Minimal clinically important differences in health-related quality of life after total hip or knee replacement

Keurentjes, J. Christiaan; Tol, Floris R van; Fiocco, Marta; Schoones, Jan W.; Nelissen, Rob G H H

doi:10.1302/2046-3758.15.2000065

Cited by 80 publications

(62 citation statements)

References 18 publications

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“…The minimum clinically important difference (MCID) in SF-36 scores from 3–20 have been reported for lower extremity primary total joint arthroplasty. 23 As yet no minimal clinically important difference has been reported for tibial shaft fractures.…”

Section: Methodsmentioning

confidence: 99%

Reaming Does Not Affect Functional Outcomes After Open and Closed Tibial Shaft Fractures

Lin

Swiontkowski

Bhandari

et al. 2016

Journal of Orthopaedic Trauma

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Objectives We sought to determine the effect of reaming on 1-year SF-36 and SMFA scores from the Study to Prospectively Evaluate Reamed Intramedullary Nails in patients with Tibial Fractures (SPRINT). Design Prospective randomized controlled trial. 1,319 patients were randomized to reamed or unreamed nails. Fractures were categorized as open or closed. Setting 29 academic and community health centers across the US, Canada, and the Netherlands Patients/Participants 1,319 skeletally mature patients with closed and open diaphyseal tibia fractures. Intervention Reamed versus unreamed tibial nails Main Outcome Measurements SF-36 and the SMFA. Outcomes were obtained during the initial hospitalization to reflect preinjury status, and again at the 2-week, 3-month, 6-month, and 1-year follow-up. Repeated measures analyses were performed with P <0.05 considered significant. Results There were no differences between the reamed and unreamed groups at 12 months for either the SF-36 Physical Component Score (PCS) (42.9 v 43.4, p = 0.54, 95% Confidence Interval for the difference [CI] −2.1 to 1.1) or the SMFA Dysfunction Index (DI) (18.0 v 17.6, p=0.79. 95% CI −2.2 to 2.9). At one year, functional outcomes were significantly below baseline for the SF-36 PCS, SMFA DI, and SMFA Bothersome Index (p < 0.001). Time and fracture type were significantly associated with functional outcome. Conclusions Reaming does not affect functional outcomes following intramedullary nailing for tibial shaft fractures. Patients with open fractures have worse functional outcomes than those with a closed injury. Patients do not reach their baseline function by one year after surgery.

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Section: Methodsmentioning

confidence: 99%

Reaming Does Not Affect Functional Outcomes After Open and Closed Tibial Shaft Fractures

Lin

Swiontkowski

Bhandari

et al. 2016

Journal of Orthopaedic Trauma

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“…Previous attempts to define treatment success on the basis of PRO scores mostly focused on change rates, comparing pre-surgical scores with follow-up assessments, and investigated minimal important differences for commonly used PRO instruments to identify patients with and without treatment success [21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

WOMAC, EQ-5D and Knee Society Score Thresholds for Treatment Success After Total Knee Arthroplasty

Giesinger

Hamilton

Jost

et al. 2015

The Journal of Arthroplasty

139

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Our study aimed at developing clinical thresholds (cut-off scores) for the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, EQ-5D and Knee Society Score for discriminating between patients with and without treatment success following total knee arthroplasty (TKA). We performed a retrospective analysis of 1055 patients 2 months after TKA and 765 patients 1 year after TKA. We considered treatment successful if the patient reported high levels of satisfaction and pain relief, functional increase, and a willingness to undergo the same procedure again. Based on this criterion we identified cut-off scores that will facilitate interpretation of the WOMAC, the EQ-5D and the KSS in TKA patients.

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“…This probability can be assessed at the individual level using the Minimal Clinically Important Difference (MCID), which is defined as the minimal difference in scores of an outcome measure that is perceived by patients as beneficial or harmful. [12], [13] MCIDs in HRQoL, measured using the Short-Form 36, have been established for THR and TKR [14]–[16]…”

Section: Introductionmentioning

confidence: 99%

Patients with Severe Radiographic Osteoarthritis Have a Better Prognosis in Physical Functioning after Hip and Knee Replacement: A Cohort-Study

et al. 2013

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IntroductionAlthough Total Hip and Knee Replacements (THR/TKR) improve Health-Related Quality of Life (HRQoL) at the group level, up to 30% of patients are dissatisfied after surgery due to unfulfilled expectations. We aimed to assess whether the pre-operative radiographic severity of osteoarthritis (OA) is related to the improvement in HRQoL after THR or TKR, both at the population and individual level.MethodsIn this multi-center observational cohort study, HRQoL of OA patients requiring THR or TKR was measured 2 weeks before surgery and at 2–5 years follow-up, using the Short-Form 36 (SF36). Additionally, we measured patient satisfaction on a 11-point Numeric Rating Scale (NRSS). The radiographic severity of OA was classified according to Kellgren and Lawrence (KL) by an independent experienced musculoskeletal radiologist, blinded for the outcome. We compared the mean improvement and probability of a relevant improvement (defined as a patients change score≥Minimal Clinically Important Difference) between patients with mild OA (KL Grade 0–2) and severe OA (KL Grade 3+4), whilst adjusting for confounders.ResultsSevere OA patients improved more and had a higher probability of a relevant improvement in physical functioning after both THR and TKR. For TKR patients with severe OA, larger improvements were found in General Health, Vitality and the Physical Component Summary Scale. The mean NRSS was also higher in severe OA TKR patients.DiscussionPatients with severe OA have a better prognosis after THR and TKR than patients with mild OA. These findings might help to prevent dissatisfaction after THR and TKR by means of patient selection or expectation management.

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Minimal clinically important differences in health-related quality of life after total hip or knee replacement

Cited by 80 publications

References 18 publications

Reaming Does Not Affect Functional Outcomes After Open and Closed Tibial Shaft Fractures

Reaming Does Not Affect Functional Outcomes After Open and Closed Tibial Shaft Fractures

WOMAC, EQ-5D and Knee Society Score Thresholds for Treatment Success After Total Knee Arthroplasty

Patients with Severe Radiographic Osteoarthritis Have a Better Prognosis in Physical Functioning after Hip and Knee Replacement: A Cohort-Study

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