The Delaware-Oslo ACL Cohort treatment algorithm yields superior outcomes to usual care 9-12 years after anterior cruciate ligament reconstruction.

Autor: Urhausen AP; Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway., Grindem H; Oslo Sport Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway., Engebretsen L; Oslo Sport Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.; Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway., Grävare Silbernagel K; Department of Physical Therapy, University of Delaware, Newark, Delaware, USA., Axe MJ; Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.; First State Orthopaedics, Newark, Delaware, USA., Snyder-Mackler L; Department of Physical Therapy, University of Delaware, Newark, Delaware, USA., Risberg MA; Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.; Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2024 Feb; Vol. 32 (2), pp. 214-222. Date of Electronic Publication: 2024 Jan 14.
DOI: 10.1002/ksa.12039
Abstrakt: Purpose: Patient-reported outcomes were compared between participants who followed the treatment algorithm of the Delaware-Oslo ACL Cohort, consisting of progressive preoperative and postoperative rehabilitation, patient education, clinical testing and shared decision-making about treatment choice, and those who followed usual care 9-12 years after anterior cruciate ligament reconstruction (ACLR).
Methods: Participants with primary ACLR were included from the Norwegian arm of the Delaware-Oslo ACL Cohort and the Norwegian Knee Ligament Registry (usual care). The Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale scores and the International Knee Documentation Committee-Subjective Knee Form (IKDC-SKF) scores were compared. KOOS scores for the usual care group were converted to IKDC-SKF scores with recently published validated crosswalk. The percentages of participants with scores above predefined thresholds for patient acceptable symptom state (PASS) were also calculated.
Results: Eighty of 100 (80%) participants from the Delaware-Oslo ACL Cohort and 1588 of 3248 (49%) from the usual care group participated in the follow-up. Participants from the Delaware-Oslo ACL Cohort had higher KOOS subscale (p < 0.001) and IKDC-SKF scores (p < 0.001), and a higher percentage reached PASS (84%-96% vs. 62%-76%, p ≤ 0.002) for KOOS Pain, symptoms, activities of daily living and sports compared to the usual care group. No significant differences were found for KOOS quality of life scores (not significant [n.s.]) or PASS percentages (80% vs. 74%, n.s.).
Conclusion: Participants with ACLR who followed the Delaware-Oslo ACL Cohort treatment algorithm had reduced knee symptoms, superior function and higher percentages of satisfactory outcomes than participants who followed usual care.
Level of Evidence: Level II.
(© 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)
Databáze: MEDLINE
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