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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2017

21.06.2016 | Knee

The minimal clinically important difference for Knee Society Clinical Rating System after total knee arthroplasty for primary osteoarthritis

verfasst von: Wu Chean Lee, Yu Heng Kwan, Hwei Chi Chong, Seng Jin Yeo

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 11/2017

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Abstract

Purpose

The Knee Society Clinical Rating System (KS) is one of the most popular tools used to assess patient outcome after total knee arthroplasty (TKA), but its minimal clinically important difference (MCID) has not been identified. This study aims to identify the MCID of KS function score (KS-FS) and knee score (KS-KS) after TKA in patients with primary knee osteoarthritis.

Methods

The authors retrospectively analysed patients who underwent TKA for primary knee osteoarthritis between 2005 and 2015 in a single institution. KS-FS, KS-KS, and Oxford Knee Score (OKS) were collected pre-operatively and 2 years post-operatively. Patient satisfaction with TKA at 2 years was also collected. Anchor-based approach with 2 external indicators was used. The MCID for KS-FS and KS-KS was determined using simple linear regression according to patient satisfaction with TKA and the MCID of OKS.

Results

The mean age of the 550 subjects studied was 66 ± 8 years. There were 373 (67.8 %) female subjects. The KS-FS improved by 22.8 (95 % CI 20.9–24.6) points, and the KS-KS improved by 44.4 (95 % CI 42.6–46.3) points. The MCID identified for KS-FS is between 6.1 (95 % CI 5.1–7.1) and 6.4 (95 % CI 4.4–8.4) and between 5.3 (95 % CI 4.3–6.3) and 5.9 (95 % CI 3.9–7.8) for KS-KS.

Conclusions

This is the first study, to the knowledge of the authors, to identify the MCID of KS. This will allow future trials to have an accurate prediction of sample size. Clinically, physicians will be able to better interpret outcomes of TKA studies to guide a treatment option.

