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Knee Function Assessment in Patients With Meniscus Injury: A Preliminary Study of Reproducibility, Response to Treatment, and Correlation With Patient-Reported Questionnaire Outcomes.

Naimark MB, Kegel G, O'Donnell T, Lavigne S, Heveran C, Crawford DC - Orthop J Sports Med (2014)

Bottom Line: Performance on all tests improved significantly with surgery (P < .05), with the greatest improvement in sit-to-stand and stair ascent and descent.A greater percentage response to surgery was seen on questionnaire outcomes (20%-65%) than on performance-based tests (3%-15%).Moderate to poor correlations existed between the KOOS activities of daily living subscale and the performance-based tests (all ICCs ≤ 0.4).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California, USA.

ABSTRACT

Background: Outcomes of meniscus surgery are typically assessed with patient questionnaires that help capture symptoms and functional limitations but may not provide an accurate representation of underlying joint health. There are currently no performance-based measures of knee function in patients with symptomatic meniscus injury.

Purpose: To assess the reproducibility, response to partial meniscectomy, and correlation with patient-reported questionnaire outcomes of novel performance-based knee function tests.

Study design: Cohort study (diagnosis); Level of evidence, 2.

Methods: A battery of 9 tests for activities that require knee movements essential for everyday living was developed. Intra- and interrater reproducibility was assessed in 50 meniscus tear patients completing the battery at 2 preoperative assessments with either the same or different examiners. Response to arthroscopic partial meniscectomy was evaluated in 35 of these patients 6 weeks after surgery. Subjects also completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) questionnaires pre- and postoperatively.

Results: The intrarater intraclass correlation coefficients (ICCs) were excellent for all tests (ICC > 0.8). Interrater ICC > 0.8 was observed for step-down, stair descent, star lunges, and timed treadmill travel. Performance on all tests improved significantly with surgery (P < .05), with the greatest improvement in sit-to-stand and stair ascent and descent. A greater percentage response to surgery was seen on questionnaire outcomes (20%-65%) than on performance-based tests (3%-15%). Moderate to poor correlations existed between the KOOS activities of daily living subscale and the performance-based tests (all ICCs ≤ 0.4).

Conclusion: Performance-based knee function tests demonstrated good reproducibility and responsiveness in patients undergoing partial meniscectomy.

Clinical relevance: As both patient perception and functional performance are determinants of patient outcomes, questionnaires and performance-based tests could be used simultaneously to provide complementary data to monitor short- and long-term outcomes after meniscus surgery.

No MeSH data available.


Related in: MedlinePlus

Performance-based knee function assessments. (A) Active/passive range of motion; (B) sit-to-stand; (C) stair ascent; (D) stair descent; (E) step-up; (F) step-down; (G) star lunges; (H) 6-minute treadmill travel.
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fig1-2325967114550987: Performance-based knee function assessments. (A) Active/passive range of motion; (B) sit-to-stand; (C) stair ascent; (D) stair descent; (E) step-up; (F) step-down; (G) star lunges; (H) 6-minute treadmill travel.

Mentions: ROM was assessed by international goniometer, as described by Lin et al.13 With the patient supine, the observer centered the pivot point of the goniometer over the lateral femoral condyle, aligning the goniometer’s stationary arm with the greater trochanter and the mobile arm with the lateral malleolus (Figure 1A). For active ROM, patients maximally extended and flexed their injured knee without assistance from the observer or use of the upper extremities. For passive ROM, the observer moved the patient’s knee from full extension to full flexion. ROM was computed as the degrees of arc between full extension and full flexion.


Knee Function Assessment in Patients With Meniscus Injury: A Preliminary Study of Reproducibility, Response to Treatment, and Correlation With Patient-Reported Questionnaire Outcomes.

Naimark MB, Kegel G, O'Donnell T, Lavigne S, Heveran C, Crawford DC - Orthop J Sports Med (2014)

Performance-based knee function assessments. (A) Active/passive range of motion; (B) sit-to-stand; (C) stair ascent; (D) stair descent; (E) step-up; (F) step-down; (G) star lunges; (H) 6-minute treadmill travel.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555631&req=5

fig1-2325967114550987: Performance-based knee function assessments. (A) Active/passive range of motion; (B) sit-to-stand; (C) stair ascent; (D) stair descent; (E) step-up; (F) step-down; (G) star lunges; (H) 6-minute treadmill travel.
Mentions: ROM was assessed by international goniometer, as described by Lin et al.13 With the patient supine, the observer centered the pivot point of the goniometer over the lateral femoral condyle, aligning the goniometer’s stationary arm with the greater trochanter and the mobile arm with the lateral malleolus (Figure 1A). For active ROM, patients maximally extended and flexed their injured knee without assistance from the observer or use of the upper extremities. For passive ROM, the observer moved the patient’s knee from full extension to full flexion. ROM was computed as the degrees of arc between full extension and full flexion.

Bottom Line: Performance on all tests improved significantly with surgery (P < .05), with the greatest improvement in sit-to-stand and stair ascent and descent.A greater percentage response to surgery was seen on questionnaire outcomes (20%-65%) than on performance-based tests (3%-15%).Moderate to poor correlations existed between the KOOS activities of daily living subscale and the performance-based tests (all ICCs ≤ 0.4).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California, USA.

ABSTRACT

Background: Outcomes of meniscus surgery are typically assessed with patient questionnaires that help capture symptoms and functional limitations but may not provide an accurate representation of underlying joint health. There are currently no performance-based measures of knee function in patients with symptomatic meniscus injury.

Purpose: To assess the reproducibility, response to partial meniscectomy, and correlation with patient-reported questionnaire outcomes of novel performance-based knee function tests.

Study design: Cohort study (diagnosis); Level of evidence, 2.

Methods: A battery of 9 tests for activities that require knee movements essential for everyday living was developed. Intra- and interrater reproducibility was assessed in 50 meniscus tear patients completing the battery at 2 preoperative assessments with either the same or different examiners. Response to arthroscopic partial meniscectomy was evaluated in 35 of these patients 6 weeks after surgery. Subjects also completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) questionnaires pre- and postoperatively.

Results: The intrarater intraclass correlation coefficients (ICCs) were excellent for all tests (ICC > 0.8). Interrater ICC > 0.8 was observed for step-down, stair descent, star lunges, and timed treadmill travel. Performance on all tests improved significantly with surgery (P < .05), with the greatest improvement in sit-to-stand and stair ascent and descent. A greater percentage response to surgery was seen on questionnaire outcomes (20%-65%) than on performance-based tests (3%-15%). Moderate to poor correlations existed between the KOOS activities of daily living subscale and the performance-based tests (all ICCs ≤ 0.4).

Conclusion: Performance-based knee function tests demonstrated good reproducibility and responsiveness in patients undergoing partial meniscectomy.

Clinical relevance: As both patient perception and functional performance are determinants of patient outcomes, questionnaires and performance-based tests could be used simultaneously to provide complementary data to monitor short- and long-term outcomes after meniscus surgery.

No MeSH data available.


Related in: MedlinePlus