--Tegner activity grading
scale (from 0 to 10)--a system for evaluating the degree of impairment, disability, and handicap of the patient with an ACL injury including functional score, activity grading
, stability testing, and measurements of performance and strength, where 0 indicates retirement, while 10 allows professional sport activities .
The diagnostic value of FT for fibrosis staging and of AT for activity grading was similar to those reported previously (8,10-18) with areas under the ROC curves of 0.80 (0.02) for the diagnosis of F2F3F4 and 0.78 (0.02) for the diagnosis of A2A3 (Fig.
In 154 of 537 patients (29%), there was a significant discordance at baseline between FT-AT and biopsy results for fibrosis staging or activity grading. This occurred in 63 patients (12%) for fibrosis staging only, in 67 patients (12%) for activity grading only, and in 24 patients (4.5%) for both.
Compared with patients who did not have false-negative activity grading based on biopsy (n = 483), patients who did have false-negative activity grading based on biopsy (n = 54) had a smaller biopsy size [13.5 (0.7) vs 16.4 (0.3) mm; P = 0.002], fewer portal tracts [12.9 (0.8) vs 15.9 (0.4); P = 0.03], poorer quality biopsies (17% vs 32%; P = 0.02), more frequent liver steatosis (64% vs 40%; P <0.001), higher ALT serum activity [203 (17) vs 99 (4) U/L; P <0.001], higher serum ferritin [502 (72) IU/L (n = 31) vs 275 (27) IU/L (n = 135); P = 0.005], and were more frequently male (76% vs 58%; P = 0.01).
In 209 of 537 patients (39%), there was a significant discordance at baseline between FT-AT and biopsy results for fibrosis staging or activity grading. This occurred in 78 patients (14%) for fibrosis staging only, in 91 patients (17%) for activity grading only, and in 24 patients (7.4%) for both.
According to the risk factors, the independent endpoints, and the follow-up, the causes of failure among the 54 cases discordant by only 1 or 1.5 stages or grades were considered highly attributable to FT-AT in 1 case (hemolysis), moderately attributable to FT-AT in 1 (isolated low [[alpha].sub.2] -macroglobulin), highly attributable to biopsy in 2 (false negative for fibrosis staging), and moderately attributable to biopsy in 14 (mostly falsely negative for activity grading).