Statistical Comparison of the Pediatric Versus Adult IKDC Subjective Knee Evaluation Form in Adolescents

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

doi:10.1177/0363546515589108

Cited by 36 publications

(47 citation statements)

References 18 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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“…A recent study showed that the Pedi-IKDC and the IKDC had statistically similar scores when administered to a group of adolescent patients with knee injuries. 28 The Pedi-IKDC questionnaire was mailed to eligible patients, and if they did not return the questionnaire or opt out of the study within 2 weeks, then they were called and invited to complete the questionnaire over the phone. For patients who did not complete the Pedi-IKDC by mail or over the phone, their clinical IKDC scores were used, as the IKDC questionnaire is routinely completed by patients during clinic as part of standard care.…”

Section: Methodsmentioning

confidence: 99%

Outcomes and Complications After All-Epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients

Wall

Ghattas²,

Eismann

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:The safest and most effective technique for anterior cruciate ligament (ACL) reconstruction in skeletally immature patients is currently unknown.Purpose:To evaluate the functional and patient-reported outcomes of a specific all-epiphyseal ACL reconstruction technique in which the graft, bone tunnels, and fixation do not cross the knee growth plates.Study Design:Case series; Level of evidence, 4.Methods:Twenty-seven patients (23 boys, 4 girls; mean age, 11 years; range, 8-15 years) underwent an all-epiphyseal ACL reconstruction with a single femoral transverse epiphyseal tunnel and primarily split tibial epiphyseal tunnels. Outcomes were evaluated in terms of the manual Lachman test, range of motion, pain, return to activity, angular or leg-length deformity on imaging, and International Knee Documentation Committee (IKDC) or Pedi-IKDC score an average of 3.8 years postoperatively, with a minimum 2-year follow-up.Results:The mean IKDC score was 94 ± 11. There were no growth arrests, but 3 patients had knee overgrowth, and 2 required a subsequent guided growth procedure. The ACL graft failed in 4 patients (15%), and 2 patients had contralateral ACL tears (7%). There were 5 subsequent ipsilateral meniscal tears, 4 of which were retears of a repaired meniscus. Ipsilateral knee reinjury significantly correlated with the number of associated injuries at the time of index surgery (P = .040) and the number of sports played (P = .029).Conclusion:All-epiphyseal ACL reconstruction resulted in excellent long-term functional outcomes, despite a high rate of complications (48%) and secondary procedures (37%) in this highly active cohort. The incidence of graft failure was similar to other standard ACL reconstruction techniques for patients younger than 20 years.

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“…Used in isolation, individual outcome measures can provide helpful clinical information, but how these measures relate to each other may offer a stronger clinical picture of the patient's actual recovery from surgery. A number of investigators 30,38,39 have assessed the association between self-reported outcomes and functional measures after ACLR. Logerstedt et al 19 found that lower IKDC scores suggested poor isometric quadriceps strength during functional testing for clearance to return to activity.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome Measures and Return-to-Sport Timing in Adolescent Athletes After Anterior Cruciate Ligament Reconstruction

Burland

Kostyun

et al. 2018

Journal of Athletic Training

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Higher strength measures at both 3 and 6 months after ACLR were associated with greater self-reported knee function and greater readiness to return to functional activities at 6 months and ultimately earlier return to sport in adolescent athletes. These results provide evidence that self-reported outcome scores should be used as an additional screening tool in conjunction with quadriceps strength testing to help provide realistic recovery timeframes for adolescent patients.

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Statistical Comparison of the Pediatric Versus Adult IKDC Subjective Knee Evaluation Form in Adolescents

Cited by 36 publications

References 18 publications

Clinical Outcome Reporting in Youth ACL Literature Is Widely Variable

Clinical Outcome Reporting in Youth ACL Literature Is Widely Variable

Outcomes and Complications After All-Epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients

Clinical Outcome Measures and Return-to-Sport Timing in Adolescent Athletes After Anterior Cruciate Ligament Reconstruction

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