Level of evidence

IV.
Literatur
1.
Zurück zum Zitat Ares O, Castellet E, Macule F, Leon V, Montanez E, Freire A, Hinarejos P, Montserrat F, Amillo JR (2013) Translation and validation of ‘The Knee Society Clinical Rating System’ into Spanish. Knee Surg Sports Traumatol Arthrosc 21(11):2618–2624CrossRefPubMed Ares O, Castellet E, Macule F, Leon V, Montanez E, Freire A, Hinarejos P, Montserrat F, Amillo JR (2013) Translation and validation of ‘The Knee Society Clinical Rating System’ into Spanish. Knee Surg Sports Traumatol Arthrosc 21(11):2618–2624CrossRefPubMed
2.
Zurück zum Zitat Bagsby D, Pierson JL (2015) Functional outcomes of simultaneous bilateral versus unilateral total knee arthroplasty. Orthopedics 38(1):e43–e47CrossRefPubMed Bagsby D, Pierson JL (2015) Functional outcomes of simultaneous bilateral versus unilateral total knee arthroplasty. Orthopedics 38(1):e43–e47CrossRefPubMed
3.
Zurück zum Zitat Baker PN, van der Meulen JH, Lewsey J, Gregg PJ (2007) The role of pain and function in determining patient satisfaction after total knee replacement. Data from the National Joint Registry for England and Wales. J Bone Joint Surg Br 89:893–900CrossRefPubMed Baker PN, van der Meulen JH, Lewsey J, Gregg PJ (2007) The role of pain and function in determining patient satisfaction after total knee replacement. Data from the National Joint Registry for England and Wales. J Bone Joint Surg Br 89:893–900CrossRefPubMed
4.
Zurück zum Zitat Beard DJ, Harris K, Dawson J, Doll H, Murray DW, Carr AJ, Price AJ (2015) Meaningful changes for the Oxford hip and knee scores after joint replacement surgery. J Clin Epidemiol 68(1):73–79CrossRefPubMedPubMedCentral Beard DJ, Harris K, Dawson J, Doll H, Murray DW, Carr AJ, Price AJ (2015) Meaningful changes for the Oxford hip and knee scores after joint replacement surgery. J Clin Epidemiol 68(1):73–79CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed
6.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, MacKenzie C (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383CrossRefPubMed Charlson ME, Pompei P, Ales KL, MacKenzie C (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383CrossRefPubMed
7.
Zurück zum Zitat Clement ND, MacDonald D, Simpson AH (2014) The minimal clinically important difference in the Oxford Knee Score and short form 12 score after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22(8):1933–1939CrossRefPubMed Clement ND, MacDonald D, Simpson AH (2014) The minimal clinically important difference in the Oxford Knee Score and short form 12 score after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22(8):1933–1939CrossRefPubMed
8.
Zurück zum Zitat Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 80:63–69CrossRefPubMed Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 80:63–69CrossRefPubMed
9.
Zurück zum Zitat Donaldson J, Joyner J, Tudor F (2015) Current controversies of alignment in total knee replacements. Open Orthop J 30(9):489–494CrossRef Donaldson J, Joyner J, Tudor F (2015) Current controversies of alignment in total knee replacements. Open Orthop J 30(9):489–494CrossRef
11.
Zurück zum Zitat Escobar A, Quintana JM, Bilbao A, Aróstegui I, Lafuente I, Vidaurreta I (2007) Responsiveness and clinically important differences for the WOMAC and SF-36 after total knee replacement. Osteoarthr Cartil 15(3):273–280CrossRefPubMed Escobar A, Quintana JM, Bilbao A, Aróstegui I, Lafuente I, Vidaurreta I (2007) Responsiveness and clinically important differences for the WOMAC and SF-36 after total knee replacement. Osteoarthr Cartil 15(3):273–280CrossRefPubMed
12.
Zurück zum Zitat Escobar A, García Pérez L, Herrera-Espiñeira C, Aizpuru F, Sarasqueta C, Sáenz Gonzalez, de Tejada M, Quintana JM, Bilbao A (2013) Total knee replacement; minimal clinically important differences and responders. Osteoarthr Cartil 21(12):2006–2012CrossRefPubMed Escobar A, García Pérez L, Herrera-Espiñeira C, Aizpuru F, Sarasqueta C, Sáenz Gonzalez, de Tejada M, Quintana JM, Bilbao A (2013) Total knee replacement; minimal clinically important differences and responders. Osteoarthr Cartil 21(12):2006–2012CrossRefPubMed
13.
Zurück zum Zitat Gulati A, Pandit H, Jenkins C, Chau R, Dodd CA, Murray DW (2009) The effect of leg alignment on the outcome of unicompartmental knee replacement. J Bone Joint Surg Br 91(4):469–474CrossRefPubMed Gulati A, Pandit H, Jenkins C, Chau R, Dodd CA, Murray DW (2009) The effect of leg alignment on the outcome of unicompartmental knee replacement. J Bone Joint Surg Br 91(4):469–474CrossRefPubMed
14.
Zurück zum Zitat Ha CW, Park YB, Song YS, Kim JH, Park YG (2015) Increased range of motion is important for functional outcome and satisfaction after total knee arthroplasty in Asian patients. J Arthroplasty. doi:10.1016/j.arth.2015.12.018 Ha CW, Park YB, Song YS, Kim JH, Park YG (2015) Increased range of motion is important for functional outcome and satisfaction after total knee arthroplasty in Asian patients. J Arthroplasty. doi:10.​1016/​j.​arth.​2015.​12.​018
15.
Zurück zum Zitat Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society Clinical Rating System. Clin Orthop Relat Res 248:13–14 Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society Clinical Rating System. Clin Orthop Relat Res 248:13–14
16.
Zurück zum Zitat Jacobs CA, Christensen CP (2009) Correlations between knee society function scores and functional force measures. Clin Orthop Relat Res 467(9):2414–2419CrossRefPubMedPubMedCentral Jacobs CA, Christensen CP (2009) Correlations between knee society function scores and functional force measures. Clin Orthop Relat Res 467(9):2414–2419CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Lee WC, Kwan YH, Yeo SJ (2016) Severe bilateral fixed flexion deformity-simultaneous or staged total knee arthroplasty? J Arthroplasty 31(1):128–131CrossRefPubMed Lee WC, Kwan YH, Yeo SJ (2016) Severe bilateral fixed flexion deformity-simultaneous or staged total knee arthroplasty? J Arthroplasty 31(1):128–131CrossRefPubMed
