Meniscus Injuries of the Knee

Reliability, Validity, and Responsiveness of the IKDC Score for Meniscus Injuries of the Knee

 Kevin Crawford, M.D., Karen K. Briggs, M.P.H., William G. Rodkey, D.V.M., and J. Richard Steadman, M.D. 

Arthroscopy Association of North America’s Research Essay Award Winner

Purpose: The purpose of this study was to determine the psychometric properties of the International Knee Documentation Committee (IKDC) score for meniscus injuries of the knee. Methods: Testretest reliability, content validity, construct validity, and responsiveness to change were determined for the IKDC score. Knees were excluded if they had ligament pathology or a chondral defect greater than Outerbridge grade 2. All patients had meniscus pathology requiring treatment. The study comprised 4 subsets of patients. Group A consisted of 31 patients who completed an IKDC form at least 2 years after surgery for meniscus pathology and were then retested within 4 weeks of the primary questionnaire. Group B contained 264 patients with preoperative IKDC scores that were used for construct and content validity. Group C contained 50 patients who had a preoperative IKDC score and completed a short form 12 survey. Group D contained 100 patients with preoperative and postoperative IKDC scores used to measure responsiveness. Results: The overall IKDC score showed acceptable test-retest reliability with an interclass correlation of 0.95. There were acceptable floor and ceiling effects. All constructs tested showed significant differences. These included lower IKDC score with the following: lower activity level, difficulty with activities of daily living, difficulty with sports, abnormal knee function, and complex/degenerative meniscus tears. Responsiveness to change showed a large effect size (2.11) and a large response mean (1.5) for the overall score. The SE of the measurement was 3.19, and the minimum detectable change was 8.8 points.

Conclusions:

The overall IKDC score showed overall acceptable psychometric performance for outcome measures of meniscus injuries of the knee. Level of Evidence: Level III, testing of previously developed diagnostic criteria in nonconsecutive patients.

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