Minimal important change values for the Oxford Knee Score and the Forgotten Joint Score at 1 year after total knee replacement

Lina H. Ingelsrud, Ewa M. Roos, Berend Terluin, Kirill Gromov, Henrik Husted, Anders Troelsen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background and purpose — Interpreting changes in Oxford Knee Score (OKS) and Forgotten Joint Score (FJS) following total knee replacement (TKR) is challenged by the lack of methodologically rigorous methods to estimate minimal important change (MIC) values. We determined MIC values by predictive modeling for the OKS and FJS in patients undergoing primary TKR. Patients and methods — We conducted a prospective cohort study in patients undergoing TKR between January 2015 and July 2016. OKS and FJS were completed preoperatively and at 1 year postoperatively, accompanied by a 7-point anchor question ranging from “better, an important improvement” to “worse, an important worsening.” MIC improvement values were defined with the predictive modeling approach based on logistic regression, with patients’ decisions on important improvement as dependent variable and change in OKS/FJS as independent variable. Furthermore, the MICs were adjusted for high proportions of improved patients. Results — 333/496 (67.1%) patients with a median age of 69 years (61% female) had complete data for OKS, FJS, and anchor questions at 1 year postoperatively. 85% were importantly improved. Spearman’s correlations between the anchor and the change score were 0.56 for OKS, and 0.61 for FJS. Adjusted predictive MIC values (95% CI) for improvement were 8 (6–9) for OKS and 14 (10–18) for FJS. Interpretation — The MIC value of 8 for OKS and 14 for FJS corresponds to minimal improvements that the average patient finds important and aids in our understanding of whether improvements after TKR are clinically relevant.
Original languageEnglish
Pages (from-to)541-547
JournalActa Orthopaedica
Volume89
Issue number5
DOIs
Publication statusPublished - 2018

Cite this

Ingelsrud, Lina H. ; Roos, Ewa M. ; Terluin, Berend ; Gromov, Kirill ; Husted, Henrik ; Troelsen, Anders. / Minimal important change values for the Oxford Knee Score and the Forgotten Joint Score at 1 year after total knee replacement. In: Acta Orthopaedica. 2018 ; Vol. 89, No. 5. pp. 541-547.
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abstract = "Background and purpose — Interpreting changes in Oxford Knee Score (OKS) and Forgotten Joint Score (FJS) following total knee replacement (TKR) is challenged by the lack of methodologically rigorous methods to estimate minimal important change (MIC) values. We determined MIC values by predictive modeling for the OKS and FJS in patients undergoing primary TKR. Patients and methods — We conducted a prospective cohort study in patients undergoing TKR between January 2015 and July 2016. OKS and FJS were completed preoperatively and at 1 year postoperatively, accompanied by a 7-point anchor question ranging from “better, an important improvement” to “worse, an important worsening.” MIC improvement values were defined with the predictive modeling approach based on logistic regression, with patients’ decisions on important improvement as dependent variable and change in OKS/FJS as independent variable. Furthermore, the MICs were adjusted for high proportions of improved patients. Results — 333/496 (67.1{\%}) patients with a median age of 69 years (61{\%} female) had complete data for OKS, FJS, and anchor questions at 1 year postoperatively. 85{\%} were importantly improved. Spearman’s correlations between the anchor and the change score were 0.56 for OKS, and 0.61 for FJS. Adjusted predictive MIC values (95{\%} CI) for improvement were 8 (6–9) for OKS and 14 (10–18) for FJS. Interpretation — The MIC value of 8 for OKS and 14 for FJS corresponds to minimal improvements that the average patient finds important and aids in our understanding of whether improvements after TKR are clinically relevant.",
author = "Ingelsrud, {Lina H.} and Roos, {Ewa M.} and Berend Terluin and Kirill Gromov and Henrik Husted and Anders Troelsen",
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Minimal important change values for the Oxford Knee Score and the Forgotten Joint Score at 1 year after total knee replacement. / Ingelsrud, Lina H.; Roos, Ewa M.; Terluin, Berend; Gromov, Kirill; Husted, Henrik; Troelsen, Anders.

In: Acta Orthopaedica, Vol. 89, No. 5, 2018, p. 541-547.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Minimal important change values for the Oxford Knee Score and the Forgotten Joint Score at 1 year after total knee replacement

AU - Ingelsrud, Lina H.

AU - Roos, Ewa M.

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AU - Husted, Henrik

AU - Troelsen, Anders

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