Comparative responsiveness of outcome measures for total knee arthroplasty

Abstract

SummaryObjectiveThe aim of this study was to compare the responsiveness of various patient-reported outcome measures (PROMs) and clinician-reported outcomes following total knee arthroplasty (TKA) over a 2-year period.MethodsData were collected in a prospective cohort study of primary TKA. Patients who had completed Forgotten Joint Score-12 (FJS-12), Western Ontario and McMaster Universities (WOMAC) osteoarthritis (OA) index, EQ-5D, Knee Society Score and range of movement (ROM) assessment were included. Five time points were assessed: pre-operative, 2 months, 6 months, 1 year and 2 years post-operative.ResultsData from 98 TKAs were available for analysis. Largest effect sizes (ES) for change from pre-operative to 2-month follow-up were observed for the Knee Society Score (KSS) Knee score (1.70) and WOMAC Total (−1.50). For the period from 6 months to 1 year the largest ES for change were shown by the FJS-12 (0.99) and the KSS Function Score (0.88). The EQ-5D showed the strongest ceiling effect at 1-year follow-up with 84.4% of patients scoring the maximum score. ES for the time from 1- to 2-year follow-up were largest for the FJS-12 (0.50). All other outcome measures showed ES equal or below 0.30.ConclusionOutcome measures differ considerably in responsiveness, especially beyond one year post-operatively. Joint-specific outcome measures are more responsive than clinician-reported or generic health outcome tools. The FJS-12 was the most responsive of the tools assessed; suggesting that joint awareness may be a more discerning measure of patient outcome than traditional PROMs.

Construct Validity and Test Re-Test Reliability of the Forgotten Joint Score

“…However other authors have found that the FJS-12 was more responsive than Knee Society Score Knee score and WOMAC after total knee arthroplasty [11].…”

Evaluating instrument responsiveness in joint function: The HOOS JR, the KOOS JR, and the PROMIS PF CAT

“…In examining the responsiveness of outcome measures in a total knee arthroplasty population, it has been shown that patient response can differ substantially depending on which measure is used for assessment . Both the HOOS JR and the KOOS JR have demonstrated high responsiveness levels in evaluating hip and knee arthroplasty, respectively .…”

Functional ligament-guided femoral rotation with patient-specific instruments: description of a new surgical technique

“…8,38,39 In correlation with these results, an adequate improvement in the FJS score was observed, standing at 34.4 ± 4.2 points after 3 mo and 57.8 ± 8.4 after 12 mo. In the study from Giesinger et al, 40 the FJS was 21 after 2 mo, 42 after 6 mo, 67 after 12 mo, and 81 after 24 mo. In their study, Thienpont et al 41 recorded an FJS score of 73 after an average of 24 mo.…”