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Comparison of self-reported knee injury and osteoarthritis outcome score to performance measures in patients after total knee arthroplasty.
PM R. 2011 Jun; 3(6):541-9; quiz 549.PM R

Abstract

OBJECTIVE

To characterize patient outcomes after total knee arthroplasty (TKA) by (1) examining changes in self-report measures (Knee Injury and Osteoarthritis Outcome Score [KOOS]) and performance measures over the first 6 months after TKA, (2) evaluating correlations between changes in KOOS self-report function (activities of daily living [ADL] subscale) and functional performance (6-minute walk [6MW]), and (3) exploring how changes in pain correlate with KOOS ADL and 6MW outcomes.

DESIGN

Retrospective cohort evaluation.

SETTING

Clinical research laboratory.

PATIENTS (OR PARTICIPANTS)

Thirty-nine patients scheduled for a unilateral, primary TKA for end-stage unilateral knee osteoarthritis.

METHODS

Patients were evaluated 2 weeks before surgery and 1, 3, and 6 months after surgery.

MAIN OUTCOME MEASUREMENTS

KOOS, 6MW, timed-up-and-go (TUG), and stair climbing tests (SCT), quadriceps strength.

RESULTS

Three of 5 KOOS subscales significantly improved by 1 month after TKA. All 5 KOOS subscales significantly improved by 3 and 6 months after TKA. In contrast, performance measures (6MW, TUG, SCT, and quadriceps strength) all significantly declined from preoperative values by 1 month after TKA and significantly improved from preoperative values by 3 and 6 months after TKA; yet, improvements from preoperative values were not clinically meaningful. Pearson correlations between changes in the KOOS ADL subscale and 6MW from before surgery were not statistically significant at 1, 3, or 6 months after TKA. In addition, KOOS Pain was strongly correlated with KOOS ADL scores at all times, but KOOS Pain was not correlated with 6MW distance at any time.

CONCLUSIONS

Patient self-report by using the KOOS did not reflect the magnitude of performance deficits present after surgery, especially 1 month after TKA. Self-report KOOS outcomes closely paralleled pain relief after surgery, whereas performance measures were not correlated with pain. These results emphasize the importance of including performance measures when tracking recovery after TKA as opposed to solely relying on self-reported measures.

Authors+Show Affiliations

Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, 13121 E 17th Ave, Bldg L28, Mail Stop C244, Aurora, CO 80045, USA. Jennifer.Stevens-Lapsley@ucdenver.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

21665167

Citation

Stevens-Lapsley, Jennifer E., et al. "Comparison of Self-reported Knee Injury and Osteoarthritis Outcome Score to Performance Measures in Patients After Total Knee Arthroplasty." PM & R : the Journal of Injury, Function, and Rehabilitation, vol. 3, no. 6, 2011, pp. 541-9; quiz 549.
Stevens-Lapsley JE, Schenkman ML, Dayton MR. Comparison of self-reported knee injury and osteoarthritis outcome score to performance measures in patients after total knee arthroplasty. PM R. 2011;3(6):541-9; quiz 549.
Stevens-Lapsley, J. E., Schenkman, M. L., & Dayton, M. R. (2011). Comparison of self-reported knee injury and osteoarthritis outcome score to performance measures in patients after total knee arthroplasty. PM & R : the Journal of Injury, Function, and Rehabilitation, 3(6), 541-9; quiz 549. https://doi.org/10.1016/j.pmrj.2011.03.002
Stevens-Lapsley JE, Schenkman ML, Dayton MR. Comparison of Self-reported Knee Injury and Osteoarthritis Outcome Score to Performance Measures in Patients After Total Knee Arthroplasty. PM R. 2011;3(6):541-9; quiz 549. PubMed PMID: 21665167.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of self-reported knee injury and osteoarthritis outcome score to performance measures in patients after total knee arthroplasty. AU - Stevens-Lapsley,Jennifer E, AU - Schenkman,Margaret L, AU - Dayton,Michael R, PY - 2010/05/04/received PY - 2010/12/02/revised PY - 2011/03/07/accepted PY - 2011/6/14/entrez PY - 2011/6/15/pubmed PY - 2011/11/4/medline SP - 541-9; quiz 549 JF - PM & R : the journal of injury, function, and rehabilitation JO - PM R VL - 3 IS - 6 N2 - OBJECTIVE: To characterize patient outcomes after total knee arthroplasty (TKA) by (1) examining changes in self-report measures (Knee Injury and Osteoarthritis Outcome Score [KOOS]) and performance measures over the first 6 months after TKA, (2) evaluating correlations between changes in KOOS self-report function (activities of daily living [ADL] subscale) and functional performance (6-minute walk [6MW]), and (3) exploring how changes in pain correlate with KOOS ADL and 6MW outcomes. DESIGN: Retrospective cohort evaluation. SETTING: Clinical research laboratory. PATIENTS (OR PARTICIPANTS): Thirty-nine patients scheduled for a unilateral, primary TKA for end-stage unilateral knee osteoarthritis. METHODS: Patients were evaluated 2 weeks before surgery and 1, 3, and 6 months after surgery. MAIN OUTCOME MEASUREMENTS: KOOS, 6MW, timed-up-and-go (TUG), and stair climbing tests (SCT), quadriceps strength. RESULTS: Three of 5 KOOS subscales significantly improved by 1 month after TKA. All 5 KOOS subscales significantly improved by 3 and 6 months after TKA. In contrast, performance measures (6MW, TUG, SCT, and quadriceps strength) all significantly declined from preoperative values by 1 month after TKA and significantly improved from preoperative values by 3 and 6 months after TKA; yet, improvements from preoperative values were not clinically meaningful. Pearson correlations between changes in the KOOS ADL subscale and 6MW from before surgery were not statistically significant at 1, 3, or 6 months after TKA. In addition, KOOS Pain was strongly correlated with KOOS ADL scores at all times, but KOOS Pain was not correlated with 6MW distance at any time. CONCLUSIONS: Patient self-report by using the KOOS did not reflect the magnitude of performance deficits present after surgery, especially 1 month after TKA. Self-report KOOS outcomes closely paralleled pain relief after surgery, whereas performance measures were not correlated with pain. These results emphasize the importance of including performance measures when tracking recovery after TKA as opposed to solely relying on self-reported measures. SN - 1934-1563 UR - https://www.unboundmedicine.com/medline/citation/21665167/Comparison_of_self_reported_knee_injury_and_osteoarthritis_outcome_score_to_performance_measures_in_patients_after_total_knee_arthroplasty_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1934-1482(11)00143-2 DB - PRIME DP - Unbound Medicine ER -