Can Preoperative Patient-reported Outcome Measures Be Used to Predict Meaningful Improvement in Function After TKA?

• DOI: 10.1007/s11999-016-4770-y
• Publication Date: 2016-03-08T15:45:10Z
• Authors: Jonathan L. Berliner; Dane J. Brodke; Vanessa Chan; Nelson F. SooHoo; Kevin J. Bozic
• Keywords: Prom; Patient-reported outcome; Oxford knee score

Despite the overall effectiveness of total knee arthroplasty (TKA), a subset patients do not experience expected improvements in pain, physical function, and quality life as documented by patient-reported outcome measures (PROMs), which assess patient's emotional health pain. It is therefore important to develop preoperative tools capable identifying unlikely improve clinically margin after surgery.The purpose this study was determine if an association exists between PROM scores patients' likelihood experiencing meaningful change function 1 year TKA.A retrospective design used evaluate 1-year postoperative Knee injury Osteoarthritis Outcome Score (KOOS) SF-12 version 2 (SF12v2) from 562 who underwent primary unilateral TKA. This cohort represented 75% 750 surgery during that time period; 188 others (25%) either did complete at designated times or were lost follow-up. Minimum differences (MCIDs) calculated for each using distribution-based method define clinical improvement. MCID values KOOS SF12v2 component summary (PCS) be 10 5, respectively. A receiver operating characteristic analysis threshold PCS their respective predictive abilities. Threshold defined point improvement began diminish. Multivariate regression control effect mental health, patient attributes quantified (MCS) scores, on surgery.Threshold maximum 58 (area under curve [AUC], 0.76; p < 0.001) 34 (AUC, 0.65; 0.001), Patients scoring above these thresholds, indicating better less likely When accounting with multivariate analysis, ability both improved (AUCs increased 0.80 0.71, respectively). Better reflected higher MCS score, resulted PCS.We identified are associated functional have diminishing probability worse baseline (as score) lower levels surgery. The results directly applicable patient-centered informed decision-making may facilitate discussions regarding benefit TKA.Level III, prognostic study.