Defining Failure in Primary Total Joint Arthroplasty: The Minimal Clinically Important Difference for Worsening Score

Humphrey, Tyler J.; Katakam, Akhil; M, Christopher Melnic; Bedair, Hany

doi:10.1016/j.arth.2021.12.025

Cited by 11 publications

(10 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Goodman et al 23 Studies have additionally revealed an association between patient factors and likelihood of achieving score changes above MCID threshold, suggesting the possibility that MCID values vary according to patient factors. [11][12][13][14] In this study, there were actually no differences in 1-year HOOS-JR MCID values between men and women as well as between patients with a mental health diagnosis and those without one. BMI was also not found to correlate with MCID.…”

Section: Discussioncontrasting

confidence: 47%

“…Prior work has shown that lower baseline functional PROMs are associated with higher probability of achieving MCID. 11 In this study, preoperative HOOS-JR score exhibited an inverse relationship with the proportion of patients achieving 1-year MCID and achieving clinically significant outcomes per PROMIS10-PH score. With an anchor-based calculated average MCID of 35.6, no patients with a preoperative HOOS-JR greater than 70 were expected to report HOOS-JR improvements above 1-year MCID threshold.…”

Section: Discussionmentioning

confidence: 51%

“…15,16 Furthermore, patients with higher preoperative function tend to experience higher absolute postoperative PROM scores but are less likely to experience clinically meaningful improvement after THA when incorporating MCID thresholds. 11 These findings highlight the importance of potentially considering patient factors when calculating an MCID for an outcome instrument if they are to be used for clinical decision-making.…”

mentioning

confidence: 94%

“…[7][8][9][10] Studies have demonstrated that factors such as gender, age, and preoperative pain and functional status can predict postoperative function and attainment of clinically significant improvements after THA. [11][12][13][14] Cumulative increases in body mass index (BMI), particularly a BMI of 40 or more, is associated with decreased likelihood of achieving supra-MCID score changes after THA. 12,13 Similarly, psychiatric diseases such as anxiety, depression, bipolar disorder, and schizophrenia can result in poor outcomes following THA.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Achievement of One-Year MCID Varies with Preoperative Function of Patients Undergoing Total Hip Arthroplasty

Albright,

Ormseth,

Huyke-Hernández

et al. 2023

The Journal of Hip Surgery

View full text Add to dashboard Cite

The minimum clinically important difference (MCID) of an orthopaedic outcome measure is commonly used to assess treatment success including for patients undergoing total hip arthroplasty (THA). Various patient factors may contribute to MCID values in patients undergoing THA. The purpose of this study was to calculate the 1-year MCID for the Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR) based on patient factors and evaluate if there were any differences between each cohort's MCID.A patient-reported outcome measure (PROM) database was reviewed for patients undergoing THA from 2017 to 2018. Patients were included that underwent primary THA and completed baseline and 1-year follow-up for Patient-Reported Outcome Measurement Information System 10-item global health form (PROMIS10) and HOOS-JR surveys. MCID was calculated using the distribution method and an anchor-based method that used the PROMIS10 Physical Health item. Differences in MCID were assessed between patient cohorts stratified by preoperative characteristics.For the 523 patients that underwent THA, the average 1-year HOOS-JR MCID values were 33.9 ± 16.3 (men), 37.0 ± 13.9 (women), 38.1 ± 17.1 (diagnosis of mental health), and 35.0 ± 14.6 (no diagnosis). MCID values were not significantly different between groups according to sex (p = 0.186) or mental health status (p = 0.302). MCID value did not correlate with body mass index (β = –0.126). MCID achievement had a notable inverse relationship with preoperative HOOS-JR.This study demonstrated that preoperative function of patients undergoing THA affects the ability to achieve HOOS-JR 1-year MCID. Future investigation is necessary to clarify which patient factors may affect MCID.

show abstract

Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 51%

mentioning

confidence: 94%

mentioning

confidence: 99%

See 2 more Smart Citations

Achievement of One-Year MCID Varies with Preoperative Function of Patients Undergoing Total Hip Arthroplasty

Albright,

Ormseth,

Huyke-Hernández

et al. 2023

The Journal of Hip Surgery

View full text Add to dashboard Cite

show abstract

“…The MCID-I and MCID-W thresholds were calculated using one-half of the SD of the mean change between the preoperative and postoperative PROMs for patients who improved and worsened, respectively. 9 Achieving improvement or failure was determined by those above or below their corresponding thresholds. Patients between these thresholds were labeled "No Change" because there was no clinically meaningful difference after surgery.…”

