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Preoperative patient-reported outcomes scores predictive of function after ACI

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SEATTLE — Preoperative IKDC and Lysholm scores can be used to predict positive patient outcomes following autologous chondrocyte implantation, according to a speaker at the American Orthopaedic Society for Sports Medicine Annual Meeting.

Christian Lattermann, MD, and researchers at the University of Kentucky evaluated 73 patients with a mean age of 35 years and a mean BMI of 30 following autologous chondrocyte implantation (ACI). Average follow-up was 2.3 years. Patient-reported outcomes (PROs) were recorded preoperatively and at 3 months, 6 months, 12 months and then annually postoperatively. Patients were asked to rate their function as severely restricted, restricted, minimally restricted, or not at all restricted at each stage. Preoperative WOMAC, IKDC, and Lysholm values along with body mass index, gender, age, and defect area and defect location were analyzed in a backwards-entry logistic regression model to predict positive outcomes

The rate of patients correctly classified as having good or poor outcomes by the model was 85.5%. Variables that influenced the final logistic model were IKDC scores higher than 35 and Lysholm scores greater than 41. According to the model, patients with a preoperative IKDC score greater than 35 were 7.4 times more likely to have a positive outcome as opposed to patients with a score less than or equal to 35. Patients with a Lysholm score greater than 41 were 8.5 times more likely to have a positive outcome than those less than or equal to 41, he said.

For patients who have values below the positive outcome indication threshold, “it is thinkable to go ahead and send these patients prior to the procedure to improve their overall scores because that may very well have an influence on the overall outcome,” Lattermann said. —by Christian Ingram

Reference:

Howard JS. Paper #28. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 10-13, 2014; Seattle.

Disclosure: Lattermann receives support from Sanofi/Genzyme, Smith & Nephew and is a board member of the International Cartilage Repair Society and The Knee Orthopaedic Journal of Sports Medicine