Patient Acceptable Symptom State at 1 and 3 Years After Total Knee Arthroplasty: Thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS)

James W Connelly; Vincent P Galea; Pakdee Rojanasopondist; Sean J Matuszak; Lina H Ingelsrud; Christian S Nielsen; Charles R Bragdon; James I Huddleston; Henrik Malchau; Anders Troelsen

doi:10.2106/JBJS.18.00233

Patient Acceptable Symptom State at 1 and 3 Years After Total Knee Arthroplasty: Thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS)

James W Connelly, Vincent P Galea, Pakdee Rojanasopondist, Sean J Matuszak, Lina H Ingelsrud, Christian S Nielsen, Charles R Bragdon, James I Huddleston, Henrik Malchau, Anders Troelsen

Department of Clinical Medicine

15 Citations (Scopus)

Abstract

BACKGROUND: To facilitate the interpretation of numerical patient-reported outcome measure (PROM) scales, concepts such as the patient acceptable symptom state (PASS) have been introduced. Currently, no PASS thresholds have been established for the Knee injury and Osteoarthritis Outcome Score (KOOS) after total knee arthroplasty. The aims of the current study were to define PASS thresholds for the KOOS subscales and several other generic and knee-specific PROMs at 1 and 3 years after total knee arthroplasty using data from an international, multicenter clinical outcome study of a modern, well-performing implant system.

METHODS: The study cohort consisted of 499 patients undergoing total knee arthroplasty from an international, multicenter study. At 1 and 3 years after a total knee arthroplasty, patients completed the KOOS, EuroQoL 5-dimension 3-level (EQ-5D-3L), EuroQol visual analog scale (EQ-VAS), and numerical rating scales (NRS) for knee-related pain and satisfaction. PASS thresholds were calculated at each follow-up interval using 3 anchor-based approaches, using patient-reported satisfaction as the anchor.

RESULTS: According to our satisfaction anchor, 302 (78.9%) of 383 responding patients were satisfied at 1 year, and 242 (80.4%) of 301 responding patients were satisfied at 3 years. PASS thresholds were 84.5 points at 1 year and 87.5 points at 3 years for KOOS pain, 80.5 points at 1 year and 84.0 points at 3 years for KOOS symptoms, 83.0 points at 1 year and 87.5 points at 3 years for KOOS activities of daily living, 66.0 points at 1 year and 66.0 points at 3 years for KOOS quality of life, 83.0 points at 1 year and 90.5 points at 3 years for EQ-VAS, 0.80 point at 1 year and 0.80 point at 3 years for EQ-5D, and 1.8 points at 1 year and 1.8 points at 3 years for NRS pain.

CONCLUSIONS: The current study is the first, to our knowledge, to propose PASS thresholds for the KOOS subscales at 1 and 3 years after total knee arthroplasty and contributes to PASS literature on other common PROMs. These findings will provide a useful reference for future total knee arthroplasty outcome studies and will help to determine what patients consider to be satisfactory operations.

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Original language	English
Journal	Journal of Bone and Joint Surgery: American Volume
Volume	101
Issue number	11
Pages (from-to)	995-1003
ISSN	0021-9355
DOIs	https://doi.org/10.2106/JBJS.18.00233
Publication status	Published - 5 Jun 2019

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10.2106/JBJS.18.00233

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Connelly, J. W., Galea, V. P., Rojanasopondist, P., Matuszak, S. J., Ingelsrud, L. H., Nielsen, C. S., Bragdon, C. R., Huddleston, J. I., Malchau, H., & Troelsen, A. (2019). Patient Acceptable Symptom State at 1 and 3 Years After Total Knee Arthroplasty: Thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS). Journal of Bone and Joint Surgery: American Volume, 101(11), 995-1003. https://doi.org/10.2106/JBJS.18.00233

Patient Acceptable Symptom State at 1 and 3 Years After Total Knee Arthroplasty: Thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS). / Connelly, James W; Galea, Vincent P; Rojanasopondist, Pakdee et al.
In: Journal of Bone and Joint Surgery: American Volume, Vol. 101, No. 11, 05.06.2019, p. 995-1003.

