PMID- 34454804 OWN - NLM STAT- MEDLINE DCOM- 20211224 LR - 20211224 IS - 1532-8406 (Electronic) IS - 0883-5403 (Linking) VI - 36 IP - 12 DP - 2021 Dec TI - A Weighted Scoring System Based on Preoperative and Long-Term Patient-Reported Outcome Measures to Guide Timing of Knee Arthroplasty. PG - 3894-3900 LID - S0883-5403(21)00648-3 [pii] LID - 10.1016/j.arth.2021.08.008 [doi] AB - BACKGROUND: There is currently no existing consensus regarding timing of knee arthroplasty. This study aimed to develop a weighted scoring system from patient-reported outcome measures (PROMs) to guide timing of knee arthroplasty based on preoperative severity and long-term effectiveness. METHODS: Prospectively collected data of 766 total knee arthroplasties (TKAs) and 382 unicompartmental knee arthroplasties (UKAs) at a single institution were analyzed. PROMs were assessed preoperatively and at 10 years using the Knee Society Score (KSS), Oxford Knee Score (OKS), and Short Form-36 physical component score (SF-36 PCS). Receiver operating characteristic analysis identified thresholds where preoperative PROMs predicted 10-year clinically meaningful improvements (minimal clinically important difference [MCID]). Threshold weights were assigned to PROMs based on their ability to predict MCID in isolation or in combination. RESULTS: Poorer baseline PROMs predicted 10-year MCID attainments. The threshold of 49.5 points for the KSS, 30.5 points for the OKS, and 40.7 points for the SF-36 PCS and 55.5 points for the KSS, 33.5 points for the OKS, and 40.5 points for the SF-36 PCS was weighted 1 point for predicting MCID in 1 PROM for TKA and UKA, respectively. The threshold of 33.4 and 33.9 points for the SF-36 PCS was weighted 2 points for predicting MCID in 2 PROMs, whereas 29.3 and 31.3 points for the SF-36 PCS were weighted 3 points for predicting MCID in 3 PROMs for TKA and UKA, respectively. The sum of weighted components from 0 (lowest) to 5 (highest) represented likelihood for long-term benefits at 10 years. CONCLUSION: This scoring system is a useful clinical adjunct for deciding timing of knee arthroplasty and prioritizing patients in institutions with long waitlists. LEVEL OF EVIDENCE: II. CI - Copyright (c) 2021 Elsevier Inc. All rights reserved. FAU - Khow, Yong Zhi AU - Khow YZ AD - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore. FAU - Liow, Ming Han Lincoln AU - Liow MHL AD - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore. FAU - Yeoh, Zhi Guang Felix AU - Yeoh ZGF AD - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore. FAU - Chen, Jerry Yongqiang AU - Chen JY 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 DEP - 20210809 PL - United States TA - J Arthroplasty JT - The Journal of arthroplasty JID - 8703515 SB - IM MH - *Arthroplasty, Replacement, Knee MH - Humans MH - Knee Joint/surgery MH - *Osteoarthritis, Knee/surgery MH - Patient Reported Outcome Measures MH - Treatment Outcome OTO - NOTNLM OT - long-term OT - minimal clinically important difference OT - patient-reported outcome measures OT - preoperative OT - scoring system OT - timing EDAT- 2021/08/30 06:00 MHDA- 2021/12/25 06:00 CRDT- 2021/08/29 20:38 PHST- 2021/05/30 00:00 [received] PHST- 2021/07/30 00:00 [revised] PHST- 2021/08/04 00:00 [accepted] PHST- 2021/08/30 06:00 [pubmed] PHST- 2021/12/25 06:00 [medline] PHST- 2021/08/29 20:38 [entrez] AID - S0883-5403(21)00648-3 [pii] AID - 10.1016/j.arth.2021.08.008 [doi] PST - ppublish SO - J Arthroplasty. 2021 Dec;36(12):3894-3900. doi: 10.1016/j.arth.2021.08.008. Epub 2021 Aug 9.