Article

Health-related quality of life in patients with an anterior cruciate ligament injury.

The Sports Medicine and Knee Center, National Hospital Organization, Kofu National Hospital, 11-35 Tenjin-cho, Kofu, Yamanashi, Japan.
Archives of Orthopaedic and Trauma Surgery (impact factor: 1.37). 09/2009; 130(3):397-9. DOI:10.1007/s00402-009-0964-z pp.397-9
Source: PubMed

ABSTRACT We evaluated the quality of life (QOL) in patients with an anterior cruciate ligament injury through SF-36 survey, which was a global health-related QOL survey, and investigated the correlation of its results with other clinical parameters.
Fifty-one patients (mean age 28.7 years) with an anterior cruciate ligament injury were studied. Clinical evaluations using SF-36 version 2 and Lysholm scoring system were conducted, and the ratio of anterior tibial translation in affected compared to unaffected knees was obtained.
In SF-36 survey, scores of both physical and mental health summary measures in our subjects were lower than the national standard values. The mean ratio of anterior tibial translation was 7.8 +/- 6.0, and no correlation with SF-36 scores was observed. The mean Lysholm score was 53.3 +/- 17.1; which tended to be correlated with the mental health score of SF-36, but not with the physical health score.
Our results clearly demonstrated that patients with an anterior cruciate ligament injury had a deterioration of mental health as well as physical health.

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    Article: Determining utility values in patients with anterior cruciate ligament tears using clinical scoring systems.
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    ABSTRACT: Several instruments and clinical scoring systems have been established to evaluate patients with ligamentous knee injuries. A comparison of individual articles in the literature is challenging, not only because of heterogeneity in methodology, but also due to the variety of the scoring systems used to document clinical outcomes. There is limited information about the correlation between used scores and quality of life with no information being available on the impact of each score on the utility values. The aim of this study was to compare the most commonly used scores for evaluating patients with anterior cruciate ligament (ACL) injuries, and to establish corresponding utility values. These values will be used for the interpretation and comparison of outcome results in the currently available literature for different treatment options. Four hypothetical vignettes were defined, based on different levels of activities after rupture of the ACL to simulate typical situations seen in daily practice. A questionnaire, including the Health Utility Index (HUI) for utility values, the IKDC subjective score, the Lysholm and the Tegner score, was created and 25 orthopedic surgeons were asked to fill the questionnaire for each hypothetical patient as proxies for all patients they had treated and who would fit in that hypothetical vignette. The utility value as an indicator for quality of life increased with the level of activity. Having discomforts already during normal activities of daily living was rated with a mean utility value of 0.37 ± 0.19, half of that of a situation where mild sport activity was possible without discomfort (0.78 ± 0.11). All investigated scores were able to distinguish clearly (p < 0.05) between the hypothetical vignettes. However, the utility values correlated best with the IKDC subjective score (r = 0.86, p < 0.001) followed by the Lysholm score (r = 0.77, p < 0.001) and the Tegner score (r = 0.77, p < 0.001). Here we report the correlation between the most commonly used scores for the assessment of patients with a ruptured ACL and utility values as an indicator of quality of life. Assumptions were based on expert opinions to provide a possible transformation algorithm. The IKDC subjective knee score showed the highest correlation to the quality of life (i.e. HUI) in patients with a ruptured ACL. Confirmation of our results is needed by systematic inclusion of a measurement instrument for utility values in future clinical studies beside the already used clinical knee scoring systems.
    BMC Health Services Research 01/2011; 11:182. · 1.66 Impact Factor

Keywords

anterior cruciate ligament injury
 
anterior tibial translation
 
Clinical evaluations
 
clinical parameters
 
correlated
 
global health-related QOL survey
 
Lysholm
 
mean Lysholm score
 
mental health
 
mental health score
 
mental health summary measures
 
physical
 
physical health
 
physical health score
 
QOL
 
scores
 
SF-36 scores
 
SF-36 survey
 
SF-36 version 2