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Age and Preoperative Knee Society Score Are Significant Predictors of Outcomes Among Asians Following Total Knee Arthroplasty.
J Bone Joint Surg Am 2016; 98(9):735-41JB

Abstract

BACKGROUND

The ability to predict patients' functional outcomes will add value to preoperative counseling. The purpose of this study was to evaluate predictors of good outcomes following total knee arthroplasty (TKA) among Asian patients.

METHODS

Registry data from 2006 to 2010 were extracted. The Oxford Knee Score (OKS) and the Short Form (SF)-36 physical component summary (PCS) were used to evaluate outcomes. A "good outcome" was defined as an improvement in scores of greater than or equal to the minimal clinically important difference (MCID) in the primary analysis. The MCID for the OKS was 5, and the MCID for the PCS was 10. For the sensitivity analyses, a "good outcome" was defined as an OKS of <30 and a PCS score of >50. Clinical variables were used to develop a multiple logistic regression model for a good outcome following total knee arthroplasty at 5 years.

RESULTS

Follow-up data were available for 3,062 patients who underwent primary TKA (mean age of 66.4 years; 79.5% female). Eighty-five percent had a good outcome on the basis of the OKS and 83%, on the basis of the SF-36 PCS. Age and preoperative Knee Society score (KSS) were found to be significant predictors. When outcomes were assessed by the MCID, lesser age and lower (worse) preoperative KSS predicted a good outcome at 5 years. When outcomes were assessed by absolute criteria (postoperative scores measured against OKS and PCS thresholds), a higher (better) preoperative KSS predicted a good outcome at 5 years. Body mass index, preoperative flexion range, SF-36 mental component summary (MCS) score, mechanical alignment, sex, education level, ethnicity, operative side, number of comorbidities, type of anesthesia, and type of implant were found not to be significant predictors.

CONCLUSIONS

The majority of Asian patients with osteoarthritis had good outcomes according to the MCID criterion and benefitted from primary TKA. On the basis of our findings, we believe that older patients with a lower (worse) preoperative KSS can be informed that they have a high likelihood of improvement but a lower likelihood of achieving as good a functional outcome as those with better scores.

LEVEL OF EVIDENCE

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Singapore General Hospital, Singapore hamidrazak@gmail.com.Saw Swee Hock School of Public Health, National University of Singapore, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27147686

Citation

Bin Abd Razak, Hamid Rahmatullah, et al. "Age and Preoperative Knee Society Score Are Significant Predictors of Outcomes Among Asians Following Total Knee Arthroplasty." The Journal of Bone and Joint Surgery. American Volume, vol. 98, no. 9, 2016, pp. 735-41.
Bin Abd Razak HR, Tan CS, Chen YJ, et al. Age and Preoperative Knee Society Score Are Significant Predictors of Outcomes Among Asians Following Total Knee Arthroplasty. J Bone Joint Surg Am. 2016;98(9):735-41.
Bin Abd Razak, H. R., Tan, C. S., Chen, Y. J., Pang, H. N., Tay, K. J., Chin, P. L., ... Yeo, S. J. (2016). Age and Preoperative Knee Society Score Are Significant Predictors of Outcomes Among Asians Following Total Knee Arthroplasty. The Journal of Bone and Joint Surgery. American Volume, 98(9), pp. 735-41. doi:10.2106/JBJS.15.00280.
Bin Abd Razak HR, et al. Age and Preoperative Knee Society Score Are Significant Predictors of Outcomes Among Asians Following Total Knee Arthroplasty. J Bone Joint Surg Am. 2016 May 4;98(9):735-41. PubMed PMID: 27147686.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Age and Preoperative Knee Society Score Are Significant Predictors of Outcomes Among Asians Following Total Knee Arthroplasty. AU - Bin Abd Razak,Hamid Rahmatullah, AU - Tan,Chuen-Seng, AU - Chen,Yongqiang Jerry Delphi, AU - Pang,Hee-Nee, AU - Tay,Keng-Jin Darren, AU - Chin,Pak-Lin, AU - Chia,Shi-Lu, AU - Lo,Ngai-Nung, AU - Yeo,Seng-Jin, PY - 2016/5/6/entrez PY - 2016/5/6/pubmed PY - 2017/4/7/medline SP - 735 EP - 41 JF - The Journal of bone and joint surgery. American volume JO - J Bone Joint Surg Am VL - 98 IS - 9 N2 - BACKGROUND: The ability to predict patients' functional outcomes will add value to preoperative counseling. The purpose of this study was to evaluate predictors of good outcomes following total knee arthroplasty (TKA) among Asian patients. METHODS: Registry data from 2006 to 2010 were extracted. The Oxford Knee Score (OKS) and the Short Form (SF)-36 physical component summary (PCS) were used to evaluate outcomes. A "good outcome" was defined as an improvement in scores of greater than or equal to the minimal clinically important difference (MCID) in the primary analysis. The MCID for the OKS was 5, and the MCID for the PCS was 10. For the sensitivity analyses, a "good outcome" was defined as an OKS of <30 and a PCS score of >50. Clinical variables were used to develop a multiple logistic regression model for a good outcome following total knee arthroplasty at 5 years. RESULTS: Follow-up data were available for 3,062 patients who underwent primary TKA (mean age of 66.4 years; 79.5% female). Eighty-five percent had a good outcome on the basis of the OKS and 83%, on the basis of the SF-36 PCS. Age and preoperative Knee Society score (KSS) were found to be significant predictors. When outcomes were assessed by the MCID, lesser age and lower (worse) preoperative KSS predicted a good outcome at 5 years. When outcomes were assessed by absolute criteria (postoperative scores measured against OKS and PCS thresholds), a higher (better) preoperative KSS predicted a good outcome at 5 years. Body mass index, preoperative flexion range, SF-36 mental component summary (MCS) score, mechanical alignment, sex, education level, ethnicity, operative side, number of comorbidities, type of anesthesia, and type of implant were found not to be significant predictors. CONCLUSIONS: The majority of Asian patients with osteoarthritis had good outcomes according to the MCID criterion and benefitted from primary TKA. On the basis of our findings, we believe that older patients with a lower (worse) preoperative KSS can be informed that they have a high likelihood of improvement but a lower likelihood of achieving as good a functional outcome as those with better scores. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. SN - 1535-1386 UR - https://www.unboundmedicine.com/medline/citation/27147686/Age_and_Preoperative_Knee_Society_Score_Are_Significant_Predictors_of_Outcomes_Among_Asians_Following_Total_Knee_Arthroplasty_ L2 - http://dx.doi.org/10.2106/JBJS.15.00280 DB - PRIME DP - Unbound Medicine ER -