Age-, Sex-, and Graft-Specific Reference Values From 783 Adolescent Patients at 5 to 7 Months After ACL Reconstruction: IKDC, Pedi-IKDC, KOOS, ACL-RSI, Single-Leg Hop, and Thigh Strength
Christopher Kuenze, Adam Weaver, Terry L. Grindstaff, Sophia Ulman, Grant E. Norte, Dylan P. Roman, Nicholas Giampetruzzi, Caroline Lisee, Thomas Birchmeier, Ashley Triplett, Brooke Farmer, Haleigh Hopper, David A. Sherman, Brandon M. Ness, Katherine Collins, Michelle Walaszek, Shelby Baez, Matthew S. Harkey, Kirsten Tulchin‐Francis, Henry B. Ellis, Philip L. Wilson, Edward S. Chang, C. Luke Wilcox, Andrew Schorfhaar, Michael Shingles, Joseph M. Hart
Abstract
OBJECTIVE: To describe age-, sex-, and graft source-specific reference values for patient-reported, physical function, and strength outcome measures in adolescents at 5 to 7 months after anterior cruciate ligament reconstruction. DESIGN: Cross-sectional study. METHODS: Data were collected at 3 universities and 2 children's hospitals. The participants completed at least one of the International Knee Documentation Committee (IKDC) Subjective Evaluation Form, Pediatric IKDC (Pedi-IKDC), Knee Injury and Osteoarthritis Outcomes Score (KOOS), and Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) Scale. Participants also completed single-leg hop tests and/or isokinetic quadriceps and hamstrings strength assessments (at 60°/s). Reference values were summarized using descriptive statistics and stratified for age, sex, and graft source. RESULTS: Reference values were reported for common patient-reported outcomes and measures of physical function and strength from 783 participants (56% females, age = 16. 4 ± 2.0 years) who were in early adolescence (12–14 years, N = 183, 52% females), middle adolescence (15–17 years, N = 456, 58% females), or late adolescence (18–20 years, N = 144, 55% females). Three hundred seventy-nine participants (48.4%) received a bone-patellar tendon-bone autograft, 292 participants (37.3%) received hamstring tendon autograft, and 112 participants (14.3%) received autograft or allograft from an alternative source. CONCLUSION: Reference values for common patient-reported outcomes and measures of physical function and strength differed depending on a patient's age, sex, and graft source. Using patient-specific reference values, in addition to previously described age-appropriate cutoff values, may help clinicians monitor and progress patients through rehabilitation and return to physical activity after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 2023;53(4):194–201. Epub: 23 January 2023. doi:10.2519/jospt.2023.11389