The minimal clinically important difference for Knee Society Clinical Rating System after total knee arthroplasty for primary osteoarthritis

Lee, Wu Chean; Kwan, Yu Heng; Chong, Hwei Chi; Yeo, Seng Jin

doi:10.1007/s00167-016-4208-9

Cited by 195 publications

(111 citation statements)

References 32 publications

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“…The OHS is a 12-item questionnaire specific to assessing function and pain for patients undergoing THA [17,18]. Minimal clinically important difference (MCID) in TKA has been previously reported to be 15 points for WOMAC [19], 4.3 points for SF-12 PCS [20], 3.1 points for SF-12 MCS [21], and 11.4 points for KSCRS [22].…”

Section: Methodsmentioning

confidence: 99%

Patient-reported outcome measures in total joint arthroplasty: defining the optimal collection window

et al. 2020

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a b s t r a c tBackground: The purpose of this study was to determine the optimal window for collection of patientreported outcome measures (PROMs) after total joint arthroplasty (TJA). Methods: Our prospectively collected institutional joint registry was queried for patients who underwent primary, unilateral TJAs. The primary outcomes were the net changes in WOMAC, SF-12 MCS, SF-12 PCS, OHS, KSCRS, and UCLA activity rating system at 6, 12, and 24 months postoperatively. Secondary outcomes were data acquisition costs and follow-up attrition rates. Results: Eight hundred sixty-six procedures (450 total hip arthroplasties, 416 TKAs) were analyzed. A consistent plateau in all PROMs was noted by 6 months postoperativelyeexcept for SF-12 MCS which showed no significant changes at any time interval. For TKA, the percentage of overall improvement achieved by 6 months was 88.7%, 84.5%, 100%, and 90.5% for the WOMAC, SF-12 PCS, UCLA, and KSCRS, respectively. For total hip arthroplasty, these values were 92.7%, 83.5%, 88.0%, and 89.8% for WOMAC, SF-12 PCS, UCLA, and OHS, respectively. There were marginal improvements from 6 to 12 months and no improvement from 12 to 24 months. Follow-up rates at 6, 12, and 24 months were 85%, 69%, and 40%, respectively. Our institutional costs for collecting a complete data set per patient were $128, $158, and $272 for 6, 12, and 24 months, respectively. Conclusions: Most of the improvement in PROMs after primary TJA occurs within the first 6 months. In addition, limiting PROMs collection to 6 months appears to be cost-efficient owing to increased attrition rates beyond this time interval.

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Section: Methodsmentioning

confidence: 99%

Patient-reported outcome measures in total joint arthroplasty: defining the optimal collection window

et al. 2020

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“…Type I error, power of test, and ratio of the treatment groups were set at 0.05, 0.80, and 1:1, respectively. The estimated sample size was 12 for each group in order to detect the minimal clinically significant mean difference of KSS of 6.1 units [21]. Loss to follow-up was estimated to be 20%, which yields a required sample size of 15 patients per group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 1-year outcomes between MAKO versus NAVIO robot-assisted medial UKA: nonrandomized, prospective, comparative study

