Abstract
BackgroundFollowing hip or knee arthroplasty, it is clinically warranted to get patients functional as quickly as possible. However, valid tools to assess function shortly after knee or hip arthroplasty are lacking. The objective was to compare the clinimetric properties of four instruments to assess function shortly after arthroplasty.MethodsOne hundred eight patients undergoing hip or knee arthroplasty were assessed preoperatively, 1 and 2 days postoperatively, and 2 and 6 weeks postoperatively with the Timed Up and Go (TUG), Iowa Level of Assistance Scale (ILAS), Postoperative Quality of Recovery Scale (PQRS), and Readiness for Hospital Discharge Scale (RHDS). Descriptive data, floor and ceiling effects, responsiveness, interpretation and construct validity were determined.ResultsOnly the ILAS and RHDS support subscale demonstrated floor or ceiling effects. A large deterioration from preoperative to postoperative, followed by large improvements after surgery were seen in the TUG and ILAS scores. The RHDS personal status subscale and the PQRS pain and function dimensions demonstrated large improvements after surgery. Changes in the RHDS global scale and personal status subscale, PQRS pain dimension and TUG were significantly related to patient perceived improvement. Minimal important changes were obtained for the RHDS global (1.1/10) and personal status subscale (2.3/10), and the TUG (43.4 s at 6 weeks). For construct validity, the PQRS function dimension and RHDS were moderately related to the TUG or ILAS. The correlation between TUG and ILAS was high from preoperative to postoperative day 2, but substantially decreased at 2 and 6 weeks.ConclusionsThe TUG and RHDS personal status subscale demonstrated the best clinimetric properties to assess function in the first 6 weeks after hip or knee arthroplasty.
Highlights
Following hip or knee arthroplasty, it is clinically warranted to get patients functional as quickly as possible
Following an overview of the literature, promising and most used patient-reported outcome measures (PROMs) and performance measures were identified in order to compare their clinimetric properties to assess function shortly after hip or knee arthroplasty
This selection was based on the theoretical relevance of tools to assess functional capacities after knee or hip arthroplasty, their frequency of clinical use in patients undergoing arthroplasty [7], or promising results in previous studies
Summary
Following hip or knee arthroplasty, it is clinically warranted to get patients functional as quickly as possible. Poitras et al BMC Musculoskeletal Disorders (2016) 17:478 function shortly after surgery, notably because they assess more advanced function such as squatting, kneeling, jumping, running and heavy domestic duties [3,4,5]. Following an overview of the literature, promising and most used PROMs and performance measures were identified in order to compare their clinimetric properties to assess function shortly after hip or knee arthroplasty. This selection was based on the theoretical relevance of tools to assess functional capacities after knee or hip arthroplasty (face validity), their frequency of clinical use in patients undergoing arthroplasty [7], or promising results in previous studies
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