Improvement of Outcomes With Nonconcurrent Strength and Cardiovascular-Endurance Rehabilitation Conditioning After ACI Surgery to the Knee

2014 ◽  
Vol 23 (3) ◽  
pp. 235-243 ◽  
Author(s):  
Andrea Kay Bailey ◽  
Claire Minshull ◽  
James Richardson ◽  
Nigel P. Gleeson
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
International Knee Documentation Committee ◽  
Knee Extensors ◽  
Electromechanical Delay ◽  
Cardiovascular Endurance ◽  
Patient Reported ◽  
Chondrocyte Implantation ◽  
Hop Test ◽  
Single Leg Hop Test

Context:Autologous chondrocyte implantation (ACI) aims to restore hyaline cartilage. Traditionally, ACI rehabilitation is prescribed in a concurrent (CON) format. However, it is well known from studies in asymptomatic populations that CON training produces an interference effect that can attenuate strength gains. Strength is integral to joint function, so adopting a nonconcurrent (N-CON) approach to ACI rehabilitation might improve outcomes.Objective:To assess changes in function and neuromuscular performance during 48 wk of CON and N-CON physical rehabilitation after ACI to the knee.Setting:Orthopedic Hospital NHS Foundation Trust.Design:Randomized control, pilot study.Participants:11 patients (9 male, 2 female; age 32.3 ± 6.6 y; body mass 79.3 ±10.4 kg; time from injury to surgery 7.1 ± 4.9 mo [mean ± SD]) randomly allocated to N-CON:CON (2:1).Interventions:Standardized CON and N-CON physiotherapy that involved separation of strength and cardiovascular-endurance conditioning.Main Outcome Measures:Function in the single-leg-hop test, patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score [KOOS], International Knee Documentation Committee subjective questionnaire [IKDC]), and neuromuscular outcomes of peak force (PF), rate of force development (RFD), electromechanical delay (EMD), and sensorimotor performance (force error [FE]) of the knee extensors and flexors of the injured and noninjured legs, measured presurgery and at 6, 12, 24, and 48 wk postsurgery.Results:Factorial ANOVAs with repeated measures of group by leg and by test occasion revealed significantly superior improvements for KOOS, IKDC, PF, EMD, and FE associated with N-CON vs CON rehabilitation (F1.5,13.4 GG = 3.7−4.7, P < .05). These results confirm increased peak effectiveness of N-CON rehabilitation (~4.5−13.3% better than CON over 48 wk of rehabilitation). N-CON and CON showed similar patterns of improvement for single-leg-hop test and RFD.Conclusions:Nonconcurrent strength and cardiovascular-endurance conditioning during 48 wk of rehabilitation after ACI surgery elicited significantly greater improvements to functional and neuromuscular outcomes than did contemporary concurrent rehabilitation.

scholarly journals Patient-Oriented and Performance-Based Outcomes After Knee Autologous Chondrocyte Implantation: A Timeline for the First Year of Recovery

