Does Achieving the Minimal Clinically Important Difference in the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement at 1 Year Postoperative Predict Satisfaction Following Total Knee Arthroplasty?
Background: Managed care systems have expressed interest in using patient-reported outcome measures (PROMs) to determine surgical eligibility for total knee arthroplasty (TKA). The relationship between PROMs and patient satisfaction following TKA is an area of active research. We asked (1) what is t...
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Elsevier
2025-08-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344125001384 |
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| author | George N. Guild, MD Anita (Alex) Bradham, BA Natalie Gresham, BS Joseph M. Schwab, MD Alexis Alva, MD Thomas L. Bradbury, MD |
| author_facet | George N. Guild, MD Anita (Alex) Bradham, BA Natalie Gresham, BS Joseph M. Schwab, MD Alexis Alva, MD Thomas L. Bradbury, MD |
| author_sort | George N. Guild, MD |
| collection | DOAJ |
| description | Background: Managed care systems have expressed interest in using patient-reported outcome measures (PROMs) to determine surgical eligibility for total knee arthroplasty (TKA). The relationship between PROMs and patient satisfaction following TKA is an area of active research. We asked (1) what is the relationship between patient satisfaction and achieving minimal clinically important difference (MCID) in Knee Injury Osteoarthritis Outcomes Survey for Joint Replacement (KOOS, JR) at 1 year post-TKA, (2) what is the optimal change in KOOS, JR from preoperative to 1-year post-TKA that predicts patient satisfaction, and (3) are there additional preoperative factors that influence patient satisfaction following TKA. Methods: A retrospective cohort study analyzed patients who underwent primary TKA at a single ambulatory surgery center. Patients completed KOOS, JR and Veterans Rand 12-Item Health Survey (VR-12) at baseline, 12 weeks, 6 months, and 1 year postoperatively. Satisfaction was assessed using a Likert scale. Logistic regression, best-fit modeling, and classification and regression tree analyses were performed to determine predictors of satisfaction. Results: Among 600 patients, 93.7% were satisfied. MCID was met in 71.8% of satisfied patients vs 44.7% of unsatisfied patients (P < .001). Preoperative to 1-year change in KOOS, JR (odds ratio 1.09, P < .001) and preoperative VR-12 mental component scores (odds ratio 1.05, P = .007) predicted satisfaction. No change threshold for KOOS, JR predicted satisfaction. Conclusions: While KOOS, JR improvement correlated with satisfaction, achieving MCID was not a reliable predictor. Preoperative factors, including VR-12 mental component scores, may better identify patients likely to be satisfied post-TKA. Further research on larger cohorts is needed to refine PROM-based eligibility criteria. |
| format | Article |
| id | doaj-art-2bc283629a4247f18ff3d6b2e0629d3b |
| institution | Matheson Library |
| issn | 2352-3441 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
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| series | Arthroplasty Today |
| spelling | doaj-art-2bc283629a4247f18ff3d6b2e0629d3b2025-06-26T09:53:06ZengElsevierArthroplasty Today2352-34412025-08-0134101751Does Achieving the Minimal Clinically Important Difference in the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement at 1 Year Postoperative Predict Satisfaction Following Total Knee Arthroplasty?George N. Guild, MD0Anita (Alex) Bradham, BA1Natalie Gresham, BS2Joseph M. Schwab, MD3Alexis Alva, MD4Thomas L. Bradbury, MD5Total Joint Specialists, LLC, Advanced Center for Joint Surgery and Northside Hospital Forsyth, Cumming, GA, USATotal Joint Specialists, LLC, Advanced Center for Joint Surgery and Northside Hospital Forsyth, Cumming, GA, USACorresponding author. 