Kantonsspital St.Gallen

Comparative responsiveness of outcome measures for total knee arthroplasty

Karlmeinrad Giesinger, D F Hamilton, Bernhard Jost, B Holzner & J M Giesinger


The 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.

Data 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.

Data 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.

Outcome 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.
citation Giesinger K, Hamilton D F, Jost B, Holzner B, Giesinger J M. Comparative responsiveness of outcome measures for total knee arthroplasty. Osteoarthr Cartil 2013; 22:184-9.
type journal paper/review (English)
date of publishing 18-11-2013
journal title Osteoarthr Cartil (22/2)
ISSN electronic 1522-9653
pages 184-9
PubMed 24262431
DOI 10.1016/j.joca.2013.11.001