2014 ◽  
Vol 23 (3) ◽  
pp. 223-234 ◽  
Author(s):  
Jennifer S. Howard ◽  
Carl G. Mattacola ◽  
David R. Mullineaux ◽  
Robert A. English ◽  
Christian Lattermann
Keyword(s):  
Outcome Measures ◽  
Autologous Chondrocyte Implantation ◽  
Short Form ◽  
Weight Bearing ◽  
Force Plate ◽  
International Knee Documentation Committee ◽  
First Year ◽  
Patient Reported ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Context:It is well established that autologous chondrocyte implantation (ACI) can require extended recovery postoperatively; however, little information exists to provide clinicians and patients with a timeline for anticipated function during the first year after ACI.Objective:To document the recovery of functional performance of activities of daily living after ACI.Patients:ACI patients (n = 48, 29 male; 35.1 ± 8.0 y).Intervention:All patients completed functional tests (weight-bearing squat, walk-across, sit-to-stand, step-up/over, and forward lunge) using the NeuroCom long force plate (Clackamas, OR) and completed patient-reported outcome measures (International Knee Documentation Committee Subjective Knee Evaluation Form, Lysholm, Western Ontario and McMaster Osteoarthritis Index [WOMAC], and 36-Item Short-Form Health Survey) preoperatively and 3, 6, and 12 mo postoperatively.Main Outcome Measures:A covariance pattern model was used to compare performance and self-reported outcome across time and provide a timeline for functional recovery after ACI.Results:Participants demonstrated significant improvement in walk-across stride length from baseline (42.0% ± 8.9% height) at 6 (46.8% ± 8.1%) and 12 mo (46.6% ± 7.6%). Weight bearing on the involved limb during squatting at 30°, 60°, and 90° was significantly less at 3 mo than presurgery. Step-up/over time was significantly slower at 3 mo (1.67 ± 0.69 s) than at baseline (1.49 ± 0.33 s), 6 mo (1.51 ± 0.36 s), and 12 mo (1.40 ± 0.26 s). Step-up/over lift-up index was increased from baseline (41.0% ± 11.3% body weight [BW]) at 3 (45.0% ± 11.7% BW), 6 (47.0% ± 11.3% BW), and 12 mo (47.3% ± 11.6% BW). Forward-lunge time was decreased at 3 mo (1.51 ± 0.44 s) compared with baseline (1.39 ± 0.43 s), 6 mo (1.32 ± 0.05 s), and 12 mo (1.27 ± 0.06). Similarly, forward-lunge impact force was decreased at 3 mo (22.2% ± 1.4% BW) compared with baseline (25.4% ± 1.5% BW). The WOMAC demonstrated significant improvements at 3 mo. All patient-reported outcomes were improved from baseline at 6 and 12 mo postsurgery.Conclusions:Patients' perceptions of improvements may outpace physical changes in function. Decreased function for at least the first 3 mo after ACI should be anticipated, and improvement in performance of tasks requiring weight-bearing knee flexion, such as squatting, going down stairs, or lunging, may not occur for a year or more after surgery.

scholarly journals Autologous Chondrocyte Implantation to Isolated Patella Cartilage Defects

Cartilage ◽  
2016 ◽  
Vol 8 (2) ◽  
pp. 146-154 ◽  
Author(s):  
Arvind von Keudell ◽  
Roger Han ◽  
Tim Bryant ◽  
Tom Minas
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Outcome Measures ◽  
Autologous Chondrocyte Implantation ◽  
Tibial Tubercle ◽  
Resonance Imaging ◽  
Patient Reported ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Background Autologous chondrocyte implantation (ACI) is a durable treatment for patients with chondral defects. This study presents the comprehensive evaluation of patients with patella defects treated with ACI at medium- to long-term follow-up. Methods Thirty consecutive patients with isolated chondral lesions of the patella were enrolled prospectively. Primary outcome measures were validated patient reported outcome measures and objective magnetic resonance imaging. Results Nineteen of 30 patients underwent tibial tubercle osteotomy (TTO) to correct lateral maltracking in combination with soft tissue balancing. The defect sizes were large, averaging 4.7 ± 2.1 cm2 (range 2.2-30.0 cm2). Pidoriano/Fulkerson classification revealed that 3 defects were type II (lateral), 9 were type III (medial), and 18 were type IV (central/panpatella). Age at the time of surgery was 32 ± 10 years. At follow-up of 2 to 14 years, knee function was rated good to excellent in 25 (83%) patients, fair in 4 (13%) patients, and poor in 1 (3%) patient. Three patients failed treatment after a mean of 75 months (6.25 years). All 3 failures were Workers Compensation (WC) cases. They were older than the non-WC patients, 42 ± 6 years compared with the non-WC 28 ± 9 years ( P = 0.0019). Significant increases in all clinical and health utility outcome scores were seen. Magnetic resonance imaging demonstrated that the fill grade, surface and integrity of the repair tissue correlated with clinical scores. Conclusion ACI to isolated patella defects results in significant functional improvement at a minimum of 24 months, with the results remaining durable at latest follow-up of 15 years. Level of evidence Level 4.