Section: Methodsmentioning

confidence: 99%

Mental Health Effects on the Minimal Clinically Important Difference in Total Joint Arthroplasty

Salimy,

Paschalidis,

Dunahoe

et al. 2024

J Am Acad Orthop Surg

Self Cite

View full text Add to dashboard Cite

Introduction: The effect of mental health on patient-reported outcome measures is not fully understood in total joint arthroplasty (TJA). Thus, we investigated the relationship between mental health diagnoses (MHDs) and the Minimal Clinically Important Difference for Improvement (MCID-I) and Worsening (MCID-W) in primary TJA and revision TJA (rTJA). Methods: Retrospective data were collected using relevant Current Procedural Terminology and MHDs International Classification of Diseases, 10th Revision, codes with completed Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form, Knee Injury and Osteoarthritis Outcome Score-Physical Function Short Form, Patient-reported Outcomes Measurement Information System (PROMIS)-Physical Function Short Form 10a, PROMIS Global-Mental, or PROMIS Global-Physical questionnaires. Logistic regressions and statistical analyses were used to determine the effect of a MHD on MCID-I/MCID-W rates. Results: Data included 4,562 patients (4,190 primary TJAs/372 rTJAs). In primary total hip arthroplasty (pTHA), MHD-affected outcomes for Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form (MCID-I: 81% versus 86%, P = 0.007; MCID-W: 6.0% versus 3.2%, P = 0.008), Physical Function Short Form 10a (MCID-I: 68% versus 77%, P < 0.001), PROMIS Global-Mental (MCID-I: 38% versus 44%, P = 0.009), and PROMIS Global-Physical (MCID-I: 61% versus 73%, P < 0.001; MCID-W: 14% versus 7.9%, P < 0.001) versus pTHA patients without MHD. A MHD led to lower rates of MCID-I for PROMIS Global-Physical (MCID-I: 56% versus 63%, P = 0.003) in primary total knee arthroplasty patients. No effects from a MHD were observed in rTJA patients. Discussion: The presence of a MHD had a prominent negative influence on pTHA patients. Patients who underwent rTJA had lower MCID-I rates, higher MCID-W rates, and lower patient-reported outcome measure scores despite less influence from a MHD. Level of evidence: Level III, retrospective comparative study.

show abstract

Strategies to Manage Poorer Outcomes After Hip or Knee Arthroplasty: A Narrative Review of Current Understanding, Unanswered Questions, and Future Directions

Karimijashni,

Ramsay,

Beaulé

et al. 2024

Musculoskeletal Care

View full text Add to dashboard Cite

PurposeAlthough hip or knee arthroplasty is generally a successful intervention, it is documented that 15%–30% of patients undergoing arthroplasty report suboptimal outcomes. This narrative review aims to provide an overview of the key findings concerning the management of poorer outcomes after hip or knee arthroplasty.MethodA comprehensive search of articles was conducted up to November 2023 across three electronic databases. Only studies written in English were included, with no limitations applied regarding study design and time.ResultEfficiently addressing poorer outcomes after arthroplasty necessitates a thorough exploration of appropriate methods for assessing recovery following hip or knee arthroplasty, ensuring accurate identification of patients at risk or experiencing poorer recovery. When selecting appropriate outcome measure tools, various factors should be taken into consideration, including understanding patients' priorities throughout the recovery process, assessing psychometric properties of outcome measure tools at different time points after arthroplasty, understanding how to combine/reconcile provider‐assessed and patient‐reported outcome measures, and determining the appropriate methods to interpret outcome measure scores. However, further research in these areas is warranted. In addition, the identification of key modifiable factors affecting outcomes and the development of interventions to manage these factors are needed.ConclusionThere is growing attention paid to delivering interventions for patients at risk or not optimally recovering following hip or knee arthroplasty. To achieve this, it is essential to identify the most appropriate outcome measure tools, factors associated with poorer recovery and management of these factors.

show abstract

Defining Failure in Primary Total Joint Arthroplasty: The Minimal Clinically Important Difference for Worsening Score

Cited by 11 publications

References 48 publications

Achievement of One-Year MCID Varies with Preoperative Function of Patients Undergoing Total Hip Arthroplasty

Achievement of One-Year MCID Varies with Preoperative Function of Patients Undergoing Total Hip Arthroplasty

Mental Health Effects on the Minimal Clinically Important Difference in Total Joint Arthroplasty

Strategies to Manage Poorer Outcomes After Hip or Knee Arthroplasty: A Narrative Review of Current Understanding, Unanswered Questions, and Future Directions

Contact Info

Product

Resources

About