Questionnaire on the perceptions of patients about total knee replacement

Abstract

We have developed a 12-item questionnaire for patients having a total knee replacement (TKR). We made a prospective study of 117 patients before operation and at follow-up six months later, asking them to complete the new questionnaire and the form SF36. Some also filled in the Stanford Health Assessment Questionnaire (HAQ). An orthopaedic surgeon completed the American Knee Society (AKS) clinical score. The single score derived from the new questionnaire had high internal consistency, and its reproducibility, examined by test-retest reliability, was found to be satisfactory. Its validity was established by obtaining significant correlations in the expected direction with the AKS scores and the relevant parts of the SF36 and HAQ. Sensitivity to change was assessed by analysing the differences between the preoperative scores and those at follow-up. We also compared change in scores with the patients' retrospective judgement of change in their condition. The effect size for the new questionnaire compared favourably with those for the relevant parts of the SF36. The change scores for the new knee questionnaire were significantly greater (p < 0.0001) for patients who reported the most improvement in their condition. The new questionnaire provides a measure of outcome for TKR that is short, practical, reliable, valid and sensitive to clinically important changes over time.

The Mark Coventry Award: Custom Cutting Guides Do Not Improve Total Knee Arthroplasty Clinical Outcomes at 2 Years Followup

“…In addition, the impact of the extremely positive or negative outliers in function would have a greater impact with smaller cohorts, leading to increases in the SDs of the clinical outcome scores and perhaps masking true differences between the two groups. However, the SDs of the clinical outcomes scores seen in both cohorts are consistent with previously published reports after TKA [7,15,38,42]. In addition, given the relatively recent implementation of this technology and the desire to have a mean of 2 years followup, we were limited by the total number of surgical procedures performed using CCGs.…”

“…Patients were seen or contacted for clinical followup at 2 weeks, 6 weeks, 6 months, 1 year, and 2 years postoperatively. UCLA [42], SF-12 [38], and Oxford knee scores [15] were compared between the two cohorts both preoperatively and at their most recent followup visit. Patients in the CCG cohort had increased UCLA, SF-12 physical component, and Oxford knee scores preoperatively (p = 0.001 to 0.03; Table 2).…”

Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group

“…However, in addition to being lengthy, it requires a licensing fee to use, potentially limiting broad implementation. The 12‐item Oxford Knee and Hip Scores assess pain and function and were designed to measure outcomes following joint replacement surgery 17, 18. They are widely used in clinical studies and joint replacement registries, but how applicable they are to the general OA population is unclear, and they require a license for use.…”

Preoperative pain location is a poor predictor of outcome after Oxford unicompartmental knee arthroplasty at 1 and 5 years

“…Clinical data were collected preoperatively and at one and five years following surgery by the same independent assessor and included Oxford Knee Score (OKS) [9,20], American Knee Society functional and objective scores (AKSS-fcn and AKSS-obj respectively) [17], and Tegner activity scale [25]. One year was determined as the principal follow-up interval because it has been demonstrated that the majority of the functional improvement after knee arthroplasty is within the first year [7,21,6,23]; a subset of these patients have attained five years' follow-up and we also present their five-year data.…”