期刊
JOURNAL OF ARTHROPLASTY
卷 35, 期 5, 页码 1200-+出版社
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2019.12.038
关键词
HOOS; KOOS; total hip arthroplasty; total knee arthroplasty; subscale; validation
类别
资金
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, part of the National Institutes of Health, USA [K23AR068449]
Background: Total hip replacement (THR)/total knee replacement (TKR) studies do not uniformly measure patient centered domains, pain, and function. We aim to validate existing measures of pain and function within subscales of standard instruments to facilitate measurement. Methods: We evaluated baseline and 2-year pain and function for THR and TKR using Hip disability and Osteoarthritis Outcome Score (HOOS)/Knee Injury and Osteoarthritis Outcome Score (KOOS), with primary unilateral TKR (4796) and THR (4801). Construct validity was assessed by correlating HOOS/KOOS pain and activities of daily living (ADL), function quality of life (QOL), and satisfaction using Spearman correlation coefficients. Patient relevant thresholds for change in pain and function were anchored to improvement in QOL; minimally clinically important difference (MCID) corresponded to a little improvement and a really important difference (RID) to a moderate improvement. Pain and ADL function scores were compared by quartiles using Kruskal-Wallis. Results: Two-year HOOS/KOOS pain and ADL function correlated with health-related QOL (KOOS pain and Short Form 12 Physical Component Scale rho = 0.54; function rho = 0.63). Comparing QOL by pain and function quartiles, the highest levels of pain relief and function were associated with the most improved QOL. MCID for pain was estimated at >= 20, and the RID >= 29; MCID for function >= 14, and the RID >= 23. The measures were responsive to change with large effect sizes (>= 1.8). Conclusion: We confirm that HOOS/KOOS pain and ADL function subscales are valid measures of critical patient centered domains after THR/TKR, and achievable thresholds anchored to improved QOL. Cost-free availability and brevity makes them feasible, to be used in a core measurement set in total joint replacement trials. (C) 2019 Elsevier Inc. All rights reserved.
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