Clinical Outcomes After Anterior Cruciate Ligament Injury: Panther Symposium ACL Injury Clinical Outcomes Consensus Group
Eleonor Svantesson, Eric Hamrin Senorski, Kate E. Webster, Jón Karlsson, Theresa Diermeier, Benjamin B. Rothrauff, Sean J. Meredith, Thomas Rauer, James J. Irrgang, Kurt P. Spindler, C. Benjamin, Volker Musahl, Freddie H. Fu, Olufemi R. Ayeni, Francesco Della Villa, Stefano Della Villa, Scott F. Dye, Mário Ferretti, Alan Getgood, Timo Järvelä, Christopher C. Kaeding, Ryosuke Kuroda, Bryson P. Lesniak, Robert G. Marx, Gregory B. Maletis, Leo A. Pinczewski, Anil S. Ranawat, Bruce Reider, Romain Seil, Carola F. van Eck, Brian R. Wolf, Patrick Shu‐Hang Yung, Stefano Zaffagnini, Minghao Zheng
Abstract
A stringent outcome assessment is a key aspect of establishing evidence-based clinical guidelines for anterior cruciate ligament (ACL) injury treatment. To establish a standardized 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, Pennsylvania, USA, in June 2019. The aim was to establish a consensus on 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. The group reached consensus on 9 statements by using a modified Delphi method. In general, outcomes after ACL treatment can be divided into 4 robust categories: early adverse events, patient-reported outcomes (PROs), ACL graft failure/recurrent ligament disruption, and clinical measures of knee function and structure. A comprehensive assessment after 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 reinjuries, validated knee-specific PROs, and health-related quality of life questionnaires. In the midterm to long-term follow-up, the presence of osteoarthritis should be evaluated. 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.