Arthroscopic Versus Open Matrix-Induced Autologous Chondrocyte Implantation: Results and Implications for Rehabilitation

2014 ◽  
Vol 23 (3) ◽  
pp. 203-215 ◽  
Author(s):  
Peter K. Edwards ◽  
Jay R. Ebert ◽  
Gregory C. Janes ◽  
David Wood ◽  
Michael Fallon ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Outcome Measures ◽  
Autologous Chondrocyte Implantation ◽  
Short Form ◽  
Cartilage Defects ◽  
Early Results ◽  
Patient Reported ◽  
Chondrocyte Implantation ◽  
Open Arthrotomy ◽  
Autologous Chondrocyte

Context:Matrix-induced autologous chondrocyte implantation (MACI) has become an established technique for the repair of chondral defects in the knee. MACI has traditionally required an open arthrotomy, but now lends itself to an arthroscopic technique, which may decrease the associated comorbidity of arthrotomy, potentially allowing for faster rehabilitation.Objective:To compare postoperative outcomes between arthroscopic and open arthrotomy techniques of MACI and present a case for faster recovery and accelerated rehabilitation after surgery.Design:Retrospective cohort study.Setting:Private functional rehabilitation facility.Patients:78 patients (41 arthroscopic, 37 open) treated with MACI for full-thickness cartilage defects to the femoral condyles.Intervention:According to surgeon preference, patients recruited over the same time period underwent MACI performed arthroscopically or via a conventional open arthrotomy. Both surgical groups were subjected to an identical rehabilitation protocol.Main Outcome Measures:Patient-reported (Knee Injury and Osteoarthritis Outcome Score, Short Form Health Survey, and visual analogue scale) and functional (6-min-walk test, 3-repetition straight-leg-raise test [3R-SLR]) outcomes were compared presurgery and at 3, 6, and 12 mo postsurgery. Active knee range of motion (ROM) was additionally assessed 4 and 8 wk postsurgery. MRI evaluation was assessed using magnetic-resonance observation of cartilage-repair tissue (MOCART) scores at 3 and 12 mo. The length of hospital stay was evaluated, while postsurgery complications were documented.Results:Significant improvements (P < .05) for both groups were observed over the 12-mo period for patient-reported and functional outcomes; however, the arthroscopic cohort performed significantly better (P < .05) in active knee-flexion and -extension ROM and the 3R-SLR. No differences were observed in MOCART scores between the 2 groups at 12 mo. Patients who received arthroscopic implantation required a significantly reduced (P < .001) hospital stay and experienced fewer postoperative complications.Conclusions:Arthroscopic MACI in combination with “best practice” rehabilitation has shown encouraging early results, with good clinical outcomes to 12 mo, reduced length of patient hospitalization, and reduced risk of postsurgery complications. This may have important implications for postoperative rehabilitation and a faster return to full function.

Changes in Isokinetic Muscle Strength of the Lower Extremity in Recreational Athletes with Anterior Cruciate Ligament Reconstruction

2002 ◽  
Vol 11 (4) ◽  
pp. 252-267 ◽  
Author(s):  
Yukio Urabe ◽  
Mitsuo Ochi ◽  
Kiyoshi Onari
Keyword(s):  
Muscle Strength ◽  
Lower Extremity ◽  
Acl Reconstruction ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Whole Body ◽  
Knee Extensors ◽  
Joint Movement ◽  
Isokinetic Muscle Strength ◽  
Dependent Variables

Objective:To investigate changes in muscle strength in the lower extremity after ACL reconstruction.Design:Prospective case series.Dependent Variables:Isokinetic muscle strength measured in 6 movements (hip extension/flexion, hip adduction/abduction, knee extension/flexion) and circumference of the thigh/calf.Setting:Clinic and home.Patients:44 (24 men, 20 women) between the ages of 16 and 47 years with an ACL rupture. All underwent reconstruction via a semitendinosus autograft.Main Outcome Measures:The peak torque for each joint movement was recorded. Repeated-measures ANOVA and power analysis were conducted to detect significant interaction effects.Results:The decline of muscle strength after ACL reconstruction remained not only in the knee extensors and flexors but also in the hip adductors.Conclusion:Rehabilitation programs that address the behavioral patterns and physiological characteristics of an ACL injury will benefit the athlete’s whole body and lead to a full recovery.

scholarly journals Matrix-associated autologous chondrocyte implantation with autologous bone grafting of osteochondral lesions of the talus in adolescents: patient-reported outcomes with a median follow-up of 6 years

