Clinical outcomes after anterior cruciate ligament injury: panther symposium ACL injury clinical outcomes consensus group

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Abstract

Purpose

A stringent outcome assessment is a key aspect for establishing evidence-based clinical guidelines for anterior cruciate ligament (ACL) injury treatment. The aim of this consensus statement was to establish what data should be reported when conducting an ACL outcome study, what specific outcome measurements should be used and at what follow-up time those outcomes should be assessed.

Methods

To establish a standardized approach to assessment of clinical outcome after ACL treatment, a consensus meeting including a multidisciplinary group of ACL experts was held at the ACL Consensus Meeting Panther Symposium, Pittsburgh, PA; USA, in June 2019. The group reached consensus on nine statements by using a modified Delphi method.

Results

In general, outcomes after ACL treatment can be divided into four robust categories—early adverse events, patient-reported outcomes, ACL graft failure/recurrent ligament disruption and clinical measures of knee function and structure. A comprehensive assessment following ACL treatment should aim to provide a complete overview of the treatment result, optimally including the various aspects of outcome categories. For most research questions, a minimum follow-up of 2 years with an optimal follow-up rate of 80% is necessary to achieve a comprehensive assessment. This should include clinical examination, any sustained re-injuries, validated knee-specific PROs and Health-Related Quality of Life questionnaires. In the mid- to long-term follow-up, the presence of osteoarthritis should be evaluated.

Conclusion

This consensus paper provides practical guidelines for how the aforementioned entities of outcomes should be reported and suggests the preferred tools for a reliable and valid assessment of outcome after ACL treatment.

Level of evidence

Electronic supplementary material

The online version of this article (10.1007/s00167-020-06061-x) contains supplementary material, which is available to authorized users.

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Most cited references 100

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The ASA's Statement onp-Values: Context, Process, and Purpose

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Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.

Amelia J Wiggins, Ravi K Grandhi, Daniel Schneider … (2016)

Injury to the ipsilateral graft used for reconstruction of the anterior cruciate ligament (ACL) or a new injury to the contralateral ACL are disastrous outcomes after successful ACL reconstruction (ACLR), rehabilitation, and return to activity. Studies reporting ACL reinjury rates in younger active populations are emerging in the literature, but these data have not yet been comprehensively synthesized.

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Author and article information

Contributors

Eleonor Svantesson:

ORCID: http://orcid.org/0000-0002-6669-5277

eleonor.svantesson@outlook.com

Journal

Journal ID (nlm-ta): Knee Surg Sports Traumatol Arthrosc

Journal ID (iso-abbrev): Knee Surg Sports Traumatol Arthrosc

Title: Knee Surgery, Sports Traumatology, Arthroscopy

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0942-2056

ISSN (Electronic): 1433-7347

Publication date (Electronic): 6 August 2020

Publication date PMC-release: 6 August 2020

Publication date (Print): 2020

Volume: 28

Issue: 8

Pages: 2415-2434

Affiliations

[1 ]GRID grid.8761.8, ISNI 0000 0000 9919 9582, Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, , University of Gothenburg, ; Gothenburg, Sweden

[2 ]Gothenburg Sports and Trauma Research Center, Gothenburg, Sweden

[3 ]GRID grid.8761.8, ISNI 0000 0000 9919 9582, Department of Rehabilitation and Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, , University of Gothenburg, ; Gothenburg, Sweden

[4 ]GRID grid.1018.8, ISNI 0000 0001 2342 0938, School of Allied Health, , La Trobe University, ; Melbourne, VIC Australia

[5 ]GRID grid.1649.a, ISNI 000000009445082X, Department of Orthopaedics, , Sahlgrenska University Hospital, ; Mölndal, Sweden

[6 ]GRID grid.15474.33, ISNI 0000 0004 0477 2438, Department of Sportorthopedics, , Klinikum rechts der Isar Technische Universitat Munchen, ; Munich, Germany

[7 ]GRID grid.21925.3d, ISNI 0000 0004 1936 9000, UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, , University of Pittsburgh, ; 3200 S Water St, Pittsburgh, 15203 PA USA

[8 ]GRID grid.411024.2, ISNI 0000 0001 2175 4264, Department of Orthopaedics, , University of Maryland School of Medicine, ; Baltimore, MD USA

[9 ]GRID grid.412004.3, ISNI 0000 0004 0478 9977, Department of Trauma Surgery, , University Hospital Zurich, ; Zurich, Switzerland

[10 ]GRID grid.412689.0, ISNI 0000 0001 0650 7433, Department of Orthopaedic Surgery, , University of Pittsburgh Medical Center, ; Pittsburgh, PA USA

[11 ]GRID grid.21925.3d, ISNI 0000 0004 1936 9000, Department of Physical Therapy, , University of Pittsburgh, ; Pittsburgh, PA USA

[12 ]GRID grid.239578.2, ISNI 0000 0001 0675 4725, Cleveland Clinic Sports Health Center, ; Garfield Heights, OH USA

[13 ]GRID grid.266102.1, ISNI 0000 0001 2297 6811, Department of Orthopedic Surgery, , University of California, ; San Francisco, California USA

Author information

Eleonor Svantesson http://orcid.org/0000-0002-6669-5277

Article

Publisher ID: 6061

DOI: 10.1007/s00167-020-06061-x

PMC ID: 7429530

PubMed ID: 32767052

SO-VID: 69fb9912-3161-4215-ace3-8f127a1b550d

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 22 March 2020

Date accepted : 10 May 2020

Funding

Funded by: Smith & Nephew

Funded by: UPMC

Funded by: Elizur

Funded by: Artrex

Funded by: Conmed

Funded by: DJO global

Funded by: Mid Atlantic surgical systems

Funded by: RTI surgical

Funded by: BlackRhino Medical

Custom metadata

ScienceOpen disciplines: Surgery

Keywords: acl,anterior cruciate ligament,outcome,consensus statement,reconstruction

Data availability:

ScienceOpen disciplines: Surgery

Keywords: acl, anterior cruciate ligament, outcome, consensus statement, reconstruction

Clinical outcomes after anterior cruciate ligament injury: panther symposium ACL injury clinical outcomes consensus group

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Purpose

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Conclusion

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Electronic supplementary material

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ScienceOpen Clinical Case Reports Collection

Most cited references 100

The ASA's Statement onp-Values: Context, Process, and Purpose

Measurement of health status. Ascertaining the minimal clinically important difference.

Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.

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