Research output: Contribution to journal › Journal article › Research › peer-review

Connelly, JW, Galea, VP, Rojanasopondist, P, Matuszak, SJ, Ingelsrud, LH, Nielsen, CS, Bragdon, CR, Huddleston, JI, Malchau, H & Troelsen, A 2019, 'Patient Acceptable Symptom State at 1 and 3 Years After Total Knee Arthroplasty: Thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS)', Journal of Bone and Joint Surgery: American Volume, vol. 101, no. 11, pp. 995-1003. https://doi.org/10.2106/JBJS.18.00233

@article{99f0fe37ff4742fc9bfff4acf33245d5,

title = "Patient Acceptable Symptom State at 1 and 3 Years After Total Knee Arthroplasty: Thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS)",

abstract = "BACKGROUND: To facilitate the interpretation of numerical patient-reported outcome measure (PROM) scales, concepts such as the patient acceptable symptom state (PASS) have been introduced. Currently, no PASS thresholds have been established for the Knee injury and Osteoarthritis Outcome Score (KOOS) after total knee arthroplasty. The aims of the current study were to define PASS thresholds for the KOOS subscales and several other generic and knee-specific PROMs at 1 and 3 years after total knee arthroplasty using data from an international, multicenter clinical outcome study of a modern, well-performing implant system.METHODS: The study cohort consisted of 499 patients undergoing total knee arthroplasty from an international, multicenter study. At 1 and 3 years after a total knee arthroplasty, patients completed the KOOS, EuroQoL 5-dimension 3-level (EQ-5D-3L), EuroQol visual analog scale (EQ-VAS), and numerical rating scales (NRS) for knee-related pain and satisfaction. PASS thresholds were calculated at each follow-up interval using 3 anchor-based approaches, using patient-reported satisfaction as the anchor.RESULTS: According to our satisfaction anchor, 302 (78.9%) of 383 responding patients were satisfied at 1 year, and 242 (80.4%) of 301 responding patients were satisfied at 3 years. PASS thresholds were 84.5 points at 1 year and 87.5 points at 3 years for KOOS pain, 80.5 points at 1 year and 84.0 points at 3 years for KOOS symptoms, 83.0 points at 1 year and 87.5 points at 3 years for KOOS activities of daily living, 66.0 points at 1 year and 66.0 points at 3 years for KOOS quality of life, 83.0 points at 1 year and 90.5 points at 3 years for EQ-VAS, 0.80 point at 1 year and 0.80 point at 3 years for EQ-5D, and 1.8 points at 1 year and 1.8 points at 3 years for NRS pain.CONCLUSIONS: The current study is the first, to our knowledge, to propose PASS thresholds for the KOOS subscales at 1 and 3 years after total knee arthroplasty and contributes to PASS literature on other common PROMs. These findings will provide a useful reference for future total knee arthroplasty outcome studies and will help to determine what patients consider to be satisfactory operations.LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.",

author = "Connelly, {James W} and Galea, {Vincent P} and Pakdee Rojanasopondist and Matuszak, {Sean J} and Ingelsrud, {Lina H} and Nielsen, {Christian S} and Bragdon, {Charles R} and Huddleston, {James I} and Henrik Malchau and Anders Troelsen",

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doi = "10.2106/JBJS.18.00233",

language = "English",

volume = "101",

pages = "995--1003",

journal = "Journal of Bone and Joint Surgery: American Volume",

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T1 - Patient Acceptable Symptom State at 1 and 3 Years After Total Knee Arthroplasty

T2 - Thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS)

