Trends in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review

BACKGROUND: Despite the prevalence of patient-reported outcomes (PROs) to evaluate results after anterior cruciate ligament (ACL) reconstruction, there exists little standardization in how these metrics are reported, which can make wider comparisons difficult. PURPOSE: To systematically review the l...

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Autores principales: Berk, Alexander N., Piasecki, Dana P., Fleischli, James E., Trofa, David P., Saltzman, Bryan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240869/
https://www.ncbi.nlm.nih.gov/pubmed/37284137
http://dx.doi.org/10.1177/23259671231174472
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author Berk, Alexander N.
Piasecki, Dana P.
Fleischli, James E.
Trofa, David P.
Saltzman, Bryan M.
author_facet Berk, Alexander N.
Piasecki, Dana P.
Fleischli, James E.
Trofa, David P.
Saltzman, Bryan M.
author_sort Berk, Alexander N.
collection PubMed
description BACKGROUND: Despite the prevalence of patient-reported outcomes (PROs) to evaluate results after anterior cruciate ligament (ACL) reconstruction, there exists little standardization in how these metrics are reported, which can make wider comparisons difficult. PURPOSE: To systematically review the literature on ACL reconstruction and report on the variability and temporal trends in PRO utilization. STUDY DESIGN: Systematic review. METHODS: We queried the PubMed Central and MEDLINE databases from inception through August 2022 to identify clinical studies reporting ≥1 PRO after ACL reconstruction. Only studies with ≥50 patients and a mean 24-month follow-up were considered for inclusion. Year of publication, study design, PROs, and reporting of return to sport (RTS) were documented. RESULTS: Across 510 studies, 72 unique PROs were identified, the most common of which were the International Knee Documentation Committee score (63.3%), Tegner Activity Scale (52.4%), Lysholm score (51.0%), and Knee injury and Osteoarthritis Outcome Score (35.7%). Of the identified PROs, 89% were utilized in <10% of studies. The most common study designs were retrospective (40.6%), prospective cohort (27.1%), and prospective randomized controlled trials (19.4%). Some consistency in PROs was observed among randomized controlled trials, with the most common PROs being the International Knee Documentation Committee score (71/99, 71.7%), Tegner Activity Scale (60/99, 60.6%), and Lysholm score (54/99, 54.5%). The mean number of PROs reported per study across all years was 2.89 (range, 1-8), with an increase from 2.1 (range, 1-4) in studies published before 2000 to 3.1 (range, 1-8) in those published after 2020. Only 105 studies (20.6%) discretely reported RTS rates, with more studies utilizing this metric after 2020 (55.1%) than before 2000 (15.0%). CONCLUSION: There exists marked heterogeneity and inconsistency regarding which validated PROs are used in studies related to ACL reconstruction. Significant variability was observed, with 89% of measures being reported in <10% of studies. RTS was discretely reported in only 20.6% of studies. Greater standardization of outcomes reporting is required to better promote objective comparisons, understand technique-specific outcomes, and facilitate value determination.
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spelling pubmed-102408692023-06-06 Trends in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review Berk, Alexander N. Piasecki, Dana P. Fleischli, James E. Trofa, David P. Saltzman, Bryan M. Orthop J Sports Med Article BACKGROUND: Despite the prevalence of patient-reported outcomes (PROs) to evaluate results after anterior cruciate ligament (ACL) reconstruction, there exists little standardization in how these metrics are reported, which can make wider comparisons difficult. PURPOSE: To systematically review the literature on ACL reconstruction and report on the variability and temporal trends in PRO utilization. STUDY DESIGN: Systematic review. METHODS: We queried the PubMed Central and MEDLINE databases from inception through August 2022 to identify clinical studies reporting ≥1 PRO after ACL reconstruction. Only studies with ≥50 patients and a mean 24-month follow-up were considered for inclusion. Year of publication, study design, PROs, and reporting of return to sport (RTS) were documented. RESULTS: Across 510 studies, 72 unique PROs were identified, the most common of which were the International Knee Documentation Committee score (63.3%), Tegner Activity Scale (52.4%), Lysholm score (51.0%), and Knee injury and Osteoarthritis Outcome Score (35.7%). Of the identified PROs, 89% were utilized in <10% of studies. The most common study designs were retrospective (40.6%), prospective cohort (27.1%), and prospective randomized controlled trials (19.4%). Some consistency in PROs was observed among randomized controlled trials, with the most common PROs being the International Knee Documentation Committee score (71/99, 71.7%), Tegner Activity Scale (60/99, 60.6%), and Lysholm score (54/99, 54.5%). The mean number of PROs reported per study across all years was 2.89 (range, 1-8), with an increase from 2.1 (range, 1-4) in studies published before 2000 to 3.1 (range, 1-8) in those published after 2020. Only 105 studies (20.6%) discretely reported RTS rates, with more studies utilizing this metric after 2020 (55.1%) than before 2000 (15.0%). CONCLUSION: There exists marked heterogeneity and inconsistency regarding which validated PROs are used in studies related to ACL reconstruction. Significant variability was observed, with 89% of measures being reported in <10% of studies. RTS was discretely reported in only 20.6% of studies. Greater standardization of outcomes reporting is required to better promote objective comparisons, understand technique-specific outcomes, and facilitate value determination. SAGE Publications 2023-05-31 /pmc/articles/PMC10240869/ /pubmed/37284137 http://dx.doi.org/10.1177/23259671231174472 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Berk, Alexander N.
Piasecki, Dana P.
Fleischli, James E.
Trofa, David P.
Saltzman, Bryan M.
Trends in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review
title Trends in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review
title_full Trends in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review
title_fullStr Trends in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review
title_full_unstemmed Trends in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review
title_short Trends in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review
title_sort trends in patient-reported outcomes after anterior cruciate ligament reconstruction: a systematic review
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240869/
https://www.ncbi.nlm.nih.gov/pubmed/37284137
http://dx.doi.org/10.1177/23259671231174472
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