2025 ISAKOS Biennial Congress ePoster
Determinants of Failing to Achieve the Minimal Important Change 1 Year After ACL Reconstruction
Janina Kaarre, MD MSc, Pittsburgh, PA UNITED STATES
Ramana Piussi, PhD, Göteborg, Sverige SWEDEN
Fritz Steuer, BS, Pittsburgh UNITED STATES
Rebecca Simonson SWEDEN
Roland Thomee, Professor, Rönnäng SWEDEN
Volker Musahl, MD, Prof., Pittsburgh, Pennsylvania UNITED STATES
Kristian Samuelsson, Prof, MD, PhD, MSc, Mölndal, Västra Götalands län SWEDEN
Eric Hamrin Senorski, PT, PhD, Assoc. Prof., Västra Frölunda SWEDEN
University of Gothenburg, Gothenburg, Västra Götaland, SWEDEN
FDA Status Not Applicable
Summary
Higher preoperative KOOS Sport/Rec and QoL scores and inferior postoperative knee self-efficacy should be considered when counseling patients about postoperative outcomes.
ePosters will be available shortly before Congress
Abstract
Introduction
Anterior cruciate ligament (ACL) injuries have been a major topic of interest for the past decade, resulting in several thousands of publications. While current knowledge is substantial, it remains unclear why some patients treated with ACL reconstruction (ACLR) do not achieve satisfactory outcomes. To assess different patient- and treatment-related variables as determinants of failure to achieve the minimal important change (MIC) for the Knee injury and Osteoarthritis Outcome Score (KOOS) Function in Sport and Recreation (Sport/Rec) and Quality of Life (QoL) 1 year after primary anterior cruciate ligament reconstruction.
Methods
Data for the study was extracted from a rehabilitation-specific registry, Project ACL. Logistic regression analyses were utilized to identify determinants, such as age, the time from injury to surgery, and patient-related preoperative and postoperative outcomes 1 year after ACLR, associated with the failure to achieve the MIC. The KOOS Sport/Rec and QoL subscales were combined into 1 subscale (KOOS Sport & QoL) by dichotomizing patients depending on whether the MIC was achieved or not. Previously determined MICs, 12.1 and 18.3 for KOOS Sport/Rec and QoL, respectively, were used in this study.
Results:Of the 358 included patients 84.1% (n=301) achieved the MIC for the combined KOOS Sport & QoL subscale. Results from the multivariable logistic regression analyses showed increased odds of failing to achieve the MIC for the combined KOOS Sport & QoL scale 1 year after ACLR among patients with higher preoperative KOOS Sport/Rec (OR 1.2, 0.68-1.1; p=0.000) and QoL (OR 1.05, 1.02-1.09; p=0.002) scores compared to patients with lower preoperative KOOS scores. Additionally, patients with higher postoperative Knee Self-Efficacy Scale (K-SES18) present and future scores had lower odds (OR 0.3, 0.2-0.5; p<0.001, and OR 0.6, 0.5-0.9; p=0.008) of failing to achieve the MIC for the KOOS Sport & QoL subscale compared to those with lower postoperative K-SES18 scores. Backward elimination stepwise reduction of the full model demonstrated similar results to the multivariable regression model with an AUC of 0.94.
Conclusion
Higher preoperative KOOS Sport/Rec and QoL scores as well as lower 1-year postoperative knee-related self-efficacy were associated with the failure to achieve the MIC for the combined KOOS Sport & QoL subscale 1 year after ACLR. Thus, higher preoperative KOOS Sport/Rec and QoL scores and inferior postoperative knee self-efficacy should be considered when counseling patients about postoperative outcomes.