AU - Connelly, James W

AU - Galea, Vincent P

AU - Rojanasopondist, Pakdee

AU - Matuszak, Sean J

AU - Ingelsrud, Lina H

AU - Nielsen, Christian S

AU - Bragdon, Charles R

AU - Huddleston, James I

AU - Malchau, Henrik

AU - Troelsen, Anders

PY - 2019/6/5

Y1 - 2019/6/5

N2 - BACKGROUND: To facilitate the interpretation of numerical patient-reported outcome measure (PROM) scales, concepts such as the patient acceptable symptom state (PASS) have been introduced. Currently, no PASS thresholds have been established for the Knee injury and Osteoarthritis Outcome Score (KOOS) after total knee arthroplasty. The aims of the current study were to define PASS thresholds for the KOOS subscales and several other generic and knee-specific PROMs at 1 and 3 years after total knee arthroplasty using data from an international, multicenter clinical outcome study of a modern, well-performing implant system.METHODS: The study cohort consisted of 499 patients undergoing total knee arthroplasty from an international, multicenter study. At 1 and 3 years after a total knee arthroplasty, patients completed the KOOS, EuroQoL 5-dimension 3-level (EQ-5D-3L), EuroQol visual analog scale (EQ-VAS), and numerical rating scales (NRS) for knee-related pain and satisfaction. PASS thresholds were calculated at each follow-up interval using 3 anchor-based approaches, using patient-reported satisfaction as the anchor.RESULTS: According to our satisfaction anchor, 302 (78.9%) of 383 responding patients were satisfied at 1 year, and 242 (80.4%) of 301 responding patients were satisfied at 3 years. PASS thresholds were 84.5 points at 1 year and 87.5 points at 3 years for KOOS pain, 80.5 points at 1 year and 84.0 points at 3 years for KOOS symptoms, 83.0 points at 1 year and 87.5 points at 3 years for KOOS activities of daily living, 66.0 points at 1 year and 66.0 points at 3 years for KOOS quality of life, 83.0 points at 1 year and 90.5 points at 3 years for EQ-VAS, 0.80 point at 1 year and 0.80 point at 3 years for EQ-5D, and 1.8 points at 1 year and 1.8 points at 3 years for NRS pain.CONCLUSIONS: The current study is the first, to our knowledge, to propose PASS thresholds for the KOOS subscales at 1 and 3 years after total knee arthroplasty and contributes to PASS literature on other common PROMs. These findings will provide a useful reference for future total knee arthroplasty outcome studies and will help to determine what patients consider to be satisfactory operations.LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

AB - BACKGROUND: To facilitate the interpretation of numerical patient-reported outcome measure (PROM) scales, concepts such as the patient acceptable symptom state (PASS) have been introduced. Currently, no PASS thresholds have been established for the Knee injury and Osteoarthritis Outcome Score (KOOS) after total knee arthroplasty. The aims of the current study were to define PASS thresholds for the KOOS subscales and several other generic and knee-specific PROMs at 1 and 3 years after total knee arthroplasty using data from an international, multicenter clinical outcome study of a modern, well-performing implant system.METHODS: The study cohort consisted of 499 patients undergoing total knee arthroplasty from an international, multicenter study. At 1 and 3 years after a total knee arthroplasty, patients completed the KOOS, EuroQoL 5-dimension 3-level (EQ-5D-3L), EuroQol visual analog scale (EQ-VAS), and numerical rating scales (NRS) for knee-related pain and satisfaction. PASS thresholds were calculated at each follow-up interval using 3 anchor-based approaches, using patient-reported satisfaction as the anchor.RESULTS: According to our satisfaction anchor, 302 (78.9%) of 383 responding patients were satisfied at 1 year, and 242 (80.4%) of 301 responding patients were satisfied at 3 years. PASS thresholds were 84.5 points at 1 year and 87.5 points at 3 years for KOOS pain, 80.5 points at 1 year and 84.0 points at 3 years for KOOS symptoms, 83.0 points at 1 year and 87.5 points at 3 years for KOOS activities of daily living, 66.0 points at 1 year and 66.0 points at 3 years for KOOS quality of life, 83.0 points at 1 year and 90.5 points at 3 years for EQ-VAS, 0.80 point at 1 year and 0.80 point at 3 years for EQ-5D, and 1.8 points at 1 year and 1.8 points at 3 years for NRS pain.CONCLUSIONS: The current study is the first, to our knowledge, to propose PASS thresholds for the KOOS subscales at 1 and 3 years after total knee arthroplasty and contributes to PASS literature on other common PROMs. These findings will provide a useful reference for future total knee arthroplasty outcome studies and will help to determine what patients consider to be satisfactory operations.LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

U2 - 10.2106/JBJS.18.00233

DO - 10.2106/JBJS.18.00233

M3 - Journal article

C2 - 31169576

SN - 0021-9355

VL - 101

SP - 995

EP - 1003

JO - Journal of Bone and Joint Surgery: American Volume

JF - Journal of Bone and Joint Surgery: American Volume

IS - 11

ER -

Patient Acceptable Symptom State at 1 and 3 Years After Total Knee Arthroplasty: Thresholds for the Knee Injury and Osteoarthritis Outcome Score (KOOS)

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