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KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study.

Publication ,  Journal Article
Wasserstein, D; Huston, LJ; Nwosu, S; MOON Group; Kaeding, CC; Parker, RD; Wright, RW; Andrish, JT; Marx, RG; Amendola, A; Wolf, BR; Dunn, WR ...
Published in: Osteoarthritis Cartilage
October 2015

OBJECTIVE: The prevalence of radiographic osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR) approaches 50%, yet the prevalence of significant knee pain is unknown. We applied three different models of Knee injury and Osteoarthritis Outcome Score (KOOS) thresholds for significant knee pain to an ACLR cohort to identify prevalence and risk factors. DESIGN: Multicenter Orthopaedic Outcomes Network (MOON) prospective cohort patients with a unilateral primary ACLR and normal contralateral knee were assessed at 2 and 6 years. Independent variables included patient demographics, validated Patient Reported Outcomes (PRO; Marx activity score, KOOS), and surgical characteristics. Models included: (1) KOOS criteria for a painful knee = quality of life subscale <87.5 and ≥2 of: KOOSpain <86.1, KOOSsymptoms <85.7, KOOSADL <86.8, or KOOSsports/rec <85.0; (2) KOOSpain subscale score ≤72 (≥2 standard deviations below population mean); (3) 10-point KOOSpain drop from 2 to 6 years. Proportional odds models (alpha ≤ 0.05) were used. RESULTS: 1761 patients of median age 23 years, median body mass index (BMI) 24.8 kg/m(2) and 56% male met inclusion, with 87% (1530/1761) and 86% (1506/1761) follow-up at 2 and 6 years, respectively. At 6 years, n = 592 (39%), n = 131 (9%) and n = 169 (12%) met criteria for models #1 through #3, respectively. The most consistent and strongest independent risk factor at both time-points was subsequent ipsilateral knee surgery. Low 2-year Marx activity score increased the odds of a painful knee at 6 years. CONCLUSIONS: Significant knee pain is prevalent after ACLR; with those who undergo subsequent ipsilateral surgery at greatest risk. The relationship between pain and structural OA warrants further study.

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Published In

Osteoarthritis Cartilage

DOI

EISSN

1522-9653

Publication Date

October 2015

Volume

23

Issue

10

Start / End Page

1674 / 1684

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Surveys and Questionnaires
  • Quality of Life
  • Prospective Studies
  • Prevalence
  • Osteoarthritis, Knee
  • Male
  • Longitudinal Studies
  • Knee Injuries
 

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Wasserstein, D., Huston, L. J., Nwosu, S., MOON Group, ., Kaeding, C. C., Parker, R. D., … Spindler, K. P. (2015). KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study. Osteoarthritis Cartilage, 23(10), 1674–1684. https://doi.org/10.1016/j.joca.2015.05.025
Wasserstein, D., L. J. Huston, S. Nwosu, S. MOON Group, C. C. Kaeding, R. D. Parker, R. W. Wright, et al. “KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study.Osteoarthritis Cartilage 23, no. 10 (October 2015): 1674–84. https://doi.org/10.1016/j.joca.2015.05.025.
Wasserstein D, Huston LJ, Nwosu S, MOON Group, Kaeding CC, Parker RD, et al. KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study. Osteoarthritis Cartilage. 2015 Oct;23(10):1674–84.
Wasserstein, D., et al. “KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study.Osteoarthritis Cartilage, vol. 23, no. 10, Oct. 2015, pp. 1674–84. Pubmed, doi:10.1016/j.joca.2015.05.025.
Wasserstein D, Huston LJ, Nwosu S, MOON Group, Kaeding CC, Parker RD, Wright RW, Andrish JT, Marx RG, Amendola A, Wolf BR, McCarty EC, Wolcott M, Dunn WR, Spindler KP. KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study. Osteoarthritis Cartilage. 2015 Oct;23(10):1674–1684.
Journal cover image

Published In

Osteoarthritis Cartilage

DOI

EISSN

1522-9653

Publication Date

October 2015

Volume

23

Issue

10

Start / End Page

1674 / 1684

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Surveys and Questionnaires
  • Quality of Life
  • Prospective Studies
  • Prevalence
  • Osteoarthritis, Knee
  • Male
  • Longitudinal Studies
  • Knee Injuries