PMID- 37852453
OWN - NLM
STAT- MEDLINE
DCOM- 20240315
LR  - 20240315
IS  - 1532-8406 (Electronic)
IS  - 0883-5403 (Linking)
VI  - 39
IP  - 4
DP  - 2024 Apr
TI  - Non-White Race and Concomitant Orthopedic Conditions Are Risk Factors for Failure 
      to Achieve Clinically Relevant Improvement After Total Knee Arthroplasty.
PG  - 927-934
LID - S0883-5403(23)01026-4 [pii]
LID - 10.1016/j.arth.2023.10.007 [doi]
AB  - BACKGROUND: Data from the American Joint Replacement Registry demonstrate that 
      1-year minimal clinically important difference (MCID) achievement rates after 
      total knee arthroplasty (TKA) are substantially lower when using general patient 
      reported outcome measures, such as Patient-Reported Outcomes Measurement 
      Information System Physical Function (PROMIS-PF), than joint specific measures. 
      The purpose of this study was to evaluate patient characteristics and outcomes 
      associated with MCID achievement after TKA using the PROMIS-PF measure. METHODS: 
      A retrospective review of 263 patients undergoing TKA with preoperative and 
      1-year postoperative PROMIS-PF scores from March 12, 2020 to February 8, 2022 was 
      performed. Three multivariate models were built to evaluate predictors of MCID 
      achievement. Preoperative predictors evaluated included demographics, 
      comorbidities, history of spine and knee surgery, and baseline PROMIS-PF. 
      Postoperative clinical outcomes evaluated included lengths of stay, discharge 
      statuses, complications, and utilizations of other orthopaedic services. RESULTS: 
      There were 109 patients (41%) who achieved an MCID at 1-year postoperatively. 
      Non-white patients had 2.17 times lower odds of achieving MCID. No clinical 
      outcomes assessed were independently predictive of MCID achievement. During the 
      1-year postoperative period, 63% of patients sought care for another orthopaedic 
      condition. Patients requiring postoperative injections on another joint had a 
      2.27 times lower odds of achieving MCID. Those seen for spine conditions 
      postoperatively had a 2.44 lower odds of achieving MCID. CONCLUSIONS: Race, 
      postoperative injections, and treatment for spine conditions after TKA were 
      independent predictors of failure to achieve MCID. These results may guide 
      preoperative patient consultation and risk-adjustment in future studies using 
      PROMIS-PF as an endpoint for evaluation of TKA outcomes.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Baxter, Samantha N
AU  - Baxter SN
AD  - Luminis Health Orthopedics, Anne Arundel Medical Center, Annapolis, Maryland.
FAU - Brennan, Jane C
AU  - Brennan JC
AD  - Luminis Health Orthopedics, Anne Arundel Medical Center, Annapolis, Maryland.
FAU - Johnson, Andrea H
AU  - Johnson AH
AD  - Luminis Health Orthopedics, Anne Arundel Medical Center, Annapolis, Maryland.
FAU - Chapa, Lauren
AU  - Chapa L
AD  - Luminis Health Orthopedics, Anne Arundel Medical Center, Annapolis, Maryland.
FAU - Robbins, Shayla
AU  - Robbins S
AD  - Luminis Health Orthopedics, Anne Arundel Medical Center, Annapolis, Maryland.
FAU - Turcotte, Justin J
AU  - Turcotte JJ
AD  - Luminis Health Orthopedics, Anne Arundel Medical Center, Annapolis, Maryland.
FAU - King, Paul J
AU  - King PJ
AD  - Luminis Health Orthopedics, Anne Arundel Medical Center, Annapolis, Maryland.
LA  - eng
PT  - Journal Article
DEP - 20231016
PL  - United States
TA  - J Arthroplasty
JT  - The Journal of arthroplasty
JID - 8703515
SB  - IM
MH  - Humans
MH  - *Arthroplasty, Replacement, Knee/adverse effects
MH  - *Orthopedics
MH  - Treatment Outcome
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Patient Reported Outcome Measures
OTO - NOTNLM
OT  - clinically relevant improvement
OT  - outcomes
OT  - patient-reported outcomes
OT  - racial disparities
OT  - total knee arthroplasty
EDAT- 2023/10/19 00:44
MHDA- 2024/03/15 06:44
CRDT- 2023/10/18 19:27
PHST- 2023/05/08 00:00 [received]
PHST- 2023/09/26 00:00 [revised]
PHST- 2023/10/02 00:00 [accepted]
PHST- 2024/03/15 06:44 [medline]
PHST- 2023/10/19 00:44 [pubmed]
PHST- 2023/10/18 19:27 [entrez]
AID - S0883-5403(23)01026-4 [pii]
AID - 10.1016/j.arth.2023.10.007 [doi]
PST - ppublish
SO  - J Arthroplasty. 2024 Apr;39(4):927-934. doi: 10.1016/j.arth.2023.10.007. Epub 
      2023 Oct 16.