Poster 343: How Does the Literature on Minimum Clinically Important Difference (MCID) Apply to the Patient Population from a Single Center: The Challenge of MCID in Anterior Cruciate Ligament Reconstruction

Objectives: The field of orthopaedic surgery continues to transition towards using patient-reported outcome measures (PROMs) measure treatment success. Metrics such as the minimum clinically important difference (MCID) can help define success, but there is no clear consensus on methodology or application scores in clinical medicine. MCID calculations vary significantly based cohort size, (e.g. anchor-based versus distribution-based methods), follow-up time point, and patient-specific factors. Anterior cruciate ligament reconstruction (ACLR) a highly prevalent procedure that provides high patient satisfaction according PROMs Knee Injury & Osteoarthritis Outcome Score (KOOS) Single Assessment Numerical Evaluation (SANE). Both scales have values reported ACLR literature. purpose this study was identify patients reached literature-reported for KOOS SANE. secondary aim if were any differences demographic, injury, characteristics among reach and/or SANE those do not. Methods: PROM database single ambulatory surgical center queried procedures from 2009-2016. Revision procedures, concomitant repairs/reconstructions, without data at baseline two-year excluded study. Demographic, extracted via chart review. Demographics included age, sex, diagnosis anxiety depression. acuity injury (≥6 months considered chronic) presence meniscal injuries. Surgical body mass index (BMI), operative time, American Society Anesthesiologists (ASA) Score, graft type, implant procedures. Outcomes evaluated after two years ACLR. Patients grouped whether they did not meet MCIDs One-way analysis variance chi-square tests conducted group differences, with p=0.05 set threshold significance. Results: A total 322 included. Most female (62.1%) had an average age 28. Average BMI 25.3 108.3 minutes, respectively. ASA score 1 (84.1%). 20.5% mental health received bone-tendon-bone autograft (49.1%). Only 6.8% presented chronic injury. proportion achieved 73.6% 45.7%, respectively (p<0.00001). majority achieving (89.8%), while just 55.7% MCID. 41.0% both SANE, 21.7% achieve scale. Compared least one PROM, higher underwent injuries (11.4% vs 5.6%, p=0.004). technique statistically differ Conclusions: rates different within same (73.6% 45.7% SANE). PROMs. percentage compared met Treatment success determined by thus function tool employed injury/patient undergoing rather than performed. This particularly found timing presentation associated likelihood As orthopaedics incorporate determine well prior authorization reimbursement policies, it refine these tailor them factors order adequately capture successful treatment. [Table: see text][Table: text]