Six-month pain and function outcome expectations were established for total knee arthroplasty using the smallest...

Area of Science:

• Orthopedic Surgery
• Patient-Reported Outcomes
• Health Economics

Background:

• Knee arthroplasty outcome interpretations often lack context regarding costs, risks, and benefits compared to non-surgical options.
• Patient expectations for pain and function post-surgery are crucial but often unquantified.
• Existing outcome measures for knee replacement lack comparative context.

Purpose of the Study:

• To estimate patient expectations for pain and function six months after knee arthroplasty.
• To compare expected outcomes with those anticipated without surgery.
• To assess the impact of interactive discussions on patient expectations and the validity of these expectations.

Main Methods:

• Secondary analysis of a prospective longitudinal cohort study involving 121 knee arthroplasty patients.
• Determination of smallest worthwhile effect estimates pre-operatively.
• Establishment of expected six-month Knee injury and Osteoarthritis Outcome Score (KOOS) Pain and Function, daily activity measures.

Main Results:

• Average expected six-month KOOS Pain score was 75 (IQR 64-86); KOOS Function, daily activity score was 74 (IQR 59-86).
• Interactive discussions significantly altered expected destination scores (e.g., KOOS Pain from 87.7 to 75.0, p < 0.001).
• Established expected outcomes align with reported literature averages, demonstrating construct validity.

Conclusions:

• Six-month expected outcomes for knee arthroplasty (KOOS Pain and Function) were successfully estimated.
• The validity of these patient-reported outcome expectations was confirmed.
• These findings support the use of expected outcomes in shared decision-making for knee arthroplasty.