Preoperative Function Affects Ability to Achieve One-Year Minimum Clinically Important Difference for Patients Undergoing Total Knee Arthroplasty

Overview

Journal Arthroplast Today

Publisher Elsevier

Date 2024 Apr 24

PMID 38654887

Authors

Patrick Albright

Fernando A Huyke-Hernandez

Andrew Ormseth

Stephen A Doxey

Evan Banks

Arthur J Only

Patrick K Horst

Brian P Cunningham

Affiliations

Soon will be listed here.

Abstract

Background: Minimum clinically important difference (MCID) values are commonly used to measure treatment success for total knee arthroplasty (TKA). MCID values vary according to calculation methodology, and prior studies have shown that patient factors are associated with failure to achieve MCID thresholds. The purpose of this study was to determine if anchor-based 1-year Knee Injury and Osteoarthritis Outcome Score Joint Replacement (KOOS-JR) MCID values varied among patients undergoing TKA based on patient-specific factors.

Methods: This was a retrospective review of patients undergoing TKA from 2017-2018. Patients without baseline or 1-year KOOS-JR or Patient-Reported Outcome Measurement Information System Global Health data or that underwent procedures other than primary TKA were excluded. MCIDs were calculated and compared between patient groups according to preoperative characteristics.

Results: Among the included 976 patients, 1-year KOOS-JR MCIDs were 26.6 for men, 28.2 for women, 30.7 for patients with a diagnosis of anxiety and/or depression, and 26.7 for patients without a diagnosis. One-year MCID values did not differ significantly according to gender ( = .379) or mental health diagnosis ( = .066), nor did they correlate with body mass index ( = -0.034, = .822). Preoperative KOOS-JR decile demonstrated an inverse relationship with 1-year MCID values and attainment of MCID.

Conclusions: The proportion of patients attaining KOOS-JR MCID values demonstrated an inverse relationship with preoperative baseline function. Future investigation may identify patient factors that allow surgeons to better capture patient satisfaction with their procedure despite failure to attain a 1-year MCID.

References

Maltenfort M . CORR Insights: What is the Responsiveness and Respondent Burden of the New Knee Society Score?. Clin Orthop Relat Res. 2017; 475(9):2228-2229. PMC: 5539025. DOI: 10.1007/s11999-017-5352-3. View

Lavernia C, Alcerro J, Brooks L, Rossi M . Mental health and outcomes in primary total joint arthroplasty. J Arthroplasty. 2012; 27(7):1276-82. DOI: 10.1016/j.arth.2011.11.015. View

Lyman S, Lee Y, McLawhorn A, Islam W, Maclean C . What Are the Minimal and Substantial Improvements in the HOOS and KOOS and JR Versions After Total Joint Replacement?. Clin Orthop Relat Res. 2018; 476(12):2432-2441. PMC: 6259893. DOI: 10.1097/CORR.0000000000000456. View

Tatman L, Obremskey W . Patient Reported Outcomes: The Foundation of Value. J Orthop Trauma. 2019; 33 Suppl 7:S53-S55. DOI: 10.1097/BOT.0000000000001613. View

Evans J, Walker R, Evans J, Blom A, Sayers A, Whitehouse M . How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019; 393(10172):655-663. PMC: 6381229. DOI: 10.1016/S0140-6736(18)32531-5. View

Darrith B, Khalil L, Franovic S, Bazydlo M, Weir R, Banka T . Preoperative Patient-Reported Outcomes Measurement Information System Global Health Scores Predict Patients Achieving the Minimal Clinically Important Difference in the Early Postoperative Time Period After Total Knee Arthroplasty. J Am Acad Orthop Surg. 2021; 29(24):e1417-e1426. DOI: 10.5435/JAAOS-D-20-01288. View

Swiontkowski M, ENGELBERG R, Martin D, Agel J . Short musculoskeletal function assessment questionnaire: validity, reliability, and responsiveness. J Bone Joint Surg Am. 1999; 81(9):1245-60. DOI: 10.2106/00004623-199909000-00006. View

Eckhard L, Munir S, Wood D, Talbot S, Brighton R, Walter B . The ceiling effects of patient reported outcome measures for total knee arthroplasty. Orthop Traumatol Surg Res. 2020; 107(3):102758. DOI: 10.1016/j.otsr.2020.102758. View

Daigle M, Weinstein A, Katz J, Losina E . The cost-effectiveness of total joint arthroplasty: a systematic review of published literature. Best Pract Res Clin Rheumatol. 2012; 26(5):649-58. PMC: 3879923. DOI: 10.1016/j.berh.2012.07.013. View

10.

