The patient acceptable symptomatic state for commonly used outcome scores 10 years after matrix-associated autologous chondrocyte implantation.

IF 3.3 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-03-28 DOI:10.1002/ksa.12661

Kevin-Arno Koch, Raphael Trefzer, Mustafa Hariri, Paul Mick, Tilman Walker, Stefanos Tsitlakidis, Johannes Weishorn

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引用次数: 0

Abstract

Purpose: To determine the Patient Acceptable Symptomatic State (PASS) thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), Lysholm and EuroQol 5 Dimensions (EQ-5D) scores and to identify predictors of PASS at 10 years after matrix-associated autologous chondrocyte implantation (M-ACI).

Methods: Patients who underwent M-ACI for chondral defects of the knee between 2011 and 2015 were prospectively evaluated. KOOS, IKDC, Lysholm and EQ-5D scores and anchor-based questions were assessed at baseline and at least 10 years post-operatively. PASS thresholds were determined using receiver operating characteristic (ROC) curve analyses. Multivariable binomial regression analysis was performed to determine the effect of sex, body mass index (BMI), articular cartilage maturation status and the presence of more than one previous knee surgery on the likelihood of achieving PASS.

Results: A total of 112 patients who met the inclusion criteria were evaluated at a mean of 11.3 ± 1.2 years post-operatively, with a mean age of 29.2 ± 11.0 years. The PASS thresholds for the aforementioned PROMs at 10 years were 61.9 for KOOS (Symptoms 51.8, Pain 79.2, Activities of Daily Living 87.5, Sport 57.5 and Quality of Life 59.4), 59.7 for IKDC, 61.5 for Lysholm and 82.5 for EQ-5D. The ROC curve showed good to excellent predictive value with an area under the curve (AUC) of 0.76-0.84. Male gender (odds ratio [OR] = 3.1; p = 0.016) and BMI between 20 and 29 (OR = 3.9; p = 0.004) had a positive predictive value for achieving PASS at long-term follow-up.

Conclusions: The present study determined long-term PASS thresholds for KOOS, IKDC, Lysholm and EQ-5D scores in patients undergoing M-ACI for cartilage repair at the knee. Male gender and a BMI of 20-29 were positive predictors of the likelihood of achieving PASS at 10 years. The identified PASS thresholds are critical for assessing clinical outcomes, evaluating procedural efficacy for regulatory considerations, and planning sample sizes for prospective, controlled studies.

Level of evidence: Level IV.

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基质相关自体软骨细胞植入后10年患者可接受的症状状态评分。

目的：确定膝关节损伤和骨关节炎结局评分（oos）、国际膝关节文献委员会（IKDC）、Lysholm和EuroQol 5维度（EQ-5D）评分的患者可接受症状状态（PASS）阈值，并确定基质相关自体软骨细胞植入（M-ACI）后10年PASS的预测因素。方法：对2011 - 2015年间膝关节软骨缺损行M-ACI的患者进行前瞻性评价。在基线和术后至少10年评估kos、IKDC、Lysholm和EQ-5D评分和锚定问题。采用受试者工作特征（ROC）曲线分析确定PASS阈值。进行多变量二项回归分析，以确定性别、体重指数（BMI）、关节软骨成熟状态和是否有过一次以上的膝关节手术对实现PASS的可能性的影响。结果：符合纳入标准的患者共112例，平均术后11.3±1.2年，平均年龄29.2±11.0岁。上述PROMs的10年PASS阈值为kos的61.9（症状51.8，疼痛79.2，日常生活活动87.5，运动57.5和生活质量59.4），IKDC的59.7，Lysholm的61.5和EQ-5D的82.5。ROC曲线具有较好的预测价值，曲线下面积（AUC）为0.76 ~ 0.84。男性(优势比[OR] = 3.1；p = 0.016)， BMI在20 ~ 29之间(OR = 3.9；p = 0.004)在长期随访中对PASS的实现具有积极的预测价值。结论：本研究确定了膝关节软骨修复M-ACI患者的oos、IKDC、Lysholm和EQ-5D评分的长期PASS阈值。男性性别和BMI在20-29之间是10年达到PASS可能性的积极预测因素。确定的PASS阈值对于评估临床结果、评估监管考虑的程序有效性以及规划前瞻性对照研究的样本量至关重要。证据等级：四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).