前交叉韧带重建术后最小临床重要差异和患者可接受症状状态阈值在不同已发表研究中差异显著：一项系统综述
简介
系统综述纳入9项ACL重建后患者报告结局研究，汇总MCID与PASS阈值。IKDC的MCID为9.0–10.4、PASS为74.2–86.8；KOOS各亚域MCID为2.5–21.9、PASS为57.1–100.0，差异显著。提示既往阈值受人群、计算方法及问题性质影响，不宜直接套用，临床解读ACL重建疗效时宜采用队列特异性阈值。
英文摘要
PURPOSE: To identify and summarize reported clinically significant outcome threshold values across commonly used patient-reported outcome measures in patients undergoing anterior cruciate ligament reconstruction. METHODS: A systematic literature search was conducted to identify studies published up to July 2025 that reported clinically significant outcome threshold values after anterior cruciate ligament reconstruction using validated patient-reported outcome measures. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies. RESULTS: A total of 9 studies were included. Reported threshold values varied substantially across patient-reported outcome measures and studies. For the International Knee Documentation Committee-Subjective Knee Form, minimal clinically important difference (MCID) thresholds ranged from 9.0 to 10.4, whereas patient acceptable symptom state (PASS) thresholds ranged from 74.2 to 86.8. Across the Knee Injury and Osteoarthritis Outcome Score subdomains, MCID thresholds ranged from 2.5 to 21.9, including 13.9 for pain, 5.4 for symptoms, 5.1 for activities of daily living, 2.5 for sport/recreation, and 21.9 for quality of life. PASS thresholds for Knee Injury and Osteoarthritis Outcome Score subdomains ranged from 57.1 to 100.0, including 88.9 to 95.8 for pain, 57.1 to 94.6 for symptoms, 99.3 to 100.0 for activities of daily living, 75.0 to 82.5 for sport/recreation, and 62.5 to 71.9 for quality of life. CONCLUSIONS: This systematic review of reported MCID and PASS thresholds after anterior cruciate ligament reconstruction shows considerable variability depending on patient population, method of calculation, and the nature of questions asked. This shows that previously published MCID and PASS values are not necessarily applicable in subsequent studies, and the calculation of cohort-specific thresholds is important. LEVEL OF EVIDENCE: Level IV, systematic review of Level II to IV studies.