Total knee replacement; minimal clinically important differences and responders

Abstract

Due to the wide variations, MCID estimates should be calculated and used according to the baseline severity score.

Can Preoperative Patient-reported Outcome Measures Be Used to Predict Meaningful Improvement in Function After TKA?

“…Prior studies aimed at defining the MCID after TKA have demonstrated that 12% to 51% of patients do not experience this degree of improvement postoperatively with respect to pain and function [2,7,9,11]. With limited appropriateness criteria, the decision to pursue surgery is complex and multifactorial for both the patient and physician.…”

“…This may suggest that distribution-based methods underestimate the amount of postoperative improvement necessary to be meaningful for patients. However, an ideal means of calculating MCID with regard to TKA, or any intervention, remains to be determined [7,9,11]. The minimum clinically important difference for a specific intervention is ultimately defined by what is interpreted as important to a patient and is therefore not a fixed attribute.…”

“…The minimum clinically important difference (MCID) can be used to specify this degree of change in health and is one way to define what constitutes a successful outcome after a surgical intervention [8,18,23]. Prior studies that have defined and evaluated the MCID after TKA have shown that a notable proportion of patients do not experience this degree of change postoperatively [9,11]. Furthermore, numerous studies have documented dissatisfaction rates after TKA ranging from 15% to 20% [25,39].…”

CORR Insights®: The Knee Society Short Form Reduces Respondent Burden in the Assessment of Patient-reported Outcomes

“…After applying the method, a minimum change in scores of 30 points was deemed clinically meaningful for TKA [2]. This number was further adjusted for baseline scores to account for the potential room for improvement for each patient [1,8]. Similar work is needed to derive baseline-adjusted MCID values for the shorter form to further strengthen its clinical relevance.…”

Variations In Good Patient Reported Outcomes After Total Knee Arthroplasty

“…The MID (synonymous with minimal clinically important difference) has been defined for other scoring systems such as the WOMAC [13] and SF-36 [14] but has not been formally defined for the OKS. Whilst progress is being made in this area, an approximation to the MID was used.…”