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Daniel Körner ◽  
Christoph E. Gonser ◽  
Stefan Döbele ◽  
Christian Konrads ◽  
Fabian Springer ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Bone Grafting ◽  
Autologous Chondrocyte Implantation ◽  
Osteochondral Lesions ◽  
Foot And Ankle ◽  
Autologous Bone Grafting ◽  
Patient Reported ◽  
Chondrocyte Implantation ◽  
Autologous Bone ◽  
Autologous Chondrocyte

Abstract Background This study presents patient-reported outcome measures after combined matrix-associated autologous chondrocyte implantation and autologous bone grafting in high-stage osteochondral lesions of the talus in adolescents. Methods A total of 12 adolescent patients (13 ankles) received matrix-associated autologous chondrocyte implantation and autologous bone grafting for a solitary osteochondral lesion of the talus at a single centre. The Foot and Ankle Outcome Score and Foot and Ankle Ability Measure were defined as outcome measures (median follow-up 80 months [range 22–107 months]). Pre- and postoperative ankle radiographs were evaluated according to the van Dijk ankle osteoarthritis scale. Results The study population consisted of four male and nine female cases (mean age at the time of surgery, 17.7 ± 2.1 years). Eight lesions were classified as traumatic and five as idiopathic. Twelve lesions were located medial vs one lateral in the coronal plane and all central in the sagittal plane. The median lesion size and depth were 1.3 cm2 (range 0.9–3.2 cm2) and 5 mm (range 5–9 mm), respectively. There were no perioperative complications in any of the cases. In 9 cases patient-reported outcome measures were available. The results of the Foot and Ankle Outcome Score subscales were symptoms, 70 ± 14; pain, 83 ± 10; activities of daily living, 89 ± 12; sports/recreational activities, 66 ± 26; and quality of life, 51 ± 17. The mean overall Foot and Ankle Outcome Score was 78 ± 13. The results of the Foot and Ankle Ability Measure subscales were activities of daily living, 81 ± 20; function/activities of daily living, 84 ± 13; sports, 65 ± 29; and function/sports, 73 ± 27. According to the function overall subscale of the Foot and Ankle Ability Measure, in two cases, the patients assessed the ankle function as normal, in three as nearly normal, and in three as abnormal (missing data, n = 1). Preoperative van Dijk scale: stage 0 in five cases and stage I in eight cases; postoperative van Dijk scale: stage 0 in four cases, stage I in 9 cases Conclusions Patient-reported outcome measures following matrix-associated autologous chondrocyte implantation and autologous bone grafting for high-stage osteochondral lesions of the talus in adolescents show heterogeneous results. Long-term limitations mainly affect sports and recreational activities. Osteochondral lesions of the talus are associated with osteoarthritis, even preoperatively. However, we did not find significant osteoarthritis progression after matrix-associated autologous chondrocyte implantation and autologous bone grafting in the long term.

Evaluation of Knee-Specific Patient-Reported Outcome Measures Using Rasch Analysis

2020 ◽  
pp. 1-8
Author(s):  
James L. Farnsworth II ◽  
Todd Evans ◽  
Helen Binkley ◽  
Minsoo Kang
Keyword(s):  
Outcome Measures ◽  
International Knee Documentation Committee ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Properties ◽  
Partial Credit Model ◽  
Convenience Sample ◽  
Specific Patient ◽  
Related Function ◽  
Patient Reported

Context: Documentation of patient outcomes following injury is critical to ensure that patients are receiving the best care. Several patient-reported outcome measures (PROMs) have been developed to assess knee-related function following injury; however, there is limited data investigating the measurement properties of these instruments using Rasch model analyses. Objective: To evaluate the measurement properties of several PROMs through application of the Rasch measurement model. Design: Cross-sectional study. Setting: Clinical setting. Patients or Other Participants: A convenience sample of 160 adults (mean age = 28.08 [10.95] y; male = 38.10%) were recruited for this study. Data collected were combined with existing pilot data from an earlier study containing de-identified Knee Injury and Osteoarthritis Outcome Score (KOOS) data from 79 adults with knee injuries resulting in a total sample size of 239 adults. Intervention(s): Psychometric evaluation of the KOOS, International Knee Documentation Committee subjective knee form, and the Marx Activity Rating Scale using the Rasch partial credit model. Main Outcome Measures: Infit and outfit statistics, item step difficulties, person ability parameters, category function, and item and test information functions. Results: Large ceiling effects were present in the KOOS and International Knee Documentation Committee subjective knee form. Of the 65 items examined in this study, 35 items showed poor measurement properties. Item step difficulty for the remaining 30 items ranged from −5.45 (least difficult) to 0.57 logits (most difficult). The 5-category response options did not function well. Measurement precision decreased significantly as ability score increased beyond 0.30 logits. Conclusions: Despite their use in clinical practice, several items showed poor measurement properties. Future studies are needed to develop and evaluate novel items that are suitable for measuring knee-related function in high-functioning populations to ensure continuity of PROMs as individuals recover from injuries.

