[PROMs as instruments for outcome assessment after total knee arthroplasty in three different EndoCert-Certified...

The use of patient-reported outcome measures (PROMs) is still limited in Germany. For EndoCert-certified centers, PROM collection is not mandatory, and analyses systematically linking PROM results with clinical follow-up examinations and the assessment of treatment success are lacking. The aim of this study was to investigate the association between PROMs and clinically defined achievement of treatment goals 3 months after total knee arthroplasty (TKA) and to assess whether differences exist between various EndoCert-certified institutional surgical settings.

In a prospective multicenter study evaluating the potential of PROMs in arthroplasty, patients undergoing TKA were included at a university hospital, a general hospital, and an outpatient practice affiliated with an arthroplasty center. Three months postoperatively, PROMs (Oxford Knee Score, EuroQol-5D, EndoCert risk scores) were collected and a clinical follow-up examination was performed to assess achievement of treatment goals. PROM results were compared between patients with achieved treatment goals and those who required further treatment, as well as among the different center types.

Patients who achieved the defined treatment goals showed significantly better postoperative PROM scores than those who did not (p < 0.001). No pain-related differences were observed between the different institutional surgical settings. In contrast, among patients with unmet treatment goals, significant center-dependent differences were found in function- and quality-of-life-related PROMs.

PROMs reliably reflect outcomes after TKA and highlight their potential as a complementary tool for outcome assessment within the frameworks of EndoCert and the German Arthroplasty Registry. The findings support a structured use of PROMs as an early warning system for targeted postoperative care management, taking patient- and center-specific factors into account.