18.
Zurück zum Zitat Lingard EA, Katz JN, Wright RJ, Wright EA, Sledge CB, Kinemax Outcomes Group (2001) Validity and responsiveness of the Knee Society Clinical Rating System in comparison with the SF-36 and WOMAC. J Bone Joint Surg Am 83-A(12):1856–1864CrossRefPubMed Lingard EA, Katz JN, Wright RJ, Wright EA, Sledge CB, Kinemax Outcomes Group (2001) Validity and responsiveness of the Knee Society Clinical Rating System in comparison with the SF-36 and WOMAC. J Bone Joint Surg Am 83-A(12):1856–1864CrossRefPubMed
19.
Zurück zum Zitat Miner AL, Lingard EA, Wright EA, Sledge CB, Katz JN, Kinemax Outcomes Group (2003) Knee range of motion after total knee arthroplasty: how important is this as an outcome measure? J Arthroplasty 18(3):286–294CrossRefPubMed Miner AL, Lingard EA, Wright EA, Sledge CB, Katz JN, Kinemax Outcomes Group (2003) Knee range of motion after total knee arthroplasty: how important is this as an outcome measure? J Arthroplasty 18(3):286–294CrossRefPubMed
20.
Zurück zum Zitat Noble PC, Conditt MA, Cook KF, Mathis KB (2006) The John insall award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 452:35–43CrossRefPubMed Noble PC, Conditt MA, Cook KF, Mathis KB (2006) The John insall award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 452:35–43CrossRefPubMed
21.
Zurück zum Zitat Norman GR, Sloan JA, Wyrwich KW (2004) The truly remarkable universality of half a standard deviation: confirmation through another look. Expert Rev Pharmacoecon Outcomes Res 4(5):581–585CrossRefPubMed Norman GR, Sloan JA, Wyrwich KW (2004) The truly remarkable universality of half a standard deviation: confirmation through another look. Expert Rev Pharmacoecon Outcomes Res 4(5):581–585CrossRefPubMed
22.
Zurück zum Zitat Peters PG, Herbenick MA, Anloague PA, Markert RJ, Rubino LJ III (2011) Knee range of motion: reliability and agreement of 3 measurement methods. Am J Orthop (Belle Mead NJ) 40(12):E249–E252 Peters PG, Herbenick MA, Anloague PA, Markert RJ, Rubino LJ III (2011) Knee range of motion: reliability and agreement of 3 measurement methods. Am J Orthop (Belle Mead NJ) 40(12):E249–E252
23.
Zurück zum Zitat Revicki D, Hays RD, Cella D, Sloan J (2008) Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. J Clin Epidemiol 61(2):102–109CrossRefPubMed Revicki D, Hays RD, Cella D, Sloan J (2008) Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. J Clin Epidemiol 61(2):102–109CrossRefPubMed
24.
Zurück zum Zitat Roos EM, Roos HP, Ekdahl C, Lohmander LS (1998) Knee injury and osteoarthritis outcome score (KOOS)—validation of a Swedish version. Scand J Med Sci Sports 8:439–448CrossRefPubMed Roos EM, Roos HP, Ekdahl C, Lohmander LS (1998) Knee injury and osteoarthritis outcome score (KOOS)—validation of a Swedish version. Scand J Med Sci Sports 8:439–448CrossRefPubMed
25.
Zurück zum Zitat Sabouret P, Lavoie F, Cloutier JM (2013) Total knee replacement with retention of both cruciate ligaments: a 22-year follow-up study. Bone Joint J 95-B(7):917–922CrossRefPubMed Sabouret P, Lavoie F, Cloutier JM (2013) Total knee replacement with retention of both cruciate ligaments: a 22-year follow-up study. Bone Joint J 95-B(7):917–922CrossRefPubMed
26.
Zurück zum Zitat Seah RB, Yeo SJ, Chin PL, Yew AK, Chong HC, Lo NN (2014) Evaluation of medial-lateral stability and functional outcome following total knee arthroplasty: results of a single hospital joint registry. J Arthroplasty 29(12):2276–2279CrossRefPubMed Seah RB, Yeo SJ, Chin PL, Yew AK, Chong HC, Lo NN (2014) Evaluation of medial-lateral stability and functional outcome following total knee arthroplasty: results of a single hospital joint registry. J Arthroplasty 29(12):2276–2279CrossRefPubMed
27.
Zurück zum Zitat Silva AL, Demange MK, Gobbi RG, da Silva TF, Pecora JR, Croci AT (2012) Translation and validation of the knee society score-KSS for Brazilian Portugese. Acta Ortop Bras 20(1):25–30CrossRefPubMedPubMedCentral Silva AL, Demange MK, Gobbi RG, da Silva TF, Pecora JR, Croci AT (2012) Translation and validation of the knee society score-KSS for Brazilian Portugese. Acta Ortop Bras 20(1):25–30CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Terwee CB, Mokkink LB, Knol DL, Ostelo RW, Bouter LM, de Vet HC (2012) Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res 21(4):651–657CrossRefPubMed Terwee CB, Mokkink LB, Knol DL, Ostelo RW, Bouter LM, de Vet HC (2012) Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res 21(4):651–657CrossRefPubMed
29.
Zurück zum Zitat Walenkamp MM, de Muinck Keizer RJ, Goslings JC, Vos LM, Rosenwasser MP, Schep NW (2015) The minimum clinically important difference of the patient-rated wrist evaluation score for patients with distal radius fractures. Clin Orthop Relat Res 473(10):3235–3241CrossRefPubMedPubMedCentral Walenkamp MM, de Muinck Keizer RJ, Goslings JC, Vos LM, Rosenwasser MP, Schep NW (2015) The minimum clinically important difference of the patient-rated wrist evaluation score for patients with distal radius fractures. Clin Orthop Relat Res 473(10):3235–3241CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483CrossRefPubMed Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483CrossRefPubMed
31.
Zurück zum Zitat Ware J, Kosinski M, Keller SD (1996) A 12-Item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233CrossRefPubMed Ware J, Kosinski M, Keller SD (1996) A 12-Item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233CrossRefPubMed
Metadaten
Titel
The minimal clinically important difference for Knee Society Clinical Rating System after total knee arthroplasty for primary osteoarthritis
verfasst von
Wu Chean Lee
Yu Heng Kwan
Hwei Chi Chong
Seng Jin Yeo
Publikationsdatum
21.06.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 11/2017
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4208-9

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