No Clinically Significant Difference Between Adult and Pediatric IKDC Subjective Knee Evaluation Scores in Adults

Stegmeier, Nicole; Oak, Sameer R.; O’Rourke, Colin; Strnad, Greg; Spindler, Kurt P.; Jones, Morgan H.; Farrow, Lutul D.; Andrish, Jack T.; Saluan, Paul

doi:10.1177/1941738116685299

Cited by 9 publications

(8 citation statements)

References 17 publications

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“…To our knowledge, for this demographic the IKDC is the only known adult PROM that has been secondarily shown to be translatable to the pediatric version in adolescent athletes. 45 In a study by Oak et al, 38 the adult and pediatric forms of the IKDC were shown to be significantly different by 1.5 points, although this difference was not clinically significant. The authors concluded that the adult version of the IKDC could be used in adolescents aged 13 to 17 years.…”

Section: Discussionmentioning

confidence: 95%

Clinical Outcome Reporting in Youth ACL Literature Is Widely Variable

Brusalis

Lakomkin

Suryavanshi

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Advances in anterior cruciate ligament (ACL) reconstruction procedures in pediatric and adolescent patients have resulted in an increase in recent clinical studies on this topic. However, the consistency with which outcome measures are reported in this demographic is unknown.Purpose:To document outcome reporting patterns of youth ACL reconstruction studies in high-impact journals.Study Design:Systematic review; Level of evidence, 4.Methods:All articles published in 5 high-impact orthopaedic journals from 2010 to 2016 were reviewed to identify those reporting clinical outcomes of young patients who underwent ACL reconstruction. Studies that were nonclinical, reported on patients older than 18 years, or included fewer than 10 patients were excluded. Outcome measures used in all included studies were recorded.Results:Seventeen studies encompassing 772 subjects (mean age, 14.3 years; range, 6.3-18.0 years) were analyzed. Eight studies (47%) reported on Tanner stage of subjects, while 1 study reported skeletal age. Ten studies (59%) clearly documented the presence or absence of surgical complications. Range of motion was reported in 65% of studies. Leg-length discrepancy and angular deformity were each reported in 76% of studies, with 12% quantifying results through radiographic measurements. Ligament testing was variably defined by inclusion of instrumented testing (65%), Lachman test (53%), and pivot-shift test (53%). Fourteen studies (82%) explicitly reported on the rate of ACL rerupture, while 71% reported on the rate of revision surgery. Rate of return to preinjury activity was reported in 8 studies (47%), of which 2 defined criteria for return to sport and 3 defined the level of competitive sport. Patient-reported outcome measures (PROMs) were used variably. For the 3 most commonly reported PROMs (Lysholm, International Knee Documentation Committee, and Tegner), 24% of studies reported all 3 PROMs, 35% of studies reported 2 PROMs, and 6% of studies reported 1 PROM in isolation. A pediatric-specific PROM was reported in 1 of the 17 studies.Conclusion:Studies on pediatric ACL reconstruction published in high-impact journals unreliably defined subjects’ skeletal maturity, inconsistently reported on objective outcome measures, and used disparate adult-validated PROMs to assess subjective outcomes. These findings highlight the need for standardized, pediatric-specific outcome measures to be applied in future studies evaluating ACL reconstruction in children and adolescents.

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Section: Discussionmentioning

confidence: 95%

Clinical Outcome Reporting in Youth ACL Literature Is Widely Variable

Brusalis

Lakomkin

Suryavanshi

et al. 2017

Orthopaedic Journal of Sports Medicine

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“…[5][6][7]16,26,49,50 To our knowledge, of these 6 PROMs, only the Marx activity, IKDC, and Kujala scores have shown some validity for use in pediatric patients. 23,50,54 Even so, these scores are not necessarily the preferred methods of reporting. Shirazi et al 50 evaluated the validity of the Marx activity score in pediatric patients and found the score appeared to be useful only in patients older than 14-thus limiting the score's overall usefulness in pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

