No Clinically Significant Difference Between Adult and Pediatric IKDC Subjective Knee Evaluation Scores in Adults

Abstract

Background:

Two versions of the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation form currently exist: the original version (1999) and a recently modified pediatric-specific version (2011). Comparison of the pediatric IKDC with the adult version in the adult population may reveal that either version could be used longitudinally.

Hypothesis:

We hypothesize that the scores for the adult IKDC and pediatric IKDC will not be clinically different among adult patients aged 18 to 50 years.

Study Design:

Randomized crossover study design.

Level of Evidence:

Level 2.

Methods:

The study consisted of 100 participants, aged 18 to 50 years, who presented to orthopaedic outpatient clinics with knee problems. All participants completed both adult and pediatric versions of the IKDC in random order with a 10-minute break in between. We used a paired t test to test for a difference between the scores and a Welch’s 2-sample t test to test for equivalence. A least-squares regression model was used to model adult scores as a function of pediatric scores, and vice versa.

Results:

A paired t test revealed a statistically significant 1.6-point difference between the mean adult and pediatric scores. However, the 95% confidence interval (0.54-2.66) for this difference did not exceed our a priori threshold of 5 points, indicating that this difference was not clinically important. Equivalence testing with an equivalence region of 5 points further supported this finding. The adult and pediatric scores had a linear relationship and were highly correlated with an R² of 92.6%.

Conclusion:

There is no clinically relevant difference between the scores of the adult and pediatric IKDC forms in adults, aged 18 to 50 years, with knee conditions.

Clinical Relevance:

Either form, adult or pediatric, of the IKDC can be used in this population for longitudinal studies. If the pediatric version is administered in adolescence, it can be used for follow-up into adulthood.

Keywords

knee general sports trauma patient-reported outcome

Get full access to this article

View all access options for this article.

References

Bischoff-Ferrari

Vondechend

Bellamy

Theiler

. Validation and patient acceptance of a computer touch screen version of the WOMAC 3.1 osteoarthritis index. Ann Rheum Dis. 2005;64:80-84.

Collins

Misra

Felson

Crossley

Roos

. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res. 2011;63(suppl 11):S208-S228.

Cox

Huston

Dunn

et al . Are articular cartilage lesions and meniscus tears predictive of IKDC, KOOS, and Marx activity level outcomes after anterior cruciate ligament reconstruction? A 6-year multicenter cohort study. Am J Sports Med. 2014;42:1058-1067.

Crawford

Briggs

Rodkey

Steadman

. Reliability, validity, and responsiveness of the IKDC score for meniscus injuries of the knee. Arthroscopy. 2007;23:839-844.

Cutilli

Bennett

. Understanding the health literacy of America: results of the National Assessment of Adult Literacy. Orthop Nurs. 2009;28:27-32.

Dawson

Doll

Fitzpatrick

Jenkinson

Carr

. The routine use of patient reported outcome measures in healthcare settings. BMJ. 2010;340:c186.

Esculier

J-F

Roy

J-S

Bouyer

. Psychometric evidence of self-reported questionnaires for patellofemoral pain syndrome: a systematic review. Disabil Rehabil. 2013;35:2181-2190.

Faul

Erdfelder

Lang

A-G

Buchner

. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-191.

Gudbergsen

Bartels

Krusager

et al . Test-retest of computerized health status questionnaires frequently used in the monitoring of knee osteoarthritis: a randomized crossover trial. BMC Musculoskelet Disord. 2011;12:190.

10.

Harris

Taylor

Thielke

Payne

Gonzalez

Conde

. Research Electronic Data Capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377-381.

11.

Irrgang

Anderson

Boland

et al . Development and validation of the International Knee Documentation Committee Subjective Knee Form. Am J Sports Med. 2001;29:600-613.

12.

Iversen

Lee

Connell

Andersen

Anderson

Kocher

. Validity and comprehensibility of the International Knee Documentation Committee Subjective Knee Evaluation form in children. Scand J Med Sci Sports. 2010;20:e87-e95.

13.

Kocher

Smith

Iversen

et al . Reliability, validity, and responsiveness of a modified International Knee Documentation Committee Subjective Knee Form (Pedi-IKDC) in children with knee disorders. Am J Sports Med. 2011;39:933-939.

14.

Schmitt

Paterno

Huang

. Validity and internal consistency of the International Knee Documentation Committee Subjective Knee Evaluation Form in children and adolescents. Am J Sports Med. 2010;38:2443-2447.

15.

Spindler

Huston

Wright

et al . The prognosis and predictors of sports function and activity at minimum 6 years after anterior cruciate ligament reconstruction: a population cohort study. Am J Sports Med. 2011;39:348-359.

16.

van Meer

Meuffels

Vissers

et al . Knee injury and osteoarthritis outcome score or International Knee Documentation Committee Subjective Knee Form: which questionnaire is most useful to monitor patients with an anterior cruciate ligament rupture in the short term? Arthroscopy. 2013;29:701-715.

17.

Wang

Jones

Khair

Miniaci

. Patient-reported outcome measures for the knee. J Knee Surg. 2010;23:137-151.