Differences in 1‑year outcome after primary total hip and knee arthroplasty

Zhai, Haohan; Geng, Hongni; Bai, Bo; Wang, Yulong

doi:10.1007/s00132-018-3636-2

Cited by 12 publications

(7 citation statements)

References 38 publications

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“…Interestingly, the PASS threshold for the HOOS JR was higher than that for the KOOS JR. This finding is intuitive in that patients undergoing THA are often more satisfied with their outcome and have higher changes in PROM scores compared with patients undergoing TKA [27][28][29] . Therefore, the threshold for a patient undergoing THA to achieve a moderate or greater improvement is expected to be relatively high (compared with the threshold for patients undergoing TKA), which did occur in our study.…”

Section: Discussionmentioning

confidence: 94%

Defining the Patient Acceptable Symptom State for the HOOS JR and KOOS JR After Primary Total Joint Arthroplasty

Kunze

Fontana

MacLean

et al. 2021

Journal of Bone and Joint Surgery

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Background: It is essential to quantify an acceptable outcome after total joint arthroplasty (TJA) in order to understand quality of care. The purpose of this study was to define patient acceptable symptom state (PASS) thresholds for the Knee injury and Osteoarthritis Outcome Score, Joint Replacement (KOOS JR) and the Hip disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS JR) after TJA.Methods: A receiver operating characteristic (ROC) curve analysis, leveraging 2-year satisfaction of "moderate improvement" or better as the anchor, was used to establish PASS thresholds among 5,216 patients who underwent primary total hip arthroplasty and 4,036 who underwent primary total knee arthroplasty from 2007 to 2012 with use of an institutional registry. Changes in PASS thresholds were explored by stratifying and recalculating these thresholds by age at the time of surgery (<70 or ‡70 years of age), sex (men or women), body mass index (BMI; <30 or ‡30 kg/m 2 ), and baseline Short Form-36 (SF-36) physical and mental component scores (<50 or ‡50). Results:The HOOS JR PASS threshold was 76.7 (area under the ROC curve [AUC] = 0.91), which was achieved by 4,334 patients (83.1%). The KOOS JR PASS threshold was 63.7 (AUC = 0.89), which was achieved by 3,461 patients (85.8%). Covariate stratification demonstrated that PASS thresholds were higher in men compared with women, and in those with higher preoperative SF-36 physical and mental scores ( ‡50) compared with lower SF-36 scores (<50). Results differed between instruments for BMI and age: higher BMI was associated with a lower PASS threshold for the HOOS JR but a higher PASS threshold for the KOOS JR. The HOOS JR PASS threshold was higher in patients who were <70 years of age compared with those who were ‡70 years of age, but was equivalent for the KOOS JR. Conclusions:The PASS thresholds for the HOOS JR and KOOS JR at 2 years after TJA were 76.7 and 63.7, respectively.The PASS thresholds were associated with certain preoperative covariates, suggesting that an acceptable symptom state after TJA is influenced by patient-specific factors.

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Section: Discussionmentioning

confidence: 94%

Defining the Patient Acceptable Symptom State for the HOOS JR and KOOS JR After Primary Total Joint Arthroplasty

Kunze

Fontana

MacLean

et al. 2021

Journal of Bone and Joint Surgery

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“…The incidence of TJA performed increases, especially in elderly patients; accordingly, geriatric complex treatment is becoming more important [ 42 ]. The combination of well-informed patients and implementation of geriatric co-management will reduce the rate of complications and the days in hospital [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Influence of Anxiety/Depression, Age, Gender and ASA on 1-Year Follow-Up Outcomes Following Total Hip and Knee Arthroplasty in 5447 Patients

Götz

Benditz

Reinhard

et al. 2021

JCM

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Introduction: There are many factors influencing the outcome after total joint arthroplasty (TJA). In particular, patient-related factors such as age, gender, ASA (American Society of Anesthesiologists), or preoperative anxiety/depression have become increasingly important. The aim of this study was to examine the association of these parameters with 1-year postoperative outcomes after total knee and total hip arthroplasty (TKA, THA). Methods: A retrospective cohort of 5447 TJA patients was evaluated by pre- and postoperative analysis of EQ-5D, EQ-VAS and WOMAC Score. Furthermore, major focus was put on the association between age, gender, ASA, preoperative anxiety/depression and outcome parameters. Results: 53.3% (2903/5447) of all patients were identified with anxiety/depression at time of surgery. In the analysis, patients without anxiety/depression showed statistically significantly (p < 0.05) better EQ-5D, EQ-VAS and WOMAC scores. In addition, patients with ASA 2 or 3 and age over 70 years showed statistically significantly (p < 0.01) worse EQ-5D and WOMAC scores. Gender did not influence the postoperative EQ-5D and WOMAC results, but men had significantly better EQ-VAS scores than women in this study. Conclusion: Preoperative anxiety/depression symptoms show worse clinical outcomes 1 year postoperatively after TJA. Other outcome-influencing factors are higher age and ASA 2 or 3. In the future, such patients should be identified, and as far as applicable, a treatment of anxiety/depression or comorbidities should be implemented preoperatively of the surgical procedure to improve clinical outcomes.

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“…The SF‐12 has also been shown to be able to discriminate between patients with rheumatoid arthritis of the hands/wrists who have high pain and those with low pain (PCS ES = 0.81 and MCS ES = 0.33) . In addition, the responsiveness of the SF‐12 to a wide range of treatments and programs for musculoskeletal conditions has been reported .…”

Section: Medical Outcomes Study 12‐item Short Form Health Surveymentioning

confidence: 96%