PMID- 27147686
OWN - NLM
STAT- MEDLINE
DCOM- 20170406
LR  - 20221207
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 98
IP  - 9
DP  - 2016 May 4
TI  - Age and Preoperative Knee Society Score Are Significant Predictors of Outcomes 
      Among Asians Following Total Knee Arthroplasty.
PG  - 735-41
LID - 10.2106/JBJS.15.00280 [doi]
AB  - BACKGROUND: The ability to predict patients' functional outcomes will add value 
      to preoperative counseling. The purpose of this study was to evaluate predictors 
      of good outcomes following total knee arthroplasty (TKA) among Asian patients. 
      METHODS: Registry data from 2006 to 2010 were extracted. The Oxford Knee Score 
      (OKS) and the Short Form (SF)-36 physical component summary (PCS) were used to 
      evaluate outcomes. A "good outcome" was defined as an improvement in scores of 
      greater than or equal to the minimal clinically important difference (MCID) in 
      the primary analysis. The MCID for the OKS was 5, and the MCID for the PCS was 
      10. For the sensitivity analyses, a "good outcome" was defined as an OKS of <30 
      and a PCS score of >50. Clinical variables were used to develop a multiple 
      logistic regression model for a good outcome following total knee arthroplasty at 
      5 years. RESULTS: Follow-up data were available for 3,062 patients who underwent 
      primary TKA (mean age of 66.4 years; 79.5% female). Eighty-five percent had a 
      good outcome on the basis of the OKS and 83%, on the basis of the SF-36 PCS. Age 
      and preoperative Knee Society score (KSS) were found to be significant 
      predictors. When outcomes were assessed by the MCID, lesser age and lower (worse) 
      preoperative KSS predicted a good outcome at 5 years. When outcomes were assessed 
      by absolute criteria (postoperative scores measured against OKS and PCS 
      thresholds), a higher (better) preoperative KSS predicted a good outcome at 5 
      years. Body mass index, preoperative flexion range, SF-36 mental component 
      summary (MCS) score, mechanical alignment, sex, education level, ethnicity, 
      operative side, number of comorbidities, type of anesthesia, and type of implant 
      were found not to be significant predictors. CONCLUSIONS: The majority of Asian 
      patients with osteoarthritis had good outcomes according to the MCID criterion 
      and benefitted from primary TKA. On the basis of our findings, we believe that 
      older patients with a lower (worse) preoperative KSS can be informed that they 
      have a high likelihood of improvement but a lower likelihood of achieving as good 
      a functional outcome as those with better scores. LEVEL OF EVIDENCE: Prognostic 
      Level IV. See Instructions for Authors for a complete description of levels of 
      evidence.
CI  - Copyright (c) 2016 by The Journal of Bone and Joint Surgery, Incorporated.
FAU - Bin Abd Razak, Hamid Rahmatullah
AU  - Bin Abd Razak HR
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 
      hamidrazak@gmail.com.
FAU - Tan, Chuen-Seng
AU  - Tan CS
AD  - Saw Swee Hock School of Public Health, National University of Singapore, 
      Singapore.
FAU - Chen, Yongqiang Jerry Delphi
AU  - Chen YJ
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Pang, Hee-Nee
AU  - Pang HN
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Tay, Keng-Jin Darren
AU  - Tay KJ
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Chin, Pak-Lin
AU  - Chin PL
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Chia, Shi-Lu
AU  - Chia SL
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Lo, Ngai-Nung
AU  - Lo NN
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Yeo, Seng-Jin
AU  - Yeo SJ
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Arthroplasty, Replacement, Knee/*methods
MH  - *Asian People
MH  - Female
MH  - Humans
MH  - Knee Joint/physiopathology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Osteoarthritis, Knee/diagnosis/physiopathology/*surgery
MH  - Patient Satisfaction
MH  - Postoperative Period
MH  - Predictive Value of Tests
MH  - Range of Motion, Articular/physiology
MH  - Severity of Illness Index
MH  - Singapore
MH  - Treatment Outcome
EDAT- 2016/05/06 06:00
MHDA- 2017/04/07 06:00
CRDT- 2016/05/06 06:00
PHST- 2016/05/06 06:00 [entrez]
PHST- 2016/05/06 06:00 [pubmed]
PHST- 2017/04/07 06:00 [medline]
AID - 98/9/735 [pii]
AID - 10.2106/JBJS.15.00280 [doi]
PST - ppublish
SO  - J Bone Joint Surg Am. 2016 May 4;98(9):735-41. doi: 10.2106/JBJS.15.00280.