Thresholds for Oxford Knee Score after total knee replacement surgery: a novel approach to post-operative evaluation
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RESEARCH ARTICLE
Open Access
Thresholds for Oxford Knee Score after total knee replacement surgery: a novel approach to post-operative evaluation Christian Lund Petersen2,3*, Jonas Bruun Kjærsgaard2, Nicolai Kjærgaard2, Michael Ulrich Jensen1 and Mogens Berg Laursen1
Abstract Background: In a prospective cohort study, we wanted to detect thresholds distinguishing between patients with a satisfactory and an unsatisfactory outcome after total knee replacement (TKR) based on Patient-Reported Outcome Measures (PROMs), namely the Oxford Knee Score (OKS), using patient satisfaction and patient-perceived function as global transition items. Methods: Seventy-three TKR patients completed the OKS questionnaire before surgery and were invited to complete the same questionnaire again 6 (4 to 9) months after surgery. Correlations between outcome measures and anchors were calculated using Pearson’s correlation coefficient. Thresholds were established by receiver operating characteristics (ROC) analysis, using multiple anchor-based approaches. Results: Patients showed a mean increase of 16.5 (SD 9.5) in OKS following TKR. Significant positive correlations were found between outcome measures and anchors. Six different thresholds were determined for outcome measures coupled with satisfaction, patient-perceived function and a combination thereof using a cut-off of 50 and 70. Conclusions: This study has established a set of clinically meaningful thresholds for Oxford Knee scores that may help to detect TKR patients who might be in need of post-operative evaluation. Keywords: PROM, Oxford Knee Score, OKS, Knee arthroplasty, Knee, Total knee replacement
Background Traditionally, when evaluating the quality of total knee replacements (TKR), indicators such as survival of the prosthesis and revision rates have been used as standard measurements [1]. However, in recent years, Patient-Reported Outcome Measures (PROMs) have gained increased attention when evaluating outcomes of TKR [2, 3]. Joint-specific PROMs allow the assessment of the outcome from the perspective of the patient, including the level of pain and function of the specific joint. One such PROM was devised in 1998. At the time of introduction of the Oxford Knee Score (OKS), the * Correspondence: [email protected] 2 School of Medicine and Health, Aalborg University, Niels Jernes Vej 12 A5, 9220 Aalborg Ø, Denmark 3 Helgolandsgade 14, 2th, 9000 Aalborg, Denmark Full list of author information is available at the end of the article
scoring system was developed as a measure of postoperative outcome for TKR [4]. Used in cohort studies and collected in national registries, such as in England and Wales, Sweden and New Zealand [5, 6], it has since been coupled to other patient-reported measures allowing a more comprehensive assessment of TKR outcomes [2, 6]. This simplifies the interpretation of the quantitative score into qualitatively meaningful information [7]. Thresholds can be established for OKS values above which patients are satisfied with surgery or have experienced i
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