2000 Howard Farm Drive, Cumming, GA 30041, USA. Tel.: +1 678 736 0416.; Total Joint Specialists, LLC, Advanced Center for Joint Surgery and Northside Hospital Forsyth, Cumming, GA, USATotal Joint Specialists, LLC, Advanced Center for Joint Surgery and Northside Hospital Forsyth, Cumming, GA, USATotal Joint Specialists, LLC, Advanced Center for Joint Surgery and Northside Hospital Forsyth, Cumming, GA, USATotal Joint Specialists, LLC, Advanced Center for Joint Surgery and Northside Hospital Forsyth, Cumming, GA, USABackground: Managed care systems have expressed interest in using patient-reported outcome measures (PROMs) to determine surgical eligibility for total knee arthroplasty (TKA). The relationship between PROMs and patient satisfaction following TKA is an area of active research. We asked (1) what is the relationship between patient satisfaction and achieving minimal clinically important difference (MCID) in Knee Injury Osteoarthritis Outcomes Survey for Joint Replacement (KOOS, JR) at 1 year post-TKA, (2) what is the optimal change in KOOS, JR from preoperative to 1-year post-TKA that predicts patient satisfaction, and (3) are there additional preoperative factors that influence patient satisfaction following TKA. Methods: A retrospective cohort study analyzed patients who underwent primary TKA at a single ambulatory surgery center. Patients completed KOOS, JR and Veterans Rand 12-Item Health Survey (VR-12) at baseline, 12 weeks, 6 months, and 1 year postoperatively. Satisfaction was assessed using a Likert scale. Logistic regression, best-fit modeling, and classification and regression tree analyses were performed to determine predictors of satisfaction. Results: Among 600 patients, 93.7% were satisfied. MCID was met in 71.8% of satisfied patients vs 44.7% of unsatisfied patients (P < .001). Preoperative to 1-year change in KOOS, JR (odds ratio 1.09, P < .001) and preoperative VR-12 mental component scores (odds ratio 1.05, P = .007) predicted satisfaction. No change threshold for KOOS, JR predicted satisfaction. Conclusions: While KOOS, JR improvement correlated with satisfaction, achieving MCID was not a reliable predictor. Preoperative factors, including VR-12 mental component scores, may better identify patients likely to be satisfied post-TKA. Further research on larger cohorts is needed to refine PROM-based eligibility criteria.http://www.sciencedirect.com/science/article/pii/S2352344125001384KOOS, JRMCIDPatient-reported outcome measuresSatisfactionTotal knee arthroplasty |
| spellingShingle | George N. Guild, MD Anita (Alex) Bradham, BA Natalie Gresham, BS Joseph M. Schwab, MD Alexis Alva, MD Thomas L. Bradbury, MD Does Achieving the Minimal Clinically Important Difference in the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement at 1 Year Postoperative Predict Satisfaction Following Total Knee Arthroplasty? Arthroplasty Today KOOS, JR MCID Patient-reported outcome measures Satisfaction Total knee arthroplasty |
| title | Does Achieving the Minimal Clinically Important Difference in the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement at 1 Year Postoperative Predict Satisfaction Following Total Knee Arthroplasty? |
| title_full | Does Achieving the Minimal Clinically Important Difference in the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement at 1 Year Postoperative Predict Satisfaction Following Total Knee Arthroplasty? |
| title_fullStr | Does Achieving the Minimal Clinically Important Difference in the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement at 1 Year Postoperative Predict Satisfaction Following Total Knee Arthroplasty? |
| title_full_unstemmed | Does Achieving the Minimal Clinically Important Difference in the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement at 1 Year Postoperative Predict Satisfaction Following Total Knee Arthroplasty? |
| title_short | Does Achieving the Minimal Clinically Important Difference in the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement at 1 Year Postoperative Predict Satisfaction Following Total Knee Arthroplasty? |
| title_sort | does achieving the minimal clinically important difference in the knee injury and osteoarthritis outcome score for joint replacement at 1 year postoperative predict satisfaction following total knee arthroplasty |
| topic | KOOS, JR MCID Patient-reported outcome measures Satisfaction Total knee arthroplasty |
| url | http://www.sciencedirect.com/science/article/pii/S2352344125001384 |
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