Weight-Bearing and Non-Weight-Bearing Knee-Joint Reposition Sense and Functional Performance

2003 ◽  
Vol 12 (1) ◽  
pp. 54-66 ◽  
Author(s):  
Joshua M. Drouin ◽  
Peggy A. Houglum ◽  
David H. Perrin ◽  
Bruce M. Gansneder
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Functional Performance ◽  
Weight Bearing ◽  
Activity Level ◽  
Repeated Measures Anova ◽  
Type Design ◽  
Hop Test ◽  
The Relationship ◽  
Pearson Correlations

Objective:To determine the relationship between weight-bearing (WB) and non-weight-bearing (NWB) joint reposition sense (JRS) and a functional hop test (FH) and to compare performance on these parameters between athletes and nonathletes.Design:Repeated-measures ANOVA and Pearson correlations.Setting:Research laboratory.Participants:40 men (age = 20.8 ± 1.7 y; ht = 176.9 ± 5.8 cm; wt = 82.6 ± 9.5 kg): 20 lacrosse players and 20 nonathletes.Main Outcome Measures:Ability to actively reproduce 30° of knee flexion in the WB and NWB conditions and functional performance on a single-leg crossover-hop test.Results:No significant correlations were observed between JRS and FH in athletes and nonathletes. No significant differences were observed between athletes and nonathletes in JRS. All participants were significantly more accurate at WB than at NWB JRS.Conclusions:There appears to be no relationship between WB or NWB JRS and functional performance, regardless of one’s physical activity level

scholarly journals Protocol for The Toxin Study: Understanding clinical and patient reported response of children and young people with cerebral palsy to intramuscular lower limb Botulinum neurotoxin-A injections, exploring all domains of the ICF. A pragmatic longitudinal observational study using a prospective one-group repeated measures design

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e049542
Author(s):  
Lesley R Katchburian ◽  
Kate Oulton ◽  
Eleanor Main ◽  
Christopher Morris ◽  
Lucinda J Carr
Keyword(s):  
Outcome Measures ◽  
Lower Limb ◽  
Repeated Measures ◽  
Botulinum Neurotoxin ◽  
Botulinum Neurotoxin A ◽  
Children And Young People ◽  
Repeated Measures Design ◽  
Longitudinal Observational Study ◽  
Patient Reported

IntroductionBotulinum neurotoxin-A (BoNT-A) is an accepted treatment modality for the management of hypertonia in children and young people with cerebral palsy (CYPwCP). Nevertheless, there are concerns about the long-term effects of BoNT-A, with a lack of consensus regarding the most meaningful outcome measures to guide its use. Most evidence to date is based on short-term outcomes, related to changes at impairment level (restrictions of body functions and structures), rather than changes in adaptive skills (enabling both activity and participation). The proposed study aims to evaluate clinical and patient reported outcomes in ambulant CYPwCP receiving lower limb BoNT-A injections over a 12-month period within all domains of the WHO’s International Classification of Functioning, Disability and Health and health-related quality of life (HRQoL).Methods and analysisThis pragmatic prospective longitudinal observational study will use a one-group repeated measures design. Sixty CYPwCP, classified as Gross Motor Function Classification System (GMFCS) levels I–III, aged between 4 and 18 years, will be recruited from an established movement disorder service in London, UK. Standardised clinical and patient reported outcome measures within all ICF domains; body structures and function, activity (including quality of movement), goal attainment, participation and HRQoL, will be collected preinjection and at 6 weeks, 6 months and up to 12 months postinjection. A representative subgroup of children and carers will participate in a qualitative component of the study, exploring how their experience of BoNT-A treatment relates to clinical outcome measures.Ethics and disseminationCentral London Research Ethics Committee has granted ethics approval (#IRAS 211617 #REC 17/LO/0579). Findings will be disseminated in peer-reviewed publications, conferences and via networks to participants and relevant stakeholders using a variety of accessible formats including social media.

