PMID- 38381811
OWN - NLM
STAT- MEDLINE
DCOM- 20240501
LR  - 20240501
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 106
IP  - 9
DP  - 2024 May 1
TI  - Diagnosis-Specific Thresholds of the Minimal Clinically Important Difference and 
      Patient Acceptable Symptom State for KOOS After Total Knee Arthroplasty.
PG  - 793-800
LID - 10.2106/JBJS.23.00027 [doi]
AB  - UPDATE: This article was updated on May 1, 2024 because of a previous error, 
      which was discovered after the preliminary version of the article was posted 
      online. The byline that had read "Ahmed K. Emara, MD 1 *, Ignacio Pasqualini, MD 
      1 *, Alison K. Klika, MS 1 , Melissa N. Orr, BS 1 , Pedro J. Rullan, MD 1 , 
      Nicolas S. Piuzzi, MD 1 , and the Cleveland Clinic Arthroplasty Groupdagger" now reads 
      "Ahmed K. Emara, MD 1 *, Ignacio Pasqualini, MD 1 *, Yuxuan Jin, MS 1 , Alison K. 
      Klika, MS 1 , Melissa N. Orr, BS 1 , Pedro J. Rullan, MD 1 , Nicolas S. Piuzzi, 
      MD 1 , and the Cleveland Clinic Arthroplasty Groupdagger". BACKGROUND: 
      Literature-reported minimal clinically important difference (MCID) and patient 
      acceptable symptom state (PASS) thresholds for patient-reported outcome measures 
      demonstrate marked variability. The purpose of this study was to determine the 
      minimal detectable change (MDC), MCID, and PASS thresholds for the Knee injury 
      and Osteoarthritis Outcome Score (KOOS) Pain subdomain, Physical Function Short 
      Form (PS), and Joint Replacement (JR) among patients with osteoarthritis (OA) who 
      underwent primary total knee arthroplasty (TKA). METHODS: A prospective cohort of 
      6,778 patients who underwent primary TKA was analyzed. Overall, 1-year follow-up 
      was completed by 5,316 patients for the KOOS Pain, 5,018 patients for the KOOS 
      PS, and 4,033 patients for the KOOS JR. A total of 5,186 patients had an OA 
      diagnosis; this group had an average age of 67.0 years and was 59.9% female and 
      80.4% White. Diagnosis-specific MDCs and MCIDs were estimated with use of a 
      distribution-based approach. PASS values were estimated with use of an 
      anchor-based approach, which corresponded to a response to a satisfaction 
      question at 1 year postoperatively. RESULTS: The MCID thresholds for the OA group 
      were 7.9 for the KOOS Pain, 8.0 for the KOOS PS, and 6.7 for the KOOS JR. A high 
      percentage of patients achieved the MCID threshold for each outcome measure (KOOS 
      Pain, 95%; KOOS PS, 88%; and KOOS JR, 94%). The MDC 80% to 95% confidence 
      intervals ranged from 9.1 to 14.0 for the KOOS Pain, 9.2 to 14.1 for the KOOS PS, 
      and 7.7 to 11.8 for the KOOS JR. The PASS thresholds for the OA group were 77.7 
      for the KOOS Pain (achieved by 73% of patients), 70.3 for the KOOS PS (achieved 
      by 68% of patients), and 70.7 for the KOOS JR (achieved by 70% of patients). 
      CONCLUSIONS: The present study provided useful MCID, MDC, and PASS thresholds for 
      the KOOS Pain, PS, and JR for patients with OA. The diagnosis-specific metrics 
      established herein can serve as benchmarks for clinically meaningful 
      postoperative improvement. Future research and quality assessments should utilize 
      these OA-specific thresholds when evaluating outcomes following TKA. Doing so 
      will enable more accurate determinations of operative success and improvements in 
      patient-centered care. LEVEL OF EVIDENCE: Prognostic Level II . See Instructions 
      for Authors for a complete description of levels of evidence.
CI  - Copyright (c) 2024 by The Journal of Bone and Joint Surgery, Incorporated.
FAU - Emara, Ahmed K
AU  - Emara AK
AUID- ORCID: 0000-0002-8421-7340
AD  - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
FAU - Pasqualini, Ignacio
AU  - Pasqualini I
AUID- ORCID: 0000-0002-9551-827
FAU - Jin, Yuxuan
AU  - Jin Y
FAU - Klika, Alison K
AU  - Klika AK
FAU - Orr, Melissa N
AU  - Orr MN
FAU - Rullan, Pedro J
AU  - Rullan PJ
AUID- ORCID: 0000-0002-5310-3332
FAU - Piuzzi, Nicolas S
AU  - Piuzzi NS
AUID- ORCID: 0000-0003-3007-7538
CN  - the Cleveland Clinic Arthroplasty Group
LA  - eng
PT  - Journal Article
DEP - 20240221
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
SB  - IM
MH  - Humans
MH  - *Arthroplasty, Replacement, Knee/adverse effects
MH  - *Patient Reported Outcome Measures
MH  - *Minimal Clinically Important Difference
MH  - Female
MH  - Male
MH  - Aged
MH  - Middle Aged
MH  - Osteoarthritis, Knee/surgery
MH  - Patient Satisfaction
COIS- Disclosure: No external funding was received for this work. The Disclosure of 
      Potential Conflicts of Interest forms are provided with the online version of the 
      article ( http://links.lww.com/JBJS/H889 ).
EDAT- 2024/02/21 18:43
MHDA- 2024/05/01 13:31
CRDT- 2024/02/21 14:03
PHST- 2024/05/01 13:31 [medline]
PHST- 2024/02/21 18:43 [pubmed]
PHST- 2024/02/21 14:03 [entrez]
AID - 00004623-990000000-01023 [pii]
AID - 10.2106/JBJS.23.00027 [doi]
PST - ppublish
SO  - J Bone Joint Surg Am. 2024 May 1;106(9):793-800. doi: 10.2106/JBJS.23.00027. Epub 
      2024 Feb 21.