A New Rating Scale for the Rapid Evaluation of High-Level Sports Ability

BACKGROUND: Nearly half of patients with an anterior cruciate ligament (ACL) injury who have returned to sport after ACL reconstruction can return to sports activity at a competitive level, so emphasis should be focused not only on the timing of return to the sport but also on measuring the ability to participate in high-level sports activity. PURPOSE: To develop and evaluate a new, self-administered rating scale for rapid evaluation of high-level sports ability among community-level athletes who return to sports after ACL reconstruction surgery. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: We developed the new rating scale—the Knee Stability in Sports/Cutting-Pivoting Ability (KSS/CPA) scale—in 2 stages. Initially, we used a survey and roundtable discussion to achieve an expert consensus for the KSS/CPA scale from a group of independent orthopaedic experts. Next, 77 amateur athletes who underwent ACL reconstruction by a single surgeon were recruited for a background analysis of data to compare the new scale with results from the Marx activity rating scale, Tegner activity scale, International Knee Documentation Committee Subjective Knee Form, and self-assessment of overall knee function. RESULTS: The KSS/CPA scale was applicable and effective for evaluating the high-level sports ability of community-level athletes who had returned to their sport after ACL reconstruction. Statistical analysis confirmed the test-retest reliability of the new rating scale (intraclass correlation coefficient, 0.85/0.84 postoperatively) as well as its internal consistency (Cronbach alpha coefficient, 0.73 preoperatively and 0.89 postoperatively), construct validity (Spearman correlation coefficient, >0.35 postoperatively), excellent discriminant validity, acceptable responsiveness, and reasonable minimal detectable change (<25). CONCLUSION: The KSS/CPA scale can act as a supplement to other clinical outcome measures for a more comprehensive evaluation of community-level athletes’ cutting-pivoting ability and knee stability.