Leelasestaporn

Tarnpichprasert

Arirachakaran

et al. 2020

Knee Surg & Relat Res

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Background: We have conducted a prospective cohort study with the aim of comparing operative time, intraoperative blood loss, and radiologic and clinical outcomes between imageless (NAVIO) and image-based (MAKO) robot-assisted unicompartmental knee arthroplasty (UKA) for medial compartment osteoarthritis (OA) of the knee. Methods: A total of 33 patients with medial compartment OA of the knee were prospectively allocated on alternate operative days of their surgery to MAKO (16 patients) or NAVIO (17 patients) robot-assisted UKA. The primary outcome (Knee Society Score [KSS] and Knee Functional Score [KFS]) and the secondary outcomes (intraoperative time of seven steps [registration of hip and ankle, femur and tibia, ligament tension, implant planning, preparation femur, tibia and trial implant], component alignment [coronal and sagittal of femur, tibia implant], blood loss, complications, and revision at 1 year after surgery) were compared between two groups. Statistical significance was set at P < 0.05. Results: Mean KSS measured at baseline and 1 year were, respectively, 70.3 (5.6) and 96.9 (5.7) in the NAVIO group and 72.3 (4.5) and 94.7 (10.01) in the MAKO group. Mean KFS measured at baseline and 1 year were, respectively, 95.5 (7.9) and 99.9 (0.25) in the NAVIO group and 67.3 (7.8) and 99.5 (1.2) in the MAKO group. There were no significant differences for KFS and KSS outcomes (P = 0.203 and P = 0.457, respectively) between the NAVIO and MAKO groups. Mean operative time and blood loss in the NAVIO versus MAKO robot-assisted UKA groups were 98 min versus 82.5 min and 136.3 ml versus 80 ml, respectively, and these differences were statistically significant. In the MAKO group, the intraoperative time was statistically significantly shorter in registration of hip and ankle center, femur and tibia, femur preparation, and trial implantation compared with the NAVIO group. There were no significant differences of component alignment and radiologic alignment at 1 year between the two groups. No perioperative or delayed complications (infection, periprosthetic fracture, thromboembolism, and compromised wound healing) and revisions were reported in either group. Conclusions: This study demonstrated that two robotic systems showed no difference in clinical outcomes at 1 year and radiologic alignment of implants, whereas operative time and intraoperative blood loss were found to be less in MAKO robot-assisted UKA. Trial registration: ClinicalTrials.gov, NCT03954912. Registered on 17 May 2019.

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“…Differences were marginal and well below the minimal clinically important differences (KS, 5 points and FS, 6 points [21]). This implies that excellent outcome can be obtained with both versions of the implant with the use of an extension-first technique.…”

Section: Discussionmentioning

confidence: 99%

Good Early Results Obtained with a Guided-Motion Implant for Total Knee Arthroplasty: A Consecutive Case Series

Hommel¹,

Wilke²

2017

TOORTHJ

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Background:Previous studies have shown a high incidence of complications with a bi-cruciate stabilized (BCS) guided-motion total knee arthroplasty (TKA) design, which led to recent modifications of the design by the manufacturer.Objective:The current study was undertaken to assess whether the use of this TKA system with an extension-first surgical technique is associated with a similar rate of short-term adverse outcome as reported in literature.Material and Methods:This retrospective study enrolled 257 consecutive patients (257 knees) undergoing TKA for osteoarthritis of the knee, with the first 153 receiving cemented Journey BCS I implants and the remaining 104 receiving cemented Journey BCS II implants when these became available.Results:Mean follow-up time for the cohort was 24.5 ± 7.8 months (range, 12 - 36 months). There were no cases of stiffness. Incidence of iliotibial friction syndrome was considered low: three (2.0%) knees in the BCS I group and two (1.9%) in the BCS II group (p = 0.676). Five (2.5%) knees presented with mild instability in midflexion, three (2.0%) in the BCS I group and two (1.9%) in the BCS II group (p = 0.676). One patient with a BCS I implant required reoperation for aseptic loosening 23 months postoperatively. At one-year follow-up, there were no clinically relevant differences in any of the clinical outcomes.Conclusion:When used in combination with an extension-first surgical technique, good early functional results with an acceptable rate of complications were obtained with both the original and the updated Journey BCS knee implant.

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The minimal clinically important difference for Knee Society Clinical Rating System after total knee arthroplasty for primary osteoarthritis

Abstract: IV.

Cited by 195 publications

References 32 publications

Patient-reported outcome measures in total joint arthroplasty: defining the optimal collection window

Patient-reported outcome measures in total joint arthroplasty: defining the optimal collection window

Comparison of 1-year outcomes between MAKO versus NAVIO robot-assisted medial UKA: nonrandomized, prospective, comparative study

Good Early Results Obtained with a Guided-Motion Implant for Total Knee Arthroplasty: A Consecutive Case Series

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