PMID- 36702437
OWN - NLM
STAT- MEDLINE
DCOM- 20230612
LR  - 20240213
IS  - 1532-8406 (Electronic)
IS  - 0883-5403 (Linking)
VI  - 38
IP  - 7
DP  - 2023 Jul
TI  - Identifying Aseptic Revision Total Knee Arthroplasty Diagnoses That Achieve 
      Minimal Clinically Important Difference and Patient Acceptable Symptom State.
PG  - 1309-1312
LID - S0883-5403(23)00020-7 [pii]
LID - 10.1016/j.arth.2023.01.020 [doi]
AB  - BACKGROUND: Minimal clinically important difference (MCID) defines a meaningful 
      clinical change in patient-reported outcome measures. Patient acceptable symptom 
      state (PASS) provides a patient-reported outcome measures threshold value to 
      indicate a satisfactory clinical state. MCID and PASS for revision total knee 
      arthroplasty (rTKA) are ill-defined. Moreover, it is unknown whether diagnosis 
      influences the likelihood of achieving MCID or PASS. The purpose of this study 
      was to calculate MCID for aseptic rTKA and compare the percentage of patients 
      achieving MCID and PASS per diagnosis. METHODS: An institutional registry of rTKA 
      was used. First-time aseptic rTKA were included. Demographics, revision 
      diagnosis, preoperative Knee Injury and Osteoarthritis Outcome Score, Jr (KOOS 
      Jr), and 1-year postoperative KOOS Jr were recorded. The 1-year postoperative 
      KOOS Jr PASS score was available. MCID was calculated using distribution-based 
      methods. Three hundred fifty eight first-time aseptic rTKAs were analyzed. The 3 
      most common diagnoses were aseptic loosening (n = 156), instability (n = 109), 
      and stiffness (n = 37). RESULTS: The mean KOOS Jr 1-year postoperative MCID for 
      rTKA was 10.3. Overall, 75.4% achieved MCID and 56.9% achieved PASS. The 
      percentage of patients per diagnosis achieving MCID and PASS, respectively, were 
      periprosthetic fracture (100, 44), aseptic loosening (94, 60), implant fracture 
      (88, 63), stiffness (60, 38), instability (59, 61), polyethylene wear/osteolysis 
      (57, 57), and metal allergy (44, 33). CONCLUSION: Aseptic rTKA MCID is 10.3 for 
      KOOS Jr at 1 year postoperatively. rTKA outcomes vary depending on preoperative 
      diagnosis. Even in diagnoses with a high proportion of MCID achieved, less than 
      2/3 of patients achieved PASS, suggesting rTKA provides noticeable improvement 
      but may not return patients to a satisfactory state.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Bendich, Ilya
AU  - Bendich I
AD  - Hospital for Special Surgery, Adult Reconstruction and Joint Replacement, New 
      York, New York.
FAU - Tarity, Thomas D
AU  - Tarity TD
AD  - Hospital for Special Surgery, Adult Reconstruction and Joint Replacement, New 
      York, New York.
FAU - Alpaugh, Kyle
AU  - Alpaugh K
AD  - Hospital for Special Surgery, Adult Reconstruction and Joint Replacement, New 
      York, New York.
FAU - Lyman, Stephen
AU  - Lyman S
AD  - Hospital for Special Surgery, Adult Reconstruction and Joint Replacement, New 
      York, New York.
FAU - Diane, Alioune
AU  - Diane A
AD  - Hospital for Special Surgery, Adult Reconstruction and Joint Replacement, New 
      York, New York.
FAU - Sculco, Peter K
AU  - Sculco PK
AD  - Hospital for Special Surgery, Adult Reconstruction and Joint Replacement, New 
      York, New York.
FAU - McLawhorn, Alexander S
AU  - McLawhorn AS
AD  - Hospital for Special Surgery, Adult Reconstruction and Joint Replacement, New 
      York, New York.
LA  - eng
PT  - Journal Article
DEP - 20230123
PL  - United States
TA  - J Arthroplasty
JT  - The Journal of arthroplasty
JID - 8703515
SB  - IM
MH  - Humans
MH  - *Arthroplasty, Replacement, Knee
MH  - Treatment Outcome
MH  - Minimal Clinically Important Difference
MH  - Registries
MH  - Patient Reported Outcome Measures
OTO - NOTNLM
OT  - minimal clinically important difference
OT  - outcomes
OT  - patient acceptable symptom state
OT  - revision joint replacement
OT  - revision total knee arthroplasty
EDAT- 2023/01/27 06:00
MHDA- 2023/06/12 06:42
CRDT- 2023/01/26 19:27
PHST- 2022/09/19 00:00 [received]
PHST- 2023/01/08 00:00 [revised]
PHST- 2023/01/17 00:00 [accepted]
PHST- 2023/06/12 06:42 [medline]
PHST- 2023/01/27 06:00 [pubmed]
PHST- 2023/01/26 19:27 [entrez]
AID - S0883-5403(23)00020-7 [pii]
AID - 10.1016/j.arth.2023.01.020 [doi]
PST - ppublish
SO  - J Arthroplasty. 2023 Jul;38(7):1309-1312. doi: 10.1016/j.arth.2023.01.020. Epub 
      2023 Jan 23.