Abstract
Background and purpose — Meaningful interpretation of postoperative Oxford Knee Score (OKS) levels is challenging. We established Patient Acceptable Symptoms State (PASS) and Treatment Failure (TF) values for the OKS in patients undergoing primary total knee replacement (TKR) in Denmark. Patients and methods — Data from patients undergoing primary TKR between February 2015 and January 2019 was extracted from the arthroplasty registry at the Copenhagen University Hospital, Hvidovre in Denmark. Data included 3, 12, and 24 months postoperative responses to the OKS and 2 anchor questions asking whether they considered their symptom state to be satisfactory, and if not, whether they considered the treatment to have failed. PASS and TF threshold values were calculated using the adjusted predictive modeling method. Non-parametric bootstrapping was used to derive 95% confidence intervals (CI). Results — Complete 3, 12, and 24 months postoperative data was obtained for 187 of 209 (89%), 884 of 915 (97%), and 575 of 586 (98%) patients, with median ages from 68 to 70 years (59 to 64% female). 72%, 77%, and 79% considered as having satisfactory symptoms, while 6%, 11%, and 11% considered the treatment to have failed, at 3, 12, and 24 months postoperatively, respectively. OKS PASS values (CI) were 27 (26–28), 30 (29–31), and 30 (29–31) at 3, 12, and 24 months postoperatively. TF values were 27 (26–28) and 27 (26–29) at 12 and 24 months postoperatively. Interpretation — The OKS PASS values can be used to guide the interpretation of TKR outcome and support quality assessment in institutional and national registries.
Highlights
Patients and methods — Data from patients undergoing primary total knee replacement (TKR) between February 2015 and January 2019 was extracted from the arthroplasty registry at the Copenhagen University Hospital, Hvidovre in Denmark
Interpretation characteristics of patient-reported outcome measures (PROMs) are context dependent (Tubach et al 2007), which highlights the relevance of evaluateing the time-dependency of Patient Acceptable Symptoms State (PASS) values for the Oxford Knee Score (OKS) after TKR
A PASS value can be interpreted as the threshold between what the average patient would consider a satisfactory state and what they would consider a nonsatisfactory state
Summary
Patients and methods — Data from patients undergoing primary TKR between February 2015 and January 2019 was extracted from the arthroplasty registry at the Copenhagen University Hospital, Hvidovre in Denmark. Data included 3, 12, and 24 months postoperative responses to the OKS and 2 anchor questions asking whether they considered their symptom state to be satisfactory, and if not, whether they considered the treatment to have failed. The Patient Acceptable Symptom State (PASS) concept was defined by Tubach et al (2005) as the score on a PROM above which patients consider themselves well. The contrary concept, Treatment Failure (TF), was introduced for patients undergoing ACL reconstruction, to define patients who consider their symptom levels unsatisfactory to a degree that they find the treatment has failed (Ingelsrud et al 2015). Having the patients’ explicit judgements of whether they have reached a satisfactory symptom state or not after surgery is necessary to derive credible PASS values. We defined PASS and TF values for the OKS at 3 months, and 1 and 2 years after a TKR
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
