Male Sex, Younger Age, Lower Body Mass Index, Athletes, Shorter Time From Injury to Surgery, and Non-contact Injury Are Associated With Achieving the Thresholds for Substantial Clinical Benefit for Patient-Reported Outcome Measures After Primary Anterior Cruciate Ligament Reconstruction.

Purpose: To determine the thresholds for substantial clinical benefit (SCB) for patient-reported outcome measures (PROMs) and to identify potential factors associated with achieving the SCB thresholds after primary anterior cruciate ligament reconstruction (ACLR).

Methods: Patients who underwent primary single-bundle ACLR using hamstring tendon autografts at our institute were included. The collected PROMs included the visual analog scale for pain, Tegner Activity Scale (Tegner score), modified Lysholm Knee Scoring Scale (Lysholm score), and International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form (IKDC score). The SCB thresholds for PROM improvements and raw postoperative PROM scores were determined based on patient responses to an anchor question. Multivariable logistic regression analyses were performed to identify factors associated with achieving the SCB thresholds.

Results: A total of 382 patients with a minimum 4-year follow-up were included in this study. The SCB thresholds for PROM improvements and raw postoperative PROM scores were determined to be 2 and 1.5, respectively, for the visual analog scale pain score; 3 and 3.5, respectively, for the Tegner score; 24.2 and 81.5, respectively, for the Lysholm score; and 27.2 and 77.6, respectively, for the IKDC score. Male sex (P = .0050 for raw postoperative score), younger age (P = .0249 for score improvement, P = .0075 for raw postoperative score), athletes (P = .0001 for score improvement), and non-contact injury (P = .0034 for raw postoperative score) were associated with increased odds of achieving the SCB threshold for the Tegner score. Higher body mass index was associated with decreased odds of achieving the SCB thresholds for both the raw postoperative Lysholm score (P = .0009) and Lysholm score improvement (P = .0036). A longer time from injury to surgery was associated with decreased odds of achieving the SCB threshold for IKDC score improvement (P = .0006).

Conclusions: The SCB thresholds for PROM improvements and raw postoperative PROM scores were determined after primary ACLR. Male sex, younger age, lower body mass index, athletes, shorter time from injury to surgery, and non-contact injury were associated with increased odds of achieving the SCB thresholds.

Level of evidence: Level IV, case series.