacle endpoint among patients receiving ACL reconstruction. However, at the time of return to sport, patients may not be participating at their previous levels of function, as defined by clinical metrics. Purpose: To establish when patients perceive maximal subjective medical improvement according to patient-reported outcome measures (PROMs). Study Design: Systematic review. Methods: A systematic review of the PubMed database was conducted to identify studies that reported sequential PROMs up to a minimum of 2 years after ACL reconstruction. Pooled analysis was conducted for PROMs at follow-up points of 3 months, 6 months, 1 year, and 2 years. Clinically significant improvement was determined between pairs of intervals with the minimal clinically important difference. Results: This review contains 30 studies including 2253 patients who underwent ACL reconstruction. Clinically significant improvement in the KOOS (Knee injury and Osteoarthritis Outcome Score) was seen up to 1 year after ACL reconstruction, but no clinical significance was noted from 1 to 2 years. Clinically significant improvement in the IKDC (International Knee Documentation Committee) and Lysholm questionnaires was seen up to 6 months postoperatively, but no clinical significance was noted beyond that. Conclusion: After ACL reconstruction, maximal subjective medical improvement is established 1 year postoperatively, with no further perceived clinical improvement beyond this time point according to current PROMs. The KOOS may be a more responsive metric to subjective improvements in this patient cohort than other patient-reported outcomes, such as the IKDC and Lysholm. Clinical Relevance: After ACL reconstruction, patients perceive interval subjective improvements until 1 year postoperatively.

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How Are We Measuring Patient Satisfaction After Anterior Cruciate Ligament Reconstruction?

Cited by 26 publications

References 45 publications

Arthroscopic Labral Treatment in Adolescents: Clinical Outcomes With Minimum 5-Year Follow-up

Arthroscopic Labral Treatment in Adolescents: Clinical Outcomes With Minimum 5-Year Follow-up

Patient Satisfaction After Total Knee Replacement: A Systematic Review

Timeline for Maximal Subjective Outcome Improvement After Anterior Cruciate Ligament Reconstruction

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