Choi Y, Ra H . Patient Satisfaction after Total Knee Arthroplasty. Knee Surg Relat Res. 2016; 28(1):1-15. PMC: 4779800. DOI: 10.5792/ksrr.2016.28.1.1. View

11.

Berliner J, Brodke D, Chan V, SooHoo N, Bozic K . John Charnley Award: Preoperative Patient-reported Outcome Measures Predict Clinically Meaningful Improvement in Function After THA. Clin Orthop Relat Res. 2015; 474(2):321-9. PMC: 4709271. DOI: 10.1007/s11999-015-4350-6. View

12.

Halawi M, Cote M, Singh H, OSullivan M, Savoy L, Lieberman J . The Effect of Depression on Patient-Reported Outcomes After Total Joint Arthroplasty Is Modulated by Baseline Mental Health: A Registry Study. J Bone Joint Surg Am. 2018; 100(20):1735-1741. DOI: 10.2106/JBJS.17.01677. View

13.

Hays R, Bjorner J, Revicki D, Spritzer K, Cella D . Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Qual Life Res. 2009; 18(7):873-80. PMC: 2724630. DOI: 10.1007/s11136-009-9496-9. View

14.

de Vet H, Ostelo R, Terwee C, van der Roer N, Knol D, Beckerman H . Minimally important change determined by a visual method integrating an anchor-based and a distribution-based approach. Qual Life Res. 2006; 16(1):131-42. PMC: 2778628. DOI: 10.1007/s11136-006-9109-9. View

15.

Maratt J, Lee Y, Lyman S, Westrich G . Predictors of Satisfaction Following Total Knee Arthroplasty. J Arthroplasty. 2015; 30(7):1142-5. DOI: 10.1016/j.arth.2015.01.039. View

16.

Chesworth B, Mahomed N, Bourne R, Davis A . Willingness to go through surgery again validated the WOMAC clinically important difference from THR/TKR surgery. J Clin Epidemiol. 2008; 61(9):907-18. DOI: 10.1016/j.jclinepi.2007.10.014. View

17.

Kuo A, Giori N, Bowe T, Manfredi L, Lalani N, Nordin D . Comparing Methods to Determine the Minimal Clinically Important Differences in Patient-Reported Outcome Measures for Veterans Undergoing Elective Total Hip or Knee Arthroplasty in Veterans Health Administration Hospitals. JAMA Surg. 2020; 155(5):404-411. PMC: 7097846. DOI: 10.1001/jamasurg.2020.0024. View

18.

Fidai M, Saltzman B, Meta F, Lizzio V, Stephens J, Bozic K . Patient-Reported Outcomes Measurement Information System and Legacy Patient-Reported Outcome Measures in the Field of Orthopaedics: A Systematic Review. Arthroscopy. 2017; 34(2):605-614. DOI: 10.1016/j.arthro.2017.07.030. View

19.

Squitieri L, Bozic K, Pusic A . The Role of Patient-Reported Outcome Measures in Value-Based Payment Reform. Value Health. 2017; 20(6):834-836. PMC: 5735998. DOI: 10.1016/j.jval.2017.02.003. View

20.

Berliner J, Brodke D, Chan V, SooHoo N, Bozic K . Can Preoperative Patient-reported Outcome Measures Be Used to Predict Meaningful Improvement in Function After TKA?. Clin Orthop Relat Res. 2016; 475(1):149-157. PMC: 5174023. DOI: 10.1007/s11999-016-4770-y. View