Prospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2022; 10(30): 10939-10955
Published online Oct 26, 2022. doi: 10.12998/wjcc.v10.i30.10939
Patient reported outcome measures in anterior cruciate ligament rupture and reconstruction: The significance of outcome score prediction
Oday Al-Dadah, Lee Shepstone, Simon T Donell
Oday Al-Dadah, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne NE2 4HH, Tyne and Wear, United Kingdom
Oday Al-Dadah, Department of Trauma and Orthopaedic Surgery, South Tyneside District Hospital, South Shields NE34 0PL, Tyne and Wear, United Kingdom
Lee Shepstone, Department of Medical Statistics, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, Norfolk, United Kingdom
Simon T Donell, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, Norfolk, United Kingdom
Author contributions: Al-Dadah O made substantial contributions to conception and design of the study and acquisition of data; He also performed the analysis and interpretation of data; Has been involved in drafting the manuscript and revising it critically for important intellectual content; Has given final approval of the version to be published; Shepstone L made substantial contributions to conception and design of the study; He also made substantial contributions to the analysis and interpretation of data; Has been involved in drafting the manuscript and revising it critically for important intellectual content; Has given final approval of the version to be published; Donell ST made substantial contributions to conception and design of the study; He also made substantial contributions to the interpretation of data; Has been involved in drafting the manuscript and revising it critically for important intellectual content; Has given final approval of the version to be published.
Institutional review board statement: Full approval was received for the study from the Research Ethics Committee and the Research Governance Committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee [East Norfolk and Waveney Research Governance Committee, United Kingdom (ID 116/07/07)] and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Clinical trial registration statement: This study was not registered on any trial registry.
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
Data sharing statement: The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study and in keeping with the United Kingdom General Data Protection Regulation and also the host study organization’s patient confidentiality guidelines.
CONSORT 2010 statement: The authors have read the CONSORT Statement—checklist of items, and the manuscript was prepared and revised according to the CONSORT Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Oday Al-Dadah, FRCS, MBChB, MD, Senior Lecturer, Surgeon, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4HH, Tyne and Wear, United Kingdom. oday.al-dadah@newcastle.ac.uk
Received: February 13, 2022
Peer-review started: February 13, 2022
First decision: June 15, 2022
Revised: July 5, 2022
Accepted: September 19, 2022
Article in press: September 19, 2022
Published online: October 26, 2022
Processing time: 249 Days and 5.2 Hours
Abstract
BACKGROUND

Numerous anterior cruciate ligament (ACL) clinical outcome measures exist. However, the result of one score does not equate to the findings of another even when evaluating the same patient group.

AIM

To investigate if statistically derived formulae can be used to predict the outcome of one knee scoring system when the result of another is known in patients with ACL rupture before and after reconstruction.

METHODS

Fifty patients with ACL rupture were evaluated using nine clinical outcome measures. These included Tegner Activity Score, Lysholm Knee Score, Cincinnati Knee Score, International Knee Documentation Committee (IKDC) Objective Knee Score, Tapper and Hoover Meniscal Grading Score, IKDC Subjective Knee Score, Knee Outcome Survey - Activities of Daily Living Scale (KOS-ADLS), Short Form-12 Item Health Survey and Knee Injury and Osteoarthritis Outcome Score. Thirty-four patients underwent an ACL reconstruction and were reassessed post-operatively.

RESULTS

The mean total of each of the nine outcome scores appreciably differed from each other. Significant correlations and regressions were found between most of the outcome scores and were stronger post-operatively. The strongest correlation was found between Cincinnati and KOS-ADLS (r = 0.91, P < 0.001). The strongest regression formula was also found between Cincinnati and KOS-ADLS (R2 = 0.84, P < 0.001).

CONCLUSION

The formulae produced from this study can be used to predict the outcome of one knee score when the results of the other are known. These formulae could facilitate the conduct of systematic reviews and meta-analysis in studies relating to ACL injuries by allowing the pooling of substantially more data.

Keywords: Anterior cruciate ligament; Prediction; Regression; Correlation; Patient reported outcome measures; Reconstruction; Rupture

Core Tip: Numerous anterior cruciate ligament (ACL) knee scoring systems exist in the literature. However, the result of one outcome measure does not equate to the findings of another even when evaluating the same patient group. Comparing the results of studies that have investigated the same field but have used different outcome measures then becomes problematic. These restrictions are especially pronounced when researchers attempt to pool data from the published literature for the purpose of statistical analysis in the context of meta-analysis and systematic reviews. The formulae produced from this study can be used to predict the outcome of one knee score when the results of the other are known. These formulae could facilitate the conduct of systematic reviews and meta-analysis in studies relating to ACL injuries by allowing the pooling of substantially more data.