Details

Autor(en) / Beteiligte

• Hawker, Gillian A
• Bohm, Eric
• Dunbar, Michael J
• Faris, Peter
• Jones, C Allyson
• Noseworthy, Tom
• Ravi, Bheeshma
• Woodhouse, Linda J
• Marshall, Deborah A
• Hawker, Gillian A.
• Marshall, Deborah A.
• Dunbar, Michael J.
• Allyson Jones, C.
• Woodhouse, Linda J.
• Arnett, Gordon
• Balyk, Robert
• Bury, Jeffery
• Cinats, John
• Dick, Donald
• Durand, D'Arcy
• Ekert, Lee
• Glasgow, Robert
• Glasgow, Don
• Goplen, Gordon
• Hui, Catherine
• Herman, Ben
• Hunka, Larry
• Jiang, Hongxing
• Johnson, William C.
• Kortbeek, Frank
• Lavoie, Guy
• Lavoie, Mitch
• Leung, Paul K.
• Mahood, James
• Masson, Edward
• McLeod, Richard
• McMillan, James
• O’Connor, Greg
• Otto, David
• Panaro, Carlo
• Paul, Paulose
• Russell, Gordon
• Weeks, Colleen
• Weber, Don
• Woo, Andrea
• Howden, Jane Squire
• Adachi, Anne-Marie
• Beatty, Jessica
• Rahman, Shakib
• Abelseth, Greg
• Souza, Kelley De
• Donaghy, John
• Duffy, Paul
• Johnston, Kelly
• Korley, Robert
• Kuchinad, Raul
• Monument, Michael
• O'Brien, Maureen
• Powell, James
• Puloski, Shannon
• Rendall, Ed
• Rezansoff, Alex
• Sharma, Raj
• Stewart, James
• Timmerman, Scott
• Werle, Jason
• Reczek, Tanya
• Depew, Jeffrey
• Dada, Bukky
• Stanaitis, Ian

Titel

Patient appropriateness for total knee arthroplasty and predicted probability of a good outcome

Ist Teil von

• Rheumatic & musculoskeletal diseases open, 2023-04, Vol.9 (2), p.e002808

Ort / Verlag

England: EULAR

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• ObjectivesOne-fifth of total knee arthroplasty (TKA) recipients experience a suboptimal outcome. Incorporation of patients’ preferences in TKA assessment may improve outcomes. We determined the discriminant ability of preoperative measures of TKA need, readiness/willingness and expectations for a good TKA outcome.MethodsIn patients with knee osteoarthritis (OA) undergoing primary TKA, we preoperatively assessed TKA need (Western Ontario-McMaster Universities OA Index (WOMAC) Pain Score and Knee injury and Osteoarthritis Outcome Score (KOOS) function, arthritis coping), health status, readiness (Patient Acceptable Symptom State, depressive symptoms), willingness (definitely yes—yes/no) and expectations (outcomes deemed ‘very important’). A good outcome was defined as symptom improvement (met Outcome Measures in Rheumatology and Osteoarthritis Research Society International (OMERACT–OARSI) responder criteria) and satisfaction with results 1 year post TKA. Using logistic regression, we assessed independent outcome predictors, model discrimination (area under the receiver operating characteristic curve, AUC) and the predicted probability of a good outcome for different need, readiness/willingness and expectations scenarios.ResultsOf 1,053 TKA recipients (mean age 66.9 years (SD 8.8); 58.6% women), 78.1% achieved a good outcome. With TKA need alone (WOMAC pain subscale, KOOS physical function short-form), model discrimination was good (AUC 0.67, 95% CI 0.63 to 0.71). Inclusion of readiness/willingness, depressive symptoms and expectations regarding kneeling, stair climbing, well-being and performing recreational activities improved discrimination (p=0.01; optimism corrected AUC 0.70, 0.66–0.74). The predicted probability of a good outcome ranged from 44.4% (33.9–55.5) to 92.4% (88.4–95.1) depending on level of TKA need, readiness/willingness, depressive symptoms and surgical expectations.ConclusionsAlthough external validation is required, our findings suggest that incorporation of patients’ TKA readiness, willingness and expectations in TKA decision-making may improve the proportion of recipients that experience a good outcome.