Document Title: Hrubesch-AJSM-Nov00

Article Title: Comparison of score evaluations and instrumented measurement after anterior cruciate ligament reconstruction

Author: Ralph Hrubesch, Christoph Rangger, Markus Reichkendler, Romed Franz Sailer, et al.

Publication: The American Journal of Sports Medicine

ISSN: 03635465

Date: November-December 2000.

(Figures included. Reference-denoting numbers appear in the same point size as document text.)

Volume: 28

Issue: 6

Pages: 850-856

Key Words: Knee, statistical analysis, ligaments, ACL, reconstruction.

 

Hrubesch et al. note the differences in how the various serviceability-rating scales that are commonly used when evaluating ACL-reconstructed knees record parameters indicative of knee functioning, and delve into the issues underlying the need for inter-rating-system universality and consistency. The reader is assumed to have an understanding of some aspects of statistics.

 

Full Text

 

ABSTRACT

Forty-four patients who had undergone unilateral anterior cruciate ligament reconstructions were evaluated retrospectively with seven different scoring systems (international Knee Documentation Committee, Orthopadische Arbeitsgruppe Knie, Lysholm, Feagin and Blake, Zarins and Rowe, Cincinnati, and Marshall scores). The results varied between systems and were therefore unreliable. Of the 44 patients, 32 were rated as excellent according to the Cincinnati score while only 3 patients were rated as normal according to the International Knee Documentation Committee form. Good and excellent results were found twice as frequently with the Cincinnati and Lysholm scores compared with the scores of Zarins and Rowe or the International Knee Documentation Committee form. Statistical analysis confirmed this observation and revealed significant differences between the scoring systems. Side-to-side differences using the manual maximum displacement test with the KT-1 000 arthrometer revealed good correlation with the International Knee Documentation Committee and the Orthopaedische Arbeitsgruppe Knie questionnaires. None of the other scoring systems, which do not measure anterior laxity, produced reasonable correlation with instrumented measurements. We found that certain population-specific factors as well as the distribution of single findings can distort the results of scoring systems. To avoid these interference factors, the patient sample should be homogeneous and selected prospectively and there should be agreement about the value of single findings.

 

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