“…The IKDC form, meanwhile, exists in an adult and a pediatric version. While no clinically significant difference has been shown between the adult and pediatric versions, 43,54 as Brusalis et al 7 point out in their study of pediatric anterior cruciate ligament postsurgical outcomes, children have a difficult time understanding many of the IKDC concepts. 24 This suggests that, when possible, the IKDC pediatric form should be used in pediatric populations.…”

Section: Discussionmentioning

confidence: 99%

Patterns in Outcomes Reporting of Operatively Managed Pediatric Patellofemoral Instability: A Systematic Review and Meta-analysis

et al. 2018

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There is a need for more pediatric-specific outcomes studies regarding operatively managed traumatic patellofemoral instability. Of the outcomes reported, both radiographic outcomes and PROMs should be standardized. Among radiographic outcomes, there is a need for more studies that report tibial tubercle-trochlear groove distances and use Caton-Deschamps and/or Blackburne-Peel indices to assess patellar height. Among PROMs, there is a need for studies that use PROMs validated in pediatric populations, such as the International Knee Documentation Committee Pediatric Form or the Hospital for Special Surgery Pediatric Functional Activity Brief Scale.

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“…4,10,19 A 10-minute washout period was chosen per similar studies comparing the standard IKDC-SKF and the pediatric IKDC. 19,21…”

Section: Methodsmentioning

confidence: 99%

Comparison of Standard and Right/Left International Knee Documentation Committee Subjective Knee Form Scores

et al. 2019

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Background: The International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) is a validated patient-reported outcome used in clinical research. No studies exist directly comparing the standard unilateral adult version (IKDC-SKF) with the bilateral adult version (R/L IKDC-SKF). Hypotheses: The first hypothesis is that no clinically relevant difference would be observed between standard IKDC-SKF scores and involved R/L scores. The second hypothesis is that a relevant difference would be observed between involved and uninvolved scores on the R/L IKDC-SKF. Study Design: Cohort study (Diagnosis); Level of evidence, 2. Methods: One hundred patients were enrolled via a crossover study design. Participants were split into 2 groups per simple randomization. One group completed the standard IKDC-SKF first and the R/L IKDC-SKF second. The other group completed forms in the reverse order. A 10-minute washout period was administered between questionnaires. Participants reported their preferred form in a postquestionnaire survey. A 5-point threshold for clinical relevance was set a priori, which is less than multiple published minimal detectable change and minimal clinically important difference metrics of the standard IKDC-SKF, ranging from 6.3 to 20.5. Data were analyzed with Bland-Altman plots, paired t tests, correlations, and chi-square tests. Results: Paired t tests between the standard IKDC-SKF and the involved R/L IKDC-SKF scores demonstrated a statistically significant mean difference of 1.4 (P = .008; 95% CI, 0.4-2.4). However, the 95% CI falls under the clinically relevant threshold of 5. Standard and involved knee scores from the R/L IKDC-SKF were highly correlated, with a rho of 0.95. Patients consistently distinguished the injured knee from the uninjured knee across a range of scores via the R/L IKDC-SKF (P < .001). The postquestionnaire survey showed that 55 patients preferred the R/L IKDC-SKF, 30 preferred the standard IKDC-SKF, and 15 had no preference. Post hoc analysis showed a significant preference for “R/L vs standard IKDC-SKF” (P = .014) and “R/L IKDC-SKF vs no preference” (P < .003). Conclusion: No clinically relevant difference was observed between the standard IKDC-SKF and the involved knee score of the R/L IKDC-SKF. Therefore, for symptomatic unilateral knee diagnosis, either form can be used. The R/L IKDC-SKF showed a consistent and clinically relevant difference between involved and uninvolved knees. Patients in this study preferred the R/L IKDC-SKF.

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No Clinically Significant Difference Between Adult and Pediatric IKDC Subjective Knee Evaluation Scores in Adults

Cited by 9 publications

References 17 publications

Clinical Outcome Reporting in Youth ACL Literature Is Widely Variable

Clinical Outcome Reporting in Youth ACL Literature Is Widely Variable

Patterns in Outcomes Reporting of Operatively Managed Pediatric Patellofemoral Instability: A Systematic Review and Meta-analysis

Comparison of Standard and Right/Left International Knee Documentation Committee Subjective Knee Form Scores

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