Journal article
KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study
Osteoarthritis and cartilage, Vol.23(10), pp.1674-1684
10/2015
DOI: 10.1016/j.joca.2015.05.025
PMCID: PMC4577458
PMID: 26072385
Abstract
The prevalence of radiographic osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR) approaches 50%, yet the prevalence of significant knee pain is unknown. We applied three different models of Knee injury and Osteoarthritis Outcome Score (KOOS) thresholds for significant knee pain to an ACLR cohort to identify prevalence and risk factors.
Multicenter Orthopaedic Outcomes Network (MOON) prospective cohort patients with a unilateral primary ACLR and normal contralateral knee were assessed at 2 and 6 years. Independent variables included patient demographics, validated Patient Reported Outcomes (PRO; Marx activity score, KOOS), and surgical characteristics. Models included: (1) KOOS criteria for a painful knee = quality of life subscale <87.5 and ≥2 of: KOOSpain <86.1, KOOSsymptoms <85.7, KOOSADL <86.8, or KOOSsports/rec <85.0; (2) KOOSpain subscale score ≤72 (≥2 standard deviations below population mean); (3) 10-point KOOSpain drop from 2 to 6 years. Proportional odds models (alpha ≤ 0.05) were used.
1761 patients of median age 23 years, median body mass index (BMI) 24.8 kg/m2 and 56% male met inclusion, with 87% (1530/1761) and 86% (1506/1761) follow-up at 2 and 6 years, respectively. At 6 years, n = 592 (39%), n = 131 (9%) and n = 169 (12%) met criteria for models #1 through #3, respectively. The most consistent and strongest independent risk factor at both time-points was subsequent ipsilateral knee surgery. Low 2-year Marx activity score increased the odds of a painful knee at 6 years.
Significant knee pain is prevalent after ACLR; with those who undergo subsequent ipsilateral surgery at greatest risk. The relationship between pain and structural OA warrants further study.
Details
- Title: Subtitle
- KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study
- Creators
- D Wasserstein - University of Toronto Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, MG301, Toronto, Ontario M4N 3M5, CanadaL.J Huston - Vanderbilt Sports Medicine, Vanderbilt University Medical Center, Nashville, TN, USAS Nwosu - Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USAC.C Kaeding - Ohio State University, Columbus, OH, USAR.D Parker - Cleveland Clinic Foundation, USAR.W Wright - Washington University in St. Louis, USAJ.T Andrish - Cleveland Clinic Foundation, Cleveland, OH, USAR.G Marx - Hospital for Special Surgery, New York, NY, USAA Amendola - University of Iowa, Iowa City, IA, USAB.R Wolf - University of Iowa, Iowa City, IA, USAE.C McCarty - University of Colorado, Denver, CO, USAM Wolcott - University of Colorado, Denver, CO, USAW.R Dunn - University of Wisconsin, Madison, WI, USAK.P Spindler - Cleveland Clinic Sports Health, Cleveland Clinic, Cleveland, OH, USA
- Resource Type
- Journal article
- Publication Details
- Osteoarthritis and cartilage, Vol.23(10), pp.1674-1684
- DOI
- 10.1016/j.joca.2015.05.025
- PMID
- 26072385
- PMCID
- PMC4577458
- NLM abbreviation
- Osteoarthritis Cartilage
- ISSN
- 1063-4584
- eISSN
- 1522-9653
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 10/2015
- Academic Unit
- Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
- Record Identifier
- 9984040300402771
Metrics
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