Predicting the longer term outcomes of total knee arthroplasty

Gandhi, Rajiv; Dhotar, Herman; Razak, Fahad; Tso, Peggy; Davey, J. Roderick; Mahomed, Nizar N.

doi:10.1016/j.knee.2009.06.003

Cited by 119 publications

(123 citation statements)

References 18 publications

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“…Additionally, the multivariate analysis demonstrated that baseline SF12v2 MCS scores paralleled functional threshold values. These findings are consistent with prior evidence, which demonstrates that poorer baseline mental and emotional health is associated with smaller improvement in function after TKA [4,5,13,16,17,19,24,26,27,40,43,44]. By comparison, patient comorbidities and age have little effect on PROM scores after TKA [13,32].…”

Section: Discussionsupporting

confidence: 89%

“…More specifically, although patients with higher levels of preoperative pain and disability demonstrate the greatest improvements in PROM scores, they do not achieve absolute postoperative scores comparable to patients with less preoperative pain and better baseline function [13,24]. A substantial body of evidence has also demonstrated that mental and emotional health influence postoperative PROMs after TKA [4,5,13,16,17,19,24,26,27,40,43,44]. Worse preoperative mental and emotional health is associated with smaller improvements in physical function scores after TKA [4,5,16,17,22,27,40].…”

Section: Introductionmentioning

confidence: 99%

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Can Preoperative Patient-reported Outcome Measures Be Used to Predict Meaningful Improvement in Function After TKA?

Berliner

Brodke

Chan

et al. 2017

Clinical Orthopaedics &Amp; Related Research

230

181

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Background Despite the overall effectiveness of total knee arthroplasty (TKA), a subset of patients do not experience expected improvements in pain, physical function, and quality of life as documented by patient-reported outcome measures (PROMs), which assess a patient's physical and emotional health and pain. It is therefore important to develop preoperative tools capable of identifying patients unlikely to improve by a clinically important margin after surgery.Questions/purposes The purpose of this study was to determine if an association exists between preoperative PROM scores and patients' likelihood of experiencing a clinically meaningful change in function 1 year after TKA. Methods A retrospective study design was used to evaluate preoperative and 1-year postoperative Knee injury and Osteoarthritis Outcome Score (KOOS) and SF-12 version 2 (SF12v2) scores from 562 patients who underwent primary unilateral TKA. This cohort represented 75% of the 750 patients who underwent surgery during that time period; a total of 188 others (25%) either did not complete PROM scores at the designated times or were lost to follow-up. Minimum clinically important differences (MCIDs) were calculated for each PROM using a distribution-based method and were used to define meaningful clinical improvement. MCID values for KOOS and SF12v2 physical component summary (PCS) scores were calculated to be 10 and 5, respectively. A receiver operating characteristic analysis was used to determine threshold values for preoperative KOOS and SF12v2 PCS scores and their respective predictive abilities. Threshold values defined the point after which the likelihood of clinically meaningful improvement began to diminish. Multivariate regression was used to control for the effect of preoperative mental and emotional health, patient attributes quantified by SF12v2 mental component summary (MCS) scores, on

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Can Preoperative Patient-reported Outcome Measures Be Used to Predict Meaningful Improvement in Function After TKA?

Berliner

Brodke

Chan

et al. 2017

Clinical Orthopaedics &Amp; Related Research

230

181

View full text Add to dashboard Cite

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“…In another study of patients having total knee replacement, patients who had preoperative depression and anxiety reported more pain at one year after surgery than did patients who did not have preoperative depression and anxiety 50 . A recent review of 551 consecutive patients from a Canadian registry revealed that a poorer mental health state at the time of surgery was associated with worse long-term (three to four years) outcomes (WOMAC and SF-36) after total knee replacement 51 . Across studies, 13% to 32% of patients report emotional health issues at the time of total knee replacement.…”

Section: Emotional Health and Functional Gain After Total Knee Replacmentioning

confidence: 99%

The Role of Emotional Health in Functional Outcomes After Orthopaedic Surgery: Extending the Biopsychosocial Model to Orthopaedics

Ayers

Franklin

Ring

2013

Journal of Bone and Joint Surgery

179

113

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“…Preoperative psychological factors of patients such as anxiety, depression, catastrophizing state, poor self-efficacy, and poor coping skills may be preoperative predictors of unsatisfactory patient outcomes after joint replacement surgery [3,15,19,20,33,42]. The duration and magnitude of the effect these factors have on postoperative outcomes remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

Khatib

Madan

Naylor

et al. 2015

Clinical Orthopaedics &Amp; Related Research

162

114

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Background A subgroup of patients undergoing TKA is unhappy with the outcome of surgery and preoperative psychological factors may play a role in their dissatisfaction. Questions/purposes We asked whether (1) psychological factors, as measured by preoperative self-reported questionnaires, predicted poor outcome after TKA, and (2) whether certain psychological factors examined predicted poor outcome better than others. Methods We performed a systematic review and metaanalysis of prospective observational studies published in MEDLINE, CINAHL 1 , EMBASE TM , and PsycINFO 1 databases from their date of inception to October 2013, augmented with a manual search of bibliographies. Study eligibility was performed according to an a priori protocol. Included studies were assessed for quality according to the Newcastle-Ottawa scale. Two reviewers independently performed the search, identified eligible studies, assessed their methodologic quality, and extracted data. Outcomes of interest included postoperative dissatisfaction, pain, or limited function of the patients.

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Predicting the longer term outcomes of total knee arthroplasty

Cited by 119 publications

References 18 publications

Can Preoperative Patient-reported Outcome Measures Be Used to Predict Meaningful Improvement in Function After TKA?

Can Preoperative Patient-reported Outcome Measures Be Used to Predict Meaningful Improvement in Function After TKA?

The Role of Emotional Health in Functional Outcomes After Orthopaedic Surgery: Extending the Biopsychosocial Model to Orthopaedics

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

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