Responsiveness of the Indonesian Versions of the Anterior Cruciate Ligament-Return to Sport After Injury Score, the International Knee Documentation Committee Subjective Knee Form, and the Lysholm Score in Patients With ACL Injury

Romy Deviandri; Hugo C van der Veen; Andri Mt Lubis; Maarten J Postma; Inge van den Akker-Scheek

doi:10.1177/23259671231191827

Responsiveness of the Indonesian Versions of the Anterior Cruciate Ligament-Return to Sport After Injury Score, the International Knee Documentation Committee Subjective Knee Form, and the Lysholm Score in Patients With ACL Injury

Orthop J Sports Med. 2023 Aug 18;11(8):23259671231191827. doi: 10.1177/23259671231191827. eCollection 2023 Aug.

Authors

Romy Deviandri^{1

2

3}, Hugo C van der Veen¹, Andri Mt Lubis⁴, Maarten J Postma^{5

6

7

8}, Inge van den Akker-Scheek¹

Affiliations

¹ Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
² Department of Physiology-Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia.
³ Division of Orthopedics-Sports Injury, Arifin Achmad Hospital, Pekanbaru, Indonesia.
⁴ Department of Orthopedics-Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
⁵ Department of Health Sciences, University of Groningen, University Medical Center Groningen, the Netherlands.
⁶ Department of Economics, Econometrics and Finance, University of Groningen, Faculty of Economics and Business, Groningen, the Netherlands.
⁷ Department of Pharmacology and Therapy, Universitas Airlangga, Surabaya, Indonesia.
⁸ Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia.

Abstract

Background: The Indonesian versions of the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI), International Knee Documentation Committee subjective knee form (IKDC), and the Lysholm scores are considered valid and reliable for Indonesian-speaking patients with anterior cruciate ligament (ACL) injury.

Purpose/hypothesis: The purpose of this study was to determine the responsiveness of the ACL-RSI, IKDC, and Lysholm scores in an Indonesian-speaking population with ACL injury. It was hypothesized that they would have good responsiveness.

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

Methods: Between March 1, 2021, and February 28, 2022, patients with an ACL injury at a single hospital in Indonesia were asked to complete the ACL-RSI, IKDC, and Lysholm scores before either reconstruction surgery or nonoperative treatment. At 6 months after treatment, the patients completed all 3 scores a second time, plus a global rating of change question. The distribution-based and the anchor-based methods were used to study responsiveness. For each scale, the standardized response mean, minimal clinically important difference (MCID), and minimal detectable change (MDC; at the group [MDC_gr] and individual [MDC_ind] levels) for each scale were determined.

Results: Of 80 eligible patients, 75 (93.8%) completed the study. The standardized response means for the ACL-RSI, IKDC, and Lysholm scores were 1.59, 1.72, and 1.51, respectively, indicating good responsiveness. The MCIDs for the ACL-RSI, IKDC, and Lysholm scores were 6.8, 7.8, and 4.8, respectively; all MCIDs were larger than that of the MDC_gr (1.1, 0.7, and 0.6, respectively). At the individual level, the MCID for the IKDC was larger than the MDC_ind (7.8 vs 5.8). However, the MCIDs for ACL-RSI and Lysholm scores were smaller than those of the MDC_ind (6.8 vs 10.9 and 4.8 vs 5.1, respectively).

Conclusion: The Indonesian ACL-RSI, IKDC, and Lysholm scores indicated good responsiveness and can be used in the follow-up of patients after ACL injury, especially at the group level. In individual patients, IKDC was found to be more efficient than the ACL-RSI or Lysholm scores for detecting clinically important changes over time after ACL treatment.

Keywords: ACL tear; ACL-RSI; IKDC; MIC; PROMs.