PMID- 29567002 OWN - NLM STAT- MEDLINE DCOM- 20190304 LR - 20220409 IS - 1532-8406 (Electronic) IS - 0883-5403 (Linking) VI - 33 IP - 7S DP - 2018 Jul TI - How Much Pain Is Significant? Defining the Minimal Clinically Important Difference for the Visual Analog Scale for Pain After Total Joint Arthroplasty. PG - S71-S75.e2 LID - S0883-5403(18)30160-8 [pii] LID - 10.1016/j.arth.2018.02.029 [doi] AB - BACKGROUND: The ability to detect changes in patient-perceived pain after total joint arthroplasty (TJA) is critical to manage postoperative pain. The minimal clinically important difference (MCID) for visual analog scale for pain (VAS-P) has not been investigated in this population. This study investigated the MCID for VAS-P in the TJA population. METHODS: Postoperative pain scores were collected on 139 total hip arthroplasty (THA) and 165 total knee arthroplasty (TKA) patients. VAS-P was measured and Likert scores for changes in pain recorded together throughout the hospitalization per patient. Using a linear mixed model, the mean difference between preceding and current VAS-P was calculated and correlated with Likert score, when the patient reported at least slight improvement or worsening in pain, defining the MCID. Minimal detectable change was calculated using the VAS-P standard error of the means for patients reporting "no change." RESULTS: For THA, the overall mean and average highest VAS-P were 35.0 mm and 50.4 mm, respectively. For TKA, the overall mean and average highest VAS-P were 42.6 mm and 61.1 mm, respectively. The minimal detectable change in VAS-P was 14.9 mm for THA and 16.1 mm for TKA. The MCID for THA and TKA pain improvement was -18.6 mm and -22.6 mm, respectively, and for worsening was 23.6 mm and 29.1 mm, respectively. CONCLUSION: In the postoperative TJA population, VAS-P MCID changes depend on the type of surgical intervention, and whether pain is improving or worsening. Statistically significant VAS-P, improving -18.6 mm and -22.6 mm for THA and TKA patients, respectively, sets a reasonable threshold to identify clinically meaningful pain intervention with high specificity. CI - Copyright (c) 2018 Elsevier Inc. All rights reserved. FAU - Danoff, Jonathan R AU - Danoff JR AD - The Rothman Institute at Thomas Jefferson University, Philadelphia, PA. FAU - Goel, Rahul AU - Goel R AD - The Rothman Institute at Thomas Jefferson University, Philadelphia, PA. FAU - Sutton, Ryan AU - Sutton R AD - The Rothman Institute at Thomas Jefferson University, Philadelphia, PA. FAU - Maltenfort, Mitchell G AU - Maltenfort MG AD - The Rothman Institute at Thomas Jefferson University, Philadelphia, PA. FAU - Austin, Matthew S AU - Austin MS AD - The Rothman Institute at Thomas Jefferson University, Philadelphia, PA. LA - eng PT - Journal Article PT - Observational Study DEP - 20180222 PL - United States TA - J Arthroplasty JT - The Journal of arthroplasty JID - 8703515 SB - IM MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Arthroplasty, Replacement, Hip/*adverse effects/statistics & numerical data MH - Arthroplasty, Replacement, Knee/*adverse effects/statistics & numerical data MH - Child MH - Child, Preschool MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Minimal Clinically Important Difference MH - Pain Management/methods MH - Pain Measurement/*methods MH - Pain Perception MH - Pain, Postoperative/*diagnosis/therapy MH - Postoperative Period MH - Prospective Studies MH - Treatment Outcome MH - *Visual Analog Scale OTO - NOTNLM OT - hip OT - knee OT - postoperative pain OT - total joint arthroplasty OT - visual analog scale EDAT- 2018/03/24 06:00 MHDA- 2019/03/05 06:00 CRDT- 2018/03/24 06:00 PHST- 2017/12/04 00:00 [received] PHST- 2018/01/30 00:00 [revised] PHST- 2018/02/05 00:00 [accepted] PHST- 2018/03/24 06:00 [pubmed] PHST- 2019/03/05 06:00 [medline] PHST- 2018/03/24 06:00 [entrez] AID - S0883-5403(18)30160-8 [pii] AID - 10.1016/j.arth.2018.02.029 [doi] PST - ppublish SO - J Arthroplasty. 2018 Jul;33(7S):S71-S75.e2. doi: 10.1016/j.arth.2018.02.029. Epub 2018 Feb 22.