{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:49:19Z","timestamp":1788457759699,"version":"build-2803163510"},"reference-count":45,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2018,5,7]],"date-time":"2018-05-07T00:00:00Z","timestamp":1525651200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Several studies have examined changes in patient-reported outcome measures (PROMs) after anterior cruciate ligament (ACL) injury, but no studies to date have prospectively evaluated changes from preinjury baseline through injury and follow-up among ACL-injured patients compared to the baseline and follow-up changes of uninjured patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To examine changes in PROMs over time from preinjury baseline to at least 2 years after ACL reconstruction and to compare these changes with those of an uninjured control group having similar physical activity requirements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The authors conducted a prospective cohort study with a nested case-control analysis at a US service academy. All incoming first year students were recruited to participate in this study. Consenting participants completed a baseline questionnaire that included the KOOS (Knee injury and Osteoarthritis Outcome Score), WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and MARS (Marx Activity Rating Scale). Participants who sustained a subsequent ACL injury completed assessments at the time of surgery and at 6, 12, and 24 months after surgery. Healthy participants were recruited to repeat the baseline assessments within 1 year of graduation. Inter- and intragroup differences at these time points were evaluated with dependent and independent t tests, respectively. We also compared these results with established minimum clinically important difference (MCID) values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 1268 first year students entering the academy, 1005 with no previous injuries consented to participate in this study (82% male, mean \u00b1 SD age 19 \u00b1 1 years). Of those enrolled, 30 suffered an ACL injury and met the inclusion criteria for this study. Ninety uninjured control students who met the inclusion criteria completed follow-up assessments. There were statistically significant differences across all KOOS and WOMAC subscales between ACL-injured group and uninjured group at the time of the final follow-up assessment. Four KOOS subscales (Pain, Symptoms, Sports and Recreation Function, and Knee-Related Quality of Life) and the WOMAC Stiffness subscale demonstrated &gt;8-point differences between groups, which exceeded the established MCID for these instruments. There were no significant differences between the ACL-injured group and uninjured groups noted for the MARS ( P = .635). At the time of final follow-up, the ACL-injured group also reported significant deficits on the WOMAC Stiffness subscale ( P = .032), the MARS ( P = .030), and all KOOS subscales, with the exception of Functional Activities of Daily Living, as compared with their preinjury baseline scores. These deficits exceeded the established MCID values for 3 KOOS subscales and the MARS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Patients with ACL injuries reported significant deficits on PROMs at least 2 years after surgical reconstruction in relation to preinjury baseline scores and an uninjured control group. Many of these deficits exceeded established MCID values.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0363546518768753","type":"journal-article","created":{"date-parts":[[2018,5,7]],"date-time":"2018-05-07T12:27:12Z","timestamp":1525696032000},"page":"1606-1616","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":51,"title":["Change in KOOS and WOMAC Scores in a Young Athletic Population With and Without Anterior Cruciate Ligament Injury"],"prefix":"10.1177","volume":"46","author":[{"given":"Ivan J.","family":"Antosh","sequence":"first","affiliation":[{"name":"Dwight D. Eisenhower Army Medical Center, Ft Gordon, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Svoboda","sequence":"additional","affiliation":[{"name":"John A. Feagin Jr Orthopaedic Sports Medicine Fellowship, United States Military Academy, West Point, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen Y.","family":"Peck","sequence":"additional","affiliation":[{"name":"John A. Feagin Jr Orthopaedic Sports Medicine Fellowship, United States Military Academy, West Point, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E\u2019Stephan J.","family":"Garcia","sequence":"additional","affiliation":[{"name":"William Beaumont Army Medical Center, El Paso, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth L.","family":"Cameron","sequence":"additional","affiliation":[{"name":"John A. Feagin Jr Orthopaedic Sports Medicine Fellowship, United States Military Academy, West Point, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,5,7]]},"reference":[{"key":"bibr1-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1023\/A:1015291021312"},{"key":"bibr2-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-091203"},{"key":"bibr3-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2010.076364"},{"key":"bibr4-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2162-8"},{"key":"bibr5-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2009.04.019"},{"key":"bibr6-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/1941738115576121"},{"key":"bibr7-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512472330"},{"key":"bibr8-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20632"},{"key":"bibr9-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-6-16"},{"key":"bibr10-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510370280"},{"key":"bibr11-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2009.01.009"},{"key":"bibr12-0363546518768753","doi-asserted-by":"publisher","DOI":"10.3233\/BMR-130406"},{"key":"bibr13-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2225-x"},{"key":"bibr14-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/1941738116666813"},{"key":"bibr15-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515584041"},{"key":"bibr16-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200209000-00009"},{"key":"bibr17-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-004-0591-8"},{"key":"bibr18-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-4719-1"},{"key":"bibr19-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1080\/17453670710014068"},{"key":"bibr20-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/03635465010290021601"},{"key":"bibr21-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512456836"},{"key":"bibr22-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/2325967114530988"},{"key":"bibr23-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516652888"},{"key":"bibr24-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2007.08.007"},{"key":"bibr25-0363546518768753","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2012.747921"},{"key":"bibr26-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-7-38"},{"key":"bibr27-0363546518768753","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2013.4057"},{"key":"bibr28-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515626539"},{"key":"bibr29-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1080\/03009749950155562"},{"key":"bibr30-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-1-64"},{"key":"bibr31-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.1998.tb00465.x"},{"key":"bibr32-0363546518768753","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.1998.28.2.88"},{"key":"bibr33-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1016\/S1063-4584(03)00089-X"},{"key":"bibr34-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2011.01.010"},{"key":"bibr35-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2008.03.004"},{"issue":"4","key":"bibr36-0363546518768753","first-page":"815","volume":"45","author":"Spindler KP","year":"2018","journal-title":"Am J Sports Med"},{"key":"bibr37-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510383481"},{"key":"bibr38-0363546518768753","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507301883"},{"key":"bibr39-0363546518768753","unstructured":"A user\u2019s guide to Knee injury and Osteoarthritis Outcome Score (KOOS). http:\/\/www.koos.nu\/. 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