Demographic Biases of Scoring Instruments for the Results of Total Knee Arthroplasty*

Brinker, Mark R.; Lund, Peter J.; Barrack, Robert L.

doi:10.2106/00004623-199706000-00009

Cited by 49 publications

(39 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies of hip and knee scoring instruments among healthy patients reported lower scores among patients living below the poverty level and those with two or more major medical comorbidities, similar to the finding of this study [10,11]. In addition, this study also found a strong association between patients' educational level and race and low postoperative outcome scores.…”

Section: Discussionsupporting

confidence: 88%

See 1 more Smart Citation

The Frank Stinchfield Award: The Impact of Socioeconomic Factors on Outcome After THA: A Prospective, Randomized Study

Butler¹,

Rosenzweig²,

Myers

et al. 2011

Clinical Orthopaedics &Amp; Related Research

Self Cite

View full text Add to dashboard Cite

Background Most studies of total hip arthroplasty (THA) focus on the effect of the type of implant on the clinical result. Relatively little data are available on the impact of the patient's preoperative status and socioeconomic factors on the clinical results following THA. Questions/purposes We determined the relative importance of patient preoperative and socioeconomic status compared to implant and technique factors in predicting patient outcome as reflected by scores on commonly utilized rating scales (eg, Harris Hip Score, WOMAC, SF-12, degree of patient satisfaction, or presence or severity of thigh pain) following cementless THA. Methods All patients during the study period were offered enrollment in a prospective, randomized study to receive either a titanium, tapered, proximally coated stem; or a Co-Cr, cylindrical, extensively coated stem; 102 patients were enrolled. We collected detailed patient data preoperatively including diagnosis, age, gender, insurance status, medical comorbidities, tobacco and alcohol use, household income, educational level, and history of treatment for lumbar spine pathology. Clinical evaluation included Harris Hip Score, SF-12, WOMAC, pain drawing, and UCLA activity rating and satisfaction questionnaire. Implant factors included stem type, stem size, fit in the canal, and stem-bone stiffness ratios. Minimum 2 year followup was obtained in 95% of the enrolled patients (102 patients).Results Patient demographics and preoperative status were more important than implant factors in predicting the presence of thigh pain, dissatisfaction, and a low hip score. The most predictive factors were ethnicity, educational level, poverty level, income, and a low preoperative WOMAC score or preoperative SF-12 mental component score. No implant parameter correlated with outcome or satisfaction. Conclusion Socioeconomic factors and preoperative status have more impact on the clinical outcome of cementless THA than implant related factors. Level of Evidence Level I, prospective, randomized clinical trial. See the guidelines online for a complete description of level of evidence.

show abstract

Section: Discussionsupporting

confidence: 88%

“…Historically, studies have focused on the effect of surgical technique and implant designs on clinical results [5,7,10,13,20,24,30,32,38,40,43]. This trend focuses on techniques such as minimal incision surgery [9] and image guided surgery [13], as well as design features such as decreased stem stiffness [1] and shorter stems [41].…”

Section: Discussionmentioning

confidence: 99%

The Frank Stinchfield Award: The Impact of Socioeconomic Factors on Outcome After THA: A Prospective, Randomized Study

Butler¹,

Rosenzweig²,

Myers

et al. 2011

Clinical Orthopaedics &Amp; Related Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…König et al (1997) have described the sequential course of the AKS in patients after knee arthroplasty. The demographic biases that may influence the reporting of results, using the AKS, have also been reported (Brinker et al 1997). …”

Section: Discussionmentioning

confidence: 98%

“…The interobserver SD for the Knee Score and the Function Score were 26 and 20 points, respectively, more than twice the magnitude of interobserver error that we obtained. It is difficult to explain this difference but the case-mix of subjects may be a factor (Brinker et al 1997). …”

Section: Discussionmentioning

confidence: 99%

The reliability of the American Knee Society Score

Liow¹,

Walker²,

Wajid³

et al. 2000

Acta Orthopaedica Scandinavica

111

View full text Add to dashboard Cite

“…The effect of Charnley Class, or co-morbidity, on the results of health outcome questionnaires applied to knee arthroplasty patients has not been well-defined (Dawson et al 1996b, Brinker et al 1997, Hawker et al 1998. Therefore, the purpose of this study was to first modify the Charnley Classification for application to knee arthroplasty patients and then determine what effect co-morbidity, as defined by the modified Charnley Class, had on the results of a spectrum of outcome questionnaires.…”

mentioning

confidence: 99%

What's all that noise?The effect of co-morbidity on health outcome questionnaire results after knee arthroplasty

Dunbar

Robertsson

Ryd

2004

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

Background We modified the Charnley Classification for hips to facilitate its use with knee arthroplasty patients and investigated what affect the different classes of co-morbidity had on the results of a spectrum of outcome questionnaires.Patients and methods 3600 patients from the Swedish Knee Arthroplasty Registry were surveyed by post with a variety of questionnaires ranging from multipleitem general health, to a single-item knee arthroplasty specific questionnaire. All patients also completed a co-morbidity questionnaire, from which a modified Charnley Classification was generated for each patient. We then investigated the correlation and relationship between the results of the questionnaires and the different classes of co-morbidity.Results The results of the questionnaires tested varied significantly by Charnley Class, regardless of the specificity of the questionnaire used.Interpretation We suggest that co-morbidity should be taken into account in outcome studies utilizing general health or disease/site specific questionnaires.

show abstract

Demographic Biases of Scoring Instruments for the Results of Total Knee Arthroplasty*

Cited by 49 publications

References 20 publications

The Frank Stinchfield Award: The Impact of Socioeconomic Factors on Outcome After THA: A Prospective, Randomized Study

The Frank Stinchfield Award: The Impact of Socioeconomic Factors on Outcome After THA: A Prospective, Randomized Study

The reliability of the American Knee Society Score

What's all that noise?The effect of co-morbidity on health outcome questionnaire results after knee arthroplasty

Contact Info

Product

Resources

About