Orthopaedic & Rheumatologic Institute Outcomes
Anterior Cruciate Ligament Reconstruction
Patient-Reported Outcome Measures 1 Year After Primary Unilateral Anterior Cruciate Ligament Reconstruction from the Prospective OME Cohort
2018-2019 (N = 461, 63.1% follow-up)
In 2018, 22 distinct surgeons performed primary unilateral anterior cruciate ligament reconstruction (ACLR) surgery on 461 patients at specific sites where the prospective Cleveland Clinic OME Cohort was active. Of these patients, 99.1% completed patient-reported outcome measures (PROMs) at baseline and 63.1% followed up at 1 year. The average patient age was 27.8 years and 59% were male.
79.7% of patients experienced improvement in knee-related quality of life after one year with a median absolute improvement of 25.0 points. Knee-related quality of life was measured by the Knee injury and Osteoarthritis Outcome Score¹ (KOOS) KRQoL scale, which ranges from 0-100 points (higher scores indicate better knee-related quality of life) and has a minimal clinically important difference (MCID) of 10.0.
63.0% of patients experienced improvement in knee function with a median absolute improvement of 16.4 points. Knee function was measured by the Knee injury and Osteoarthritis Outcome Score Physical Function Shortform² (KOOS-PS) instrument, which ranges from 0-100 points (higher scores indicate better knee function) and has an MCID of 10.0.
70.6% of patients experienced improvement in overall physical health with a median absolute improvement of 10.0 points. Physical health was measured by the Veterans RAND 12-Item Health Survey³ (VR-12), which is a norm-based scale where 50 represents the mean score of a nonpatient control group and every 10 units represents 1 standard deviation from the mean. The MCID is estimated at 5.0.
The box plot illustrates patients' one-year outcomes with respect to three separate PROMs: knee-related quality of life, knee function, and overall physical health. Here, "improvement" means that the change in score from pre-op to post-op exceeds the MCID for a PROM and is represented by the shaded region around the horizontal axis. The center horizontal line of each box represents the median change in PROM score, while the boxed regions above and below the center line represent the middle 50% of patients. Error bars represent 95% of patients and circular bubbles represent outliers.