Recovery of Contractile Properties of the Knee-Extensor Muscles after Arthroscopic Partial Meniscectomy

2001 ◽  
Vol 10 (4) ◽  
pp. 298-307 ◽  
Author(s):  
Helena Gapeyeva ◽  
Mati Pääsuke ◽  
Jaan Ereline ◽  
Vallo Vaher ◽  
Aivar Pintsaar ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Knee Extensor ◽  
Voluntary Contraction ◽  
Partial Meniscectomy ◽  
Extensor Muscle ◽  
Knee Extensors ◽  
Arthroscopic Partial Meniscectomy ◽  
Voluntary Strength ◽  
Contractile Characteristics

Context:Contractile characteristics of the knee extensors after arthroscopic meniscectomy are poorly understood.Objective:To measure the recovery of knee-extensor-muscle contractility after arthroscopic partial meniscectomy.Design:Single-group repeated measures.Setting:Kinesiology and biomechanics laboratory.Subjects:Fourteen patients with arthroscopic partial medial meniscectomies.Main Outcome Measures:Maximal isometric voluntary contraction (MVC) force, rate of force development (MRFDES), and half-relaxation time (HRTES) of evoked tetanic contraction preoperatively and during 6 months postoperatively.Results:Two weeks postoperatively, a reduction in MVC force of 27.1% and in MRFDESof 17.8% and a prolongation of HRTESof 34.0% in the injured leg were found. A significant MVC-force deficit (17.5%) was observed 3 months postoperatively.Conclusions:The recovery of knee-extensor-muscle voluntary strength is more delayed than are evoked tetanic-contractile characteristics after partial meniscectomy. The rehabilitation protocol seems to be insufficient to attain effective recovery of knee-extensor-muscle voluntary strength.

scholarly journals Minimal Clinically Important Differences and Substantial Clinical Benefit in Patient-Reported Outcome Measures after Autologous Chondrocyte Implantation

Cartilage ◽  
2018 ◽  
Vol 11 (4) ◽  
pp. 412-422 ◽  
Author(s):  
Takahiro Ogura ◽  
Jakob Ackermann ◽  
Alexandre Barbieri Mestriner ◽  
Gergo Merkely ◽  
Andreas H. Gomoll
Keyword(s):  
Clinical Benefit ◽  
Autologous Chondrocyte Implantation ◽  
Short Form ◽  
International Knee Documentation Committee ◽  
Patient Reported Outcome ◽  
Roc Curve Analysis ◽  
Substantial Clinical Benefit ◽  
Patient Reported ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Objective We sought to determine the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) associated with the Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm, and Short Form–12 (SF-12) after autologous chondrocyte implantation (ACI). Design Ninety-two patients with satisfaction surveys at a minimum of 2 years postoperatively and at least 1 repeated patient-reported outcome measure (PROM) were analysed. The MCID was determined using 4 anchor-based methods: average change, mean change, minimally detectable change, and the optimal cutoff point for receiver operating characteristic (ROC) curves. If an anchor-based method was not applicable, standard deviation–based and effect size–based estimates were used. SCB was determined using ROC curve analysis. Results The 4 anchor-based methods provided a range of MCID values for each PROM (11-18.8 for the KOOS pain, 9.2-17.3 for the KOOS activities of daily living, 12.5-18.6 for the KOOS sport/recreation, 12.8-19.6 for the KOOS quality of life, 10.8-16.4 for the IKDC, and 6.2-8.2 for the SF-12 physical component summary). Using the 2 distribution-based methods, the following MCID value ranges were obtained: KOOS symptom, 3.6 to 8.4; the Lysholm, 4.2 to 10.5; and the SF-12 mental component summary, 1.9 to 4.6. SCB was 30 for the KOOS sport/recreation and 34.4 for the IKDC, which most accurately predict substantial improvement. No significant association was noted between SCB achievement and the baseline PROMs. Conclusion The MCID and SCB determined in our study will allow interpretation of the effects of treatment in clinical practice and trials. Given the varied MCID values in this study, standardisation of the most appropriate calculation methods is warranted.

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