TY - JOUR
T1 - Knee Injury and Osteoarthritis Outcome Score Interpretation Thresholds at 3 and 12 Months After Arthroscopic Meniscal Surgery. What Changes, and What Stays the Same?
AU - Ingelsrud, Lina Holm
AU - Terluin, Berend
AU - Thorlund, Jonas Bloch
AU - Pedersen, Julie R. nne
AU - Roos, Ewa M.
N1 - Funding Information: 1Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark. 2Department of General Practice and Elderly Care Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands. 3Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark. 4Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark. 5Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark. ORCID: Ingelsrud, 0000-0003-2261-7709; Thorlund, 0000-0001-7789-8224. The study protocol for the Knee Arthroscopy Cohort Southern Denmark is registered at ClinicalTrials.gov (registration number NCT01871272). The Knee Arthroscopy Cohort Southern Denmark was funded by the Independent Research Fund Denmark and the Region of Southern Denmark. Jonas Bloch Thorlund reports a research grant from Pfizer outside the submitted work (completed in 2022). Ewa Roos is the developer of Knee injury and Osteoarthritis Outcome Score (KOOS) and several other freely available patient-reported outcome measures, and co-founder of the Good Life with Osteoarthritis in Denmark (GLA:D), a not-for-profit initiative to implement clinical guidelines in primary care hosted by University of Southern Denmark. Ewa Roos declares that she or her institution has received payments for online lectures for TrustMe-ED and Learn.Physio outside of the submitted work. The other authors certify that they have no affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article. Address correspondence to Lina Holm Ingelsrud, Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark. E-mail: lina.holm.ingelsrud@regionh.dk t Copyright 2023 JOSPT ®, Inc Publisher Copyright: © 2023 JOSPT®, Inc.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - OBJECTIVE: To evaluate the change in minimal important change (MIC), patient acceptable symptom state (PASS), and treatment failure (TF) thresholds for the Knee injury and Osteoarthritis Outcome Score (KOOS) from 3 to 12 months following arthroscopic meniscus surgery. DESIGN: Retrospective cohort study. METHODS: We included patients from the Knee Arthroscopy Cohort Southern Denmark who had meniscus surgery between 2013 and 2015. We calculated the interpretation threshold values for MIC, PASS, and TF using an anchor-based adjusted predictive modeling method. Thresholds at 3 and 12 months postoperatively were compared to evaluate changes over time. RESULTS: The proportions of people who reported a clinically relevant improvement, or their symptoms being acceptable, increased by 10% to 15% points from 3 to 12 months after surgery. MIC thresholds for the 5 KOOS subscales remained stable from 3 to 12 months with statistically nonsignificant differences (95% confidence intervals) ranging from -0.3 (-3.0, 2.6) to -2.4 (-6.1, 1.3). All PASS thresholds except for quality of life (QOL) decreased by -6.5 (-11.8, -1.5) to -3.7 (-7.1, -0.4) points, indicating that higher symptom levels were accepted at 12 months. In contrast, the proportion reporting their treatment to have failed remained stable over time (19% and 17%). For QOL, a 7.4 (2.0, 13.2) higher TF threshold at 12 months suggested that improved QOL was required to not consider that the treatment had failed. CONCLUSION: More patients reported being improved at 1 year compared to at 3 months following meniscus surgery. The KOOS MIC thresholds were stable over time, whereas time-specific PASS values should be applied after meniscus surgery.
AB - OBJECTIVE: To evaluate the change in minimal important change (MIC), patient acceptable symptom state (PASS), and treatment failure (TF) thresholds for the Knee injury and Osteoarthritis Outcome Score (KOOS) from 3 to 12 months following arthroscopic meniscus surgery. DESIGN: Retrospective cohort study. METHODS: We included patients from the Knee Arthroscopy Cohort Southern Denmark who had meniscus surgery between 2013 and 2015. We calculated the interpretation threshold values for MIC, PASS, and TF using an anchor-based adjusted predictive modeling method. Thresholds at 3 and 12 months postoperatively were compared to evaluate changes over time. RESULTS: The proportions of people who reported a clinically relevant improvement, or their symptoms being acceptable, increased by 10% to 15% points from 3 to 12 months after surgery. MIC thresholds for the 5 KOOS subscales remained stable from 3 to 12 months with statistically nonsignificant differences (95% confidence intervals) ranging from -0.3 (-3.0, 2.6) to -2.4 (-6.1, 1.3). All PASS thresholds except for quality of life (QOL) decreased by -6.5 (-11.8, -1.5) to -3.7 (-7.1, -0.4) points, indicating that higher symptom levels were accepted at 12 months. In contrast, the proportion reporting their treatment to have failed remained stable over time (19% and 17%). For QOL, a 7.4 (2.0, 13.2) higher TF threshold at 12 months suggested that improved QOL was required to not consider that the treatment had failed. CONCLUSION: More patients reported being improved at 1 year compared to at 3 months following meniscus surgery. The KOOS MIC thresholds were stable over time, whereas time-specific PASS values should be applied after meniscus surgery.
KW - Knee injury and Osteoarthritis Outcome Score
KW - arthroscopic meniscus surgery
KW - minimal important change
KW - patient acceptable symptom state
KW - treatment failure
UR - http://www.scopus.com/inward/record.url?scp=85175770119&partnerID=8YFLogxK
U2 - https://doi.org/10.2519/jospt.2023.11993
DO - https://doi.org/10.2519/jospt.2023.11993
M3 - Article
C2 - 37787579
SN - 0190-6011
VL - 53
SP - 685
EP - 702
JO - The Journal of orthopaedic and sports physical therapy
JF - The Journal of orthopaedic and sports physical therapy
IS - 11
ER -