Preoperative Function Affects Ability to Achieve One-Year Minimum Clinically Important Difference for Patients...

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Health Outcomes Research

Background:

• Minimum clinically important difference (MCID) is crucial for assessing treatment success in total knee arthroplasty (TKA).
• Existing research indicates that MCID values can differ based on calculation methods and patient factors.
• Patient-specific characteristics are associated with the failure to meet established MCID thresholds post-TKA.

Purpose of the Study:

• To investigate whether anchor-based 1-year Knee Injury and Osteoarthritis Outcome Score Joint Replacement (KOOS-JR) MCID values differ among TKA patients based on specific patient factors.
• To analyze the influence of preoperative characteristics on MCID attainment in TKA.

Main Methods:

• Retrospective review of 976 patients undergoing primary TKA between 2017-2018.
• Exclusion of patients lacking baseline/1-year KOOS-JR or PROMIS Global Health data, or those who had non-primary TKA procedures.
• Calculation and comparison of 1-year MCID values across different preoperative patient groups.

Main Results:

• 1-year KOOS-JR MCIDs were 26.6 for men and 28.2 for women; 30.7 for patients with anxiety/depression and 26.7 for those without.
• No significant differences in MCID were found based on gender (P = .379) or mental health diagnosis (P = .066).
• Preoperative KOOS-JR decile showed an inverse relationship with 1-year MCID values and MCID attainment.

Conclusions:

• The proportion of patients achieving KOOS-JR MCID values was inversely related to preoperative baseline function.
• Further research is needed to identify patient factors that may influence surgeon's ability to capture patient satisfaction despite not achieving MCID.
• Understanding these factors can help improve patient outcomes and satisfaction after TKA.