Project 458740

Anterior cruciate ligament (ACL) injuries are among the most common musculoskeletal injuries (~200,000/year), especially in young active individuals. ACL injuries often result in reduced quality of life, social and financial burden, and increased risk of future injuries or arthritis. Studies have shown how various techniques for ACL reconstruction (ACLR) can significantly improve surgical outcomes such as knee stability and return to sport rates. However, when investigating patient reported outcome measures (e.g., pain or function), there seems to be little difference between patients whose surgeries have "succeeded" vs "failed". This may be due to response shift, whereby patients' interpretations of their outcomes change across time and circumstances. If response shift is present, the way clinicians and researchers analyze/interpret change may not be entirely valid. The goals of my research are to 1) improve the outcome measures used to assess patients following ACL injury, 2) understand factors related to patient recovery and response shift across time, and 3) translate this knowledge for clinicians, researchers, and patients. These goals will be accomplished through the completion of three studies. First, a dataset of over 600 patients who had ACLR will be analyzed to evaluate and improve the most common patient reported outcome measures used in this population. Second, 155 patients undergoing ACLR will be asked to complete patient reported outcome measures pre- and post-surgery. At follow-up patients will be asked about coping strategies, significant life events, and to recall their pre-surgery state, allowing us to identify and predict response shift. Third, young athletes will be interviewed to explore their definition of quality of life, and if this definition changes across time. Overall this work will improve clinicians' and researchers' ability to accurately assess change following ACLR and can be applied to measuring change across other health conditions.