Can KOOS-PS Be Replaced with a Simple Anchor Question in Patients After Total Knee Arthroplasty?: an Agreement Study of 2,478 Primary Surgeries

Overview

Journal Acta Orthop

Specialty Orthopedics

Date 2024 Nov 12

PMID 39531519

Authors

Siri Bjorgen Winther

Anders Sjostrom

Solvi Liabakk-Selli

Olav A Foss

Tina S Wik

Jomar Klaksvik

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Physical function and pain are the most important outcomes following total knee arthroplasty (TKA). These can be evaluated by patient-reported outcome measures (PROMs), or by an anchor question. The primary aim of the study was to evaluate whether a simple anchor question can replace KOOS-PS in assessing postoperative knee function until 1-year follow-up, evaluated by analyzing the agreement between the 2 methods using the diagnostic odds ratio (DOR). Secondary aims were pain (NRS) at rest and during mobilization.

Methods: This is a diagnostic accuracy study with primary TKAs performed between 2010 and 2022. The surgeries were categorized as improved (I) or worsened (W) based on a dichotomized anchor question related to self-perceived change in physical function, and the dichotomized change in KOOS-PS until 1-year follow-up. This led to 4 groups: (II, IW, WI, and WW).

Results: Agreement was found with a DOR of 11.3 (CI 7.9-16.2). 2,335 (94%) reported improved function on the anchor question and 143 (6%) worsened function. Among those with improved anchor 2,132 (91%) had improved KOOS-PS, but among those with worsened anchor only 74 (52%) had worsened KOOS-PS. Pain at 1-year follow-up was lower in the groups reporting improved anchor.

Conclusion: The KOOS-PS can be replaced with an anchor question to assess change in function until 1 year. However, the KOOS-PS might be a valuable supplement in patients reporting worsened anchor as only half of those had worsened KOOS-PS.

Citing Articles

Response to Letter: Using KOOS-PS to validate dichotomous global rating of improvement or worsening following total knee arthroplasty.

Winther S, Sjostrom A, Liabakk-Selli S, Foss O, Wik T, Klaksvik J Acta Orthop. 2024; 95:750-751.

PMID: 39711297 PMC: 11664431. DOI: 10.2340/17453674.2024.42743.

Letter to the Editor: Using KOOS-PS to validate dichotomous global ratings of improvement or worsening following total knee arthroplasty.

Riddle D, Dumenci L Acta Orthop. 2024; 95:746-747.

PMID: 39711295 PMC: 11664430. DOI: 10.2340/17453674.2024.42632.

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