2017 ISAKOS Biennial Congress ePoster #1112

 

Evolution Of IKDC And KOOS Scores For Patients With Hamstring And Patellar Tendon Autograft Within The First Year After Primary ACL Reconstruction

Nina Magnitskaya, MD, PhD, Moscow RUSSIAN FEDERATION
Caroline Mouton, PhD, Luxembourg LUXEMBOURG
Christian Nührenbörger, MD, Luxembourg LUXEMBOURG
Dietrich Pape, MD, PhD, Luxembourg LUXEMBOURG
Daniel Theisen, MSc, PhD, Luxembourg LUXEMBOURG
Romain Seil, MD, Prof., Luxembourg LUXEMBOURG

Centre Hospitalier de Luxembourg – Clinique d’Eich, Luxembourg, LUXEMBOURG

FDA Status Not Applicable

Summary

Patient reported outcomes (PRO) are used to assess clinical outcomes after ACL-R, but no individualized references or targets have been established so far. In this study, patients with BPTB graft showed clinically lower scores in IKDC and KOOS subscales 6 weeks, 3 and 6 months after primary ACL-R compared to patients with STGR graft so that specific targets should be foreseen for each group.

Abstract

Introduction

Patient reported outcomes (PRO) are used to assess clinical outcomes after anterior cruciate ligament reconstruction (ACL-R). However it remains unclear which scores should be targeted for The International Knee Documentation Committee (IKDC) subjective form and Knee injury and Osteoarthritis Outcome Score (KOOS) during first year after surgery and no individualized references exist nowadays. The purpose of the present study was to compare and establish reference values for patients with bone-patellar tendon-bone (BPTB) and hamstring (STGR) autografts for IKDC and KOOS within 1st year after ACL-R. We hypothesized that scores would differ in BPTB and STGR groups.

Material And Methods

Patients were recruited from intrahospital registry after primary ACL-R with a BPTB or STGR autograft. IKDC and KOOS were evaluated 6 weeks (n=159), 3 (n=226), 6 (n=182) and 12 months (n=88) after surgery. Depending on the normality of score distributions as checked by the Kolmogrorov-Sminov test, the average or the median was reported. Accordingly, the scores for STGR and BTPB groups were compared using a paired samples t-test or the Mann-Whitney test. Level of significance was defined at p<0.05. The study was approved by the national ethics committee.

Results

Medians were reported as only the IKDC score was normally distributed 6 weeks after ACL-R. Median IKDC score was significantly higher in STGR group compared to BPTB group at 6 weeks, 3 and 6 months (59, 75, 84 for STGR; 53, 69, 77 for BPTB, p<0.05). By 12 months, score was similar between both groups (94 for STGR; 92 for BPTB). At 6 weeks, the median score for KOOS-Pain, ADL, Sport/Rec and QOL subscales in STGR group were higher than in BPTB group (78, 87, 35, 44 for STGR; 69, 74, 25, 38 for BPTB, p<0.05). At 3 months, the same observation was made for Pain, ADL and Sport/Rec subscales (89, 96, 70 for STGR; 83, 93, 55 for BPTB, p<0.05) and at 6 months for Pain, ADL, Sport/Rec and QOL subscales (92, 99, 85, 69 for STGR; 89, 97, 75, 56 for BPTB, p<0.05). By 12 months, no difference could be observed between both groups (Pain: 97, ADL: 100, Sport/Rec: 90, QOL: 81). For KOOS-Symptoms subscales, no significant differences could be found between STGR and BPTB groups at 6 weeks, 3, 6 and 12 months.

Discussion

We confirmed that IKDC and KOOS median scores were higher in STGR group compared to BPTB group at 6 weeks, 3 and 6 months after ACL-R. At 12 months, no difference could be observed between both grafts. Most of the differences were clinically significant as compared to the minimal detectable change reported in the literature [1]. Thus, specific references/targets should be foreseen for each group to help identifying patients with poor outcomes.

Conclusion

Median IKDC and most of KOOS subscales were lower in BPTB group than in STGR group at 6 weeks, 3 and 6 months after primary ACL-R, but equalized by 12 months period.

[1] Collins NJ, Misra D, et al. Measures of Knee Function. Arthritis Care Res (Hoboken); 2011, 63: S208–S228.