PMID- 35202758
OWN - NLM
STAT- MEDLINE
DCOM- 20220608
LR  - 20220728
IS  - 1532-8406 (Electronic)
IS  - 0883-5403 (Linking)
VI  - 37
IP  - 7
DP  - 2022 Jul
TI  - Outcomes Vary Significantly Using a Tiered Approach to Define Success After Total 
      Knee Arthroplasty.
PG  - 1266-1272
LID - S0883-5403(22)00213-3 [pii]
LID - 10.1016/j.arth.2022.02.065 [doi]
AB  - BACKGROUND: Patient-reported outcome measures (PROM) allow assessment of clinical 
      outcomes following primary total knee arthroplasty (TKA). The purpose of this 
      study is to use progressively more stringent definitions of success to examine 
      clinical outcomes of primary TKA at 1 year postoperatively and to determine which 
      demographic variables were associated with achieving clinical success. METHODS: 
      The American Joint Replacement Registry was queried from 2012 to 2020 for primary 
      TKA. Patients who completed the following PROMs preoperatively and 1 year 
      postoperatively were included: Western Ontario and McMaster Universities 
      Arthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), and 
      KOOS for Joint Replacement (KOOS JR). Mean PROM scores were determined for each 
      visit and between-visit changes were evaluated using paired t-tests. Rates of 
      achievement of minimal clinically important difference (MCID) by 
      distribution-based and anchor-based criteria, Patient Acceptable Symptom State, 
      and substantial clinical benefit were calculated. Logistic regression was used to 
      evaluate the association between demographic variables and odds of clinical 
      success. RESULTS: In total, 12,341 TKAs were included. Mean improvement in PROM 
      scores were as follows: KOOS JR, 29; WOMAC-Pain, 33; and WOMAC-Function, 31 (P < 
      .0001 for all). Rates of achievement of each metric were the following: 
      distribution-based MCID, 84%-87%; anchor-based MCID, 46%-79%; Patient Acceptable 
      Symptom State, 54%-82%; and substantial clinical benefit, 68%-81%. Patient age 
      and gender were the most influential demographic factors on achievement of 
      clinical success. CONCLUSION: Clinical outcomes at 1 year following TKA vary 
      significantly when using a tiered approach to define success. A tiered approach 
      to interpretation of PROMs should be considered for future research and clinical 
      assessment.
CI  - Copyright (c) 2022 Elsevier Inc. All rights reserved.
FAU - Carender, Christopher N
AU  - Carender CN
AD  - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and 
      Clinics, Iowa City, Iowa.
FAU - Glass, Natalie A
AU  - Glass NA
AD  - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and 
      Clinics, Iowa City, Iowa.
FAU - De, Ayushmita
AU  - De A
AD  - American Academy of Orthopedic Surgeons, Rosemont, Illinois.
FAU - Bozic, Kevin J
AU  - Bozic KJ
AD  - Department of Surgery and Perioperative Care, University of Texas at Austin, 
      Austin, Texas.
FAU - Callaghan, John J
AU  - Callaghan JJ
AD  - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and 
      Clinics, Iowa City, Iowa.
FAU - Bedard, Nicholas A
AU  - Bedard NA
AD  - Department of Orthopedic Surgery, Division of Hip and Knee Reconstruction, Mayo 
      Clinic, Rochester, Minnesota.
LA  - eng
PT  - Journal Article
DEP - 20220221
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  - Minimal Clinically Important Difference
MH  - *Osteoarthritis, Knee/surgery
MH  - Patient Reported Outcome Measures
MH  - Treatment Outcome
OTO - NOTNLM
OT  - MCID
OT  - PROM
OT  - minimal clinically important difference
OT  - patient-reported outcome measures
OT  - total knee arthroplasty
EDAT- 2022/02/25 06:00
MHDA- 2022/06/09 06:00
CRDT- 2022/02/24 20:11
PHST- 2022/01/31 00:00 [received]
PHST- 2022/02/12 00:00 [revised]
PHST- 2022/02/15 00:00 [accepted]
PHST- 2022/02/25 06:00 [pubmed]
PHST- 2022/06/09 06:00 [medline]
PHST- 2022/02/24 20:11 [entrez]
AID - S0883-5403(22)00213-3 [pii]
AID - 10.1016/j.arth.2022.02.065 [doi]
PST - ppublish
SO  - J Arthroplasty. 2022 Jul;37(7):1266-1272. doi: 10.1016/j.arth.2022.02.065. Epub 
      2022 Feb 21.