Evaluation of the need for delayed anterior cruciate ligament reconstruction: Predictors and validation of Knee Outcome Survey and ForceFrame

Kamilla Arp*

*Corresponding author for this work

Research output: ThesisPh.D. thesis

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Abstract

Injury to the anterior cruciate ligament (ACL) injury is a devastating injury that typically occurs in young and active patients. Muscle weakness, risk of instability and poor knee function are often consequences of an ACL injury. These impairments are typically present in the short term but can persist long term. Rehabilitation as the first line of treatment after an ACL injury has become common practice, at least in parts of the world. Some patients will still need ACL reconstruction (ACLR), but it is unclear how these patients can be identified. Moreover, it is important to assess patients' own perspectives on their knee using a patient-reported outcome measure (PROM) and ensuring that loss of muscle strength is re-established after the injury. These issues may also be important when considering the need for ACLR.

The overall aim of this thesis was to evaluate the necessity for ACLR in patients with ACL injury after initial treatment with rehabilitation, including the validation of measurement tools for assessing knee function.

Study I was a scoping review that described predictors for ACLR in patients who were initially treated with rehabilitation. The findings showed that only two predictors described patients having ACLR; lower age and preinjury activity level. 

Study II was a study that translated, culturally adapted and evaluated measurement properties of Knee Outcome Survey – Activities of Daily Living Scale (KOS-ADLS) in a Danish ACL-injured population. The findings showed that the Danish version of KOS-ADLS was valid, reliable and responsive for assessing symptoms and functional limitations in patients with ACL injury, but that it has some minor limitations in regard to its construct validity.

Study III was a reproducibility study in which we evaluated validity, reliability and agreement of the novel dynamometer ForceFrame for assessing knee extension and flexion strength in patients with ACL injury. The findings showed that ForceFrame can obtain valid and reliable results to assess MVIC of knee extension. However, absolute results may be considered an underestimation of actual MVIC. Positioning patients in a seated test position when assessing knee flexion using the ForceFrame does not appear to be optimal, and different test positions may be considered.
Original languageEnglish
Awarding Institution
  • University of Southern Denmark
Supervisors/Advisors
  • Varnum, Claus, Principal supervisor
  • Viberg, Bjarke, Co-supervisor
  • Ingwersen, Kim Gordon, Co-supervisor
Date of defence4. Oct 2024
Publisher
DOIs
Publication statusPublished - 17. Sept 2024

Note re. dissertation

Print copy of the full thesis is restricted to reference use in the library.

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