Tag: ACL

Patients May Not Feel As Good As They Look On PaperPatients May Not Feel As Good As They Look On Paper

It Is Good To Feel Better, But Better To Feel Good: Whether A Patient Finds Treatment ‘Successful’ Or Not Depends On The Questions Researchers AskRoos EM, Boyle E, Frobell RB, Lohmander LS, Ingelsrud LH. Br J Sports Med. 2019 Apr. doi:10.1136/ bjsports-2018-100260. Epub Ahead of Print https://www.ncbi.nlm.nih.gov/pubmed/31072841 Take Home Message:While patients may exceed minimal important change on patient-reported outcome scores after an ACL injury, many feel their treatment was unsuccessful. We commonly use patient-reported outcome (PRO) measures in clinical trials to determine the success or failure of a treatment regimen after a musculoskeletal injury. Several PROs are readily available to clinicians, yet these measurements often focus on a patient’s functional ability or symptoms and not their satisfaction with how they feel after treatment.  When clinicians focus on a change score from baseline to follow-up it tells them if a patient is “feeling better,” but not if a patient “feels good.” It’s important to appreciate how these different ways to interpret PROs may alter the reported benefit of a treatment. Hence, the authors applied three different criteria to determine responders and non-responders in the KANON trial, which was a high-quality randomized trial that compared (1) exercise therapy and early anterior cruciate ligament reconstruction…

PASS Passes to Evaluate Success of Anterior Cruciate Ligament ReconstructionPASS Passes to Evaluate Success of Anterior Cruciate Ligament Reconstruction

Prospective Evaluation of the Patient Acceptable Symptom State to Identify Clinically Successful Anterior Cruciate Ligament Reconstruction        Vega JF, Jacobs CA, Strnad GJ, Farrow L, Jones MH, Miniaci A, Parker RD, Rosneck J, Saluan P, Williams JS, Spindler KP. Am J Sports Med. 2019 [Epub ahead of print]https://journals.sagepub.com/doi/full/10.1177/0363546519831008Take Home Message: A single Patient Acceptable Symptom State question may be enough to identify a patient who views their knee recovery as unsuccessful after an anterior cruciate ligament reconstruction. Many clinicians omit patient-reported outcome measuresduring evaluations because they are at least in part to time consuming. For example, the Knee Injury and Osteoarthritis Outcome Score (KOOS), which is commonly used following an anterior cruciate ligament reconstruction to measure a patient’s view of their recovery, has over 40 questions. One way to reduce the burden on a patient is to use a single-item, patient-reported outcome measure such as the Patient Acceptable Symptom State (PASS). However, there has been no research to determine if a PASS question could be a surrogate for a lengthier joint-specific patient-reported outcome measure. Hence, the authors conducted a cohort study to determine if the response to a PASS question would relate to a successful outcome 1 year after an…

Repair may be Just as Good as ReconstructionRepair may be Just as Good as Reconstruction

Acute Anterior Cruciate Ligament Rupture: Repair or Reconstruction?Hoogeslag RAG, Brouwer RW, Boer BC, de Vries AJ, and Huis in ‘t Veld H. Am J Sports Med. 2019. [Epub Ahead of Print].https://journals.sagepub.com/doi/abs/10.1177/0363546519825878Take Home Message: People who receive a dynamic augmented anterior cruciate ligament (ACL) repair have similar outcomes to those who receive an ACL reconstruction during the first 2 years after surgeryMany clinicians have discussed the pros and cons of a surgical reconstruction or conservative care for an anterior cruciate ligament (ACL) rupture. In recent years, there has also been a renewed interest in re-assessing suture repair of a ruptured ACL. Therefore, Hoogeslag and colleagues completed a randomized trial to examine patient-reported, clinical, and radiological outcomes among young adults receiving a dynamic augmented ACL repair or ACL reconstruction.Read more »…

BEAR in Mind: There’s a New ACL Repair Technique on the BlockBEAR in Mind: There’s a New ACL Repair Technique on the Block

Bridge-Enhanced Anterior Cruciate Ligament Repair: Two-year results of a first-in-human studyMurray MM, Kalish LA, Fleming BC, Proffen BL, Ecklund K, Kramer DE, Yen YM, & Micheli LJ.  Ortho J Sports Med. 2019; 7(3).  DOI: 10.1177/2325967118824356  https://journals.sagepub.com/doi/abs/10.1177/2325967118824356Take Home Message: Bridge-enhanced anterior cruciate ligament repair is producing similar outcomes to hamstring autograft reconstruction up to 2 years post-surgery. Anterior cruciate ligament (ACL) surgical reconstruction techniques are evolving to improve short- and long-term outcomes for patients after surgery.  A newer approach that is getting a lot of attention is the bridge-enhanced anterior cruciate ligament repair(BEAR). To perform a BEAR, a surgeon repairs the ACL with sutures and a scaffold to promote optimal alignment and healing.  Before large clinical trials can be performed with this new procedure it is critical to have initial results to ensure it is safe and potentially beneficial. Hence, the authors conducted an observational cohort study of 10 participants who received a BEAR and 10 who received a hamstring autograft ACL reconstruction to assess physical exam findings, patient-reported outcomes, and adverse events at one and two years after surgery.Read more »…

Let’s Chat: 1 in 8 Patients Are Diagnosed with Osteoarthritis within 5 Years of an ACL ReconstructionLet’s Chat: 1 in 8 Patients Are Diagnosed with Osteoarthritis within 5 Years of an ACL Reconstruction

Post-traumatic osteoarthritis diagnosed within 5 years following ACL reconstructionBodkin SG, Werner BC, Slater LV, and Hart JM. Knee Surg Sports Traumatol Arthrosc. 2019. [Epub Ahead of Print].https://link.springer.com/article/10.1007%2Fs00167-019-05461-y  Take Home Message: Almost 1 in 8 patients seek medical care and are diagnosed with knee osteoarthritis within 5 years of an anterior cruciate ligament reconstruction.Anterior cruciate ligament (ACL) rupture can lead to long-term changes in joint health and greatly affect an person’s short- and long-term quality of life. However, most studies have relied on sending surveys or inviting former patients back for an evaluation. Few studies have used large samples of healthcare data to identify people who are diagnosed with symptomatic knee osteoarthritis and seeking medical care. Therefore, Bodkin and colleagues completed an analysis of a national insurance-based, for-fee database of patient records to calculate the incidence of osteoarthritis following an ACL reconstruction and examine the risk factors related with osteoarthritis development.Read more »…