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Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.

Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.

Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.

Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.

Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.



NAVIGATION


         

 

Background: The International Knee Documentation Committee Subjective Knee Evaluation Form is a knee-specific instrument composed of 18 questions. It is commonly used in adult and pediatric studies as a surgical outcome measure. Normative data exist for an adult population, but there have been no published normative results for younger subjects.

Purpose: To compile and report pilot normative International Knee Documentation Committee Subjective Knee Evaluation Form scores in a preadolescent population.

Study Design: Cross-sectional study; Level of evidence, 3.

Methods: The International Knee Documentation Committee Subjective Knee Evaluation Form was administered to 146 seventh-grade students (aged 12–14 years) at 2 local schools. The form was administered in its original format. Demographic and descriptive results were compiled.

Results: One hundred twenty-five completed responses were eligible for analysis. The mean age was 13.2 years (SD, 0.5; range, 12.2–14.2 years); 15% of participants had a history of knee injury or pain. The mean International Knee Documentation Committee score for all respondents was 89.4 (SD, 10.5; 95% confidence interval, 87.6–91.3; range, 52–100).

Conclusion: This study provides pilot normative data for mean International Knee Documentation Committee scores in a preadolescent population. The mean score in this younger cohort is consistent with normative data of adults age 35 years or younger. Although the International Knee Documentation Committee Subjective Knee Evaluation Form is often used in adolescent surgical studies, its validity in these populations remains to be established. Further work to establish the psychometric properties of the current form in younger age groups would be of significant benefit to clinicians.




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