PMID- 34014863
OWN - NLM
STAT- MEDLINE
DCOM- 20211124
LR  - 20211124
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 103
IP  - 15
DP  - 2021 Aug 4
TI  - Minimal Clinically Important Differences for Patient-Reported Outcomes After TKA 
      Depend on Central Sensitization.
PG  - 1374-1382
LID - 10.2106/JBJS.20.02138 [doi]
AB  - BACKGROUND: To our knowledge, it is still unknown if central sensitization (CS) 
      influences the magnitude of the minimal clinically important difference (MCID) 
      for patient-reported outcome measures after total knee arthroplasty (TKA). The 
      purpose of this study was to determine the influence of CS on the MCID for the 
      Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score in 
      patients who underwent TKA for knee osteoarthritis. METHODS: A total of 422 
      patients who underwent unilateral TKA and completed a 2-year follow-up were 
      enrolled in this study. CS was measured using the Central Sensitization Inventory 
      (CSI). The WOMAC score was used to evaluate preoperative and postoperative 
      patient-reported outcomes. The measurement of the MCID was performed separately 
      for patients with and without CS using both the anchor-based method and the 
      distribution method. The change difference method defined the MCID as the 
      difference in preoperative-to-postoperative change between the 
      minimal-improvement group and the no-change group. In addition, the MCID was 
      calculated using receiver operating characteristic (ROC) curve analysis. The 
      percentage of MCID achievement in each group was also compared. RESULTS: 
      According to the change difference method, the MCID for the WOMAC total score was 
      23.4 points for patients with CS and 14.7 points for patients without CS. The 
      MCID using the ROC cutoff value for the WOMAC total score was 29.5 points for the 
      patients with CS and 26.5 points for the patients without CS. MCID achievement 
      rates in WOMAC pain, function, and total scores were all found to be 
      significantly higher in the patients without CS through the change difference 
      method and the ROC method (all p < 0.05). CONCLUSIONS: The MCID for the WOMAC 
      score of patients with CS after TKA was greater than that for patients without 
      CS. Furthermore, by applying the calculated MCID to the group to which the 
      patients belonged (with or without CS), we determined that patients with CS 
      showed a lower MCID achievement rate than patients without CS. LEVEL OF EVIDENCE: 
      Prognostic Level III. See Instructions for Authors for a complete description of 
      levels of evidence.
CI  - Copyright (c) 2021 by The Journal of Bone and Joint Surgery, Incorporated.
FAU - Kim, Man Soo
AU  - Kim MS
AUID- ORCID: 0000-0002-1374-9964
AD  - Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of 
      Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
FAU - Koh, In Jun
AU  - Koh IJ
AUID- ORCID: 0000-0002-7941-1587
AD  - Department of Orthopaedic Surgery, Eunpyeong St. Mary's Hospital, College of 
      Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
FAU - Choi, Keun Young
AU  - Choi KY
AUID- ORCID: 0000-0002-4118-3742
AD  - Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of 
      Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
FAU - Seo, Jeong Yong
AU  - Seo JY
AUID- ORCID: 0000-0001-9814-2856
AD  - Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of 
      Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
FAU - In, Yong
AU  - In Y
AUID- ORCID: 0000-0002-5932-3934
AD  - Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of 
      Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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
CIN - J Bone Joint Surg Am. 2021 Aug 4;103(15):e60. PMID: 34357895
MH  - Aged
MH  - Arthralgia/diagnosis/etiology/*surgery
MH  - Arthroplasty, Replacement, Knee/*statistics & numerical data
MH  - Central Nervous System Sensitization/*physiology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - Nociception/*physiology
MH  - Osteoarthritis, Knee/complications/diagnosis/*surgery
MH  - Pain Measurement/statistics & numerical data
MH  - Patient Reported Outcome Measures
MH  - ROC Curve
MH  - Treatment Outcome
COIS- Disclosure: The authors indicated that no external funding was received for any 
      aspect of this work. The Disclosure of Potential Conflicts of Interest forms are 
      provided with the online version of the article (http://links.lww.com/JBJS/G515).
EDAT- 2021/05/21 06:00
MHDA- 2021/11/25 06:00
CRDT- 2021/05/20 18:06
PHST- 2021/05/21 06:00 [pubmed]
PHST- 2021/11/25 06:00 [medline]
PHST- 2021/05/20 18:06 [entrez]
AID - 00004623-202108040-00003 [pii]
AID - 10.2106/JBJS.20.02138 [doi]
PST - ppublish
SO  - J Bone Joint Surg Am. 2021 Aug 4;103(15):1374-1382. doi: 10.2106/JBJS.20.02138.