Health Policy & EconomicsDevelopment of a Prognostic Nomogram for Predicting the Probability of Nonresponse to Total Knee Arthroplasty 1 Year After Surgery
Section snippets
Study Setting and Participants
This study was conducted at a university-affiliated tertiary hospital in Melbourne, Australia. All patients admitted to the hospital who underwent a primary elective TKA between January 2012 and December 2013 were considered eligible for study inclusion.
Data Collection
The hospital houses the SMART Registry, which is a clinical registry of all elective lower limb joint arthroplasties performed at the institution since 1998. As previously described, data collection and storage include an extensive range of
Study Population
There were 626 primary elective TKAs performed in 562 patients all of whