Prevalence of Clinically Significant Improvement Following Total Knee Replacement

Alzahrani, Khalid; Gandhi, Rajiv; DeBeer, Justin; Petruccelli, Danielle; Mahomed, Nizar N.

doi:10.3899/jrheum.100233

Cited by 41 publications

(37 citation statements)

References 53 publications

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“…Prior studies aimed at defining the MCID after TKA have demonstrated that 12% to 51% of patients do not experience this degree of improvement postoperatively with respect to pain and function [2,7,9,11]. With limited appropriateness criteria, the decision to pursue surgery is complex and multifactorial for both the patient and physician.…”

Section: Discussionmentioning

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

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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: Discussionmentioning

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

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“…In this section we summarise results from 22 studies of pre-operative BMI, mental health, pain and physical function as predictors of long-term patient-reported outcomes. 46,50,127,[147][148][149][150][151][152][153][154][155][156][157][158][159][160][161][162][163][164][165] One study included important data in a second publication. 166 Details of studies are summarised in Appendix 6 with brief details in Table 5.…”

Section: Total Knee Replacementmentioning

confidence: 99%

“…46,127,147,149,[151][152][153][154][155][159][160][161][162] Details of these studies are summarised in Table 5. As a marker of generalisability, one study reported a registry analysis, 147 eight studies included multiple centres, 46,127,149,[151][152][153][154][155] and four studies included patients from a single centre.…”

mentioning

confidence: 99%

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Blom

Artz

Beswick

et al. 2016

Programme Grants Appl Res

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms PROGRAMME GRANTS FOR APPLIED RESEARCH VOLUME 4 ISSUE 12 AUGUST 2016 ISSN 2050 DOI 10.3310/pgfar04120Improving patients' experience and outcome of total joint replacement: the RESTORE programme Ashley W Blom, Neil Artz, Andrew D Beswick, Amanda Burston, Paul Dieppe, Karen T Elvers, Rachael Gooberman-Hill, Jeremy Horwood, Paul Jepson, Emma Johnson, Erik Lenguerrand, Elsa Marques, Sian Noble, Mark Pyke, Catherine Sackley, Gina Sands, Adrian Sayers, Victoria Wells and Vikki Wylde Improving patients' experience and outcome of total joint replacement: the RESTORE programme ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10070. The contractual start date was in December 2008. The final report began editorial review in September 2014 and was accepted for publication in August 2015. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accurac...

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“…tor analysis of variance with repeated measures (assessment time [presurgery, postsurgery], age group [1,2,3,4]) was used to compare presurgical and postsurgical OKS results between the 4 groups. Significant main effects of group and significant interaction effects were further analyzed using multiple t tests, with Bonferroni corrections.…”

Section: Discussionmentioning

confidence: 99%

“…5,10,15,31 The OKS has been reported to be the most reliable and valid system for patient self-assessment following knee replacement. 9,41 These findings have led to the common use of the OKS as a postoperative measure for patients with knee osteoarthritis following total knee replacement (TKR) 2,19,38,40,50 and in a recent report 23 demonstrated good preoperative discrimination.…”

mentioning

confidence: 99%

Younger Patients Report Greater Improvement in Self-Reported Function After Knee Joint Replacement

Wong¹,

Rotondi²,

Gage³

2013

J Orthop Sports Phys Ther

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Prevalence of Clinically Significant Improvement Following Total Knee Replacement

Abstract: Awareness of the prevalence of patients who may show no clinically important improvement and factors that predict this outcome will help patients and surgeons set realistic expectations of surgery.

Cited by 41 publications

References 53 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?

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Younger Patients Report Greater Improvement in Self-Reported Function After Knee Joint Replacement

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