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Context: The Balance Error Scoring System (BESS) is a commonly used clinical tool to evaluate postural control that is traditionally performed through visual assessment and subjective evaluation of balance errors. The purpose of this study was to evaluate an automated computer-based scoring system using an instrumented pressure mat compared to the traditional human-based manual assessment. Design: A descriptive cross-sectional study design was used to evaluate the performance of the automated versus human BESS scoring methodology in healthy individuals. Methods: Fifty-one healthy active participants performed BESS trials following standard BESS procedures on an instrumented pressure mat (MobileMat, Tekscan Inc). Trained evaluators manually scored balance errors from frontal and sagittal plane video recordings for comparison to errors scored using center of force measurements and an automated scoring software (SportsAT, version 2.0.2, Tekscan Inc). A linear mixed model was used to determine measurement discrepancies across the 2 methods. Bland–Altman analyses were conducted to determine limit of agreement for the automated and manual scoring methods. Results: Significant differences between the automated and manual errors scored were observed across all conditions (P <.05), excluding bilateral firm stance. The greatest discrepancy between scoring methods was during the tandem foam stance, while the smallest discrepancy was during the tandem firm stance. Conclusion: The 2 methods of BESS scoring are different with wide limits of agreement. The benefits and risks of each approach to error scoring should be considered when selecting the most appropriate metric for clinical use or research studies. [ABSTRACT FROM AUTHOR]

Context: The purpose of this study was to compare short-term clinical outcomes between meniscus procedures performed with anterior cruciate ligament reconstruction (ACLR), ACLR (ACLR-only), ACLR with meniscectomy/resection (ACLR-resect), and ACLR with meniscal repair (ACLR-repair) for bone patellar tendon bone grafts (BPTB) and hamstring tendon grafts, separately. Design: This was a cross-sectional study conducted in a controlled laboratory setting as part of a large point-of-care collaborative research program. Methods: This study included 314 participants (168 females; mean [SD]: age, 19.7 [4.8]) with primary unilateral ACLR with a BPTB or hamstring tendon. Patients were divided into 3 groups depending on meniscal procedure (ACLR-only, ACLR-resect, and ACLR-repair). Postsurgical testing included: isokinetic assessment of knee extension and flexion, single-leg hop tests, and patient-reported outcomes. Multivariate analysis of covariance compared differences between meniscal procedures on the battery of tests, and for each statistically significant variable an analysis of covariance assessed the effect of meniscal procedure within each graft type. Chi-square analysis assessed the influence of meniscal procedure on tests' pass rates defined as 90% of limb symmetry index. Results: BPTB: ACLR-only had greater hamstring strength than ACLR-resect (P = .05) and ACLR-repair (P = .005). ACLR-only had the highest proportion of participants to pass the hamstring strength test (P=.02). amstring tendon: ACLR-only (P=.03) and ACLR-resect (P=.003) had higher International Knee Documentation Committee scale scores than ACLR-repair. There was a significant difference in the proportion of participants who scored >90% limb symmetry index on the timed hop test (P = .05). Conclusions: The influence of meniscal repair on clinical outcomes is dependent on the graft choice. Following an ACLR with BPTB and a meniscal procedure, hamstring function should be more closely monitored for optimal short-term recovery. [ABSTRACT FROM AUTHOR]

Context: There are significant disparities in access to health care, but there are limited data about the impact of race and socioeconomic status (SES) on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction (ACLR) surgery., Objective: To identify associations between area deprivation index (ADI), strength measures and patient-reported outcomes (PROs) following ACLR as well as to examine differences in outcomes between race, sex, and race., Design: Case control study in a single hospital setting., Setting: Database secondary analysis., Patients or Other Participants: Data was collected from 340 patients who underwent primary, isolated, unilateral ACLR., Main Outcome Measures: Strength measures and PROs were obtained at patients' postoperative assessments at approximately six months post-surgery. Area Deprivation Index values were calculated on each patient's census tract, determined through medical records review. Correlations were conducted to determine the relationship between ADI and KOOS measures, IKDC, and limb symmetry on strength measurements. The racial composition of the sample was heavily skewed and was excluded from statistical analyses., Results: ADI was weakly correlated with IKDC (ρ=0.11, p=0.04) outcomes, with more disadvantaged patients reporting better quality of life and knee function. ADI was not correlated with other outcomes of interest. The median ADI value of the sample was 32 (range 1-86 [IQR 19-47])., Conclusions: Our study revealed a weak correlation between higher levels of socioeconomic disadvantage as measured by ADI and improved subjective assessment of knee function and quality of life as measured by IKDC. These findings are contrary to what other studies on this subject have found and highlight the importance of further research into the impact of SES and other social determinants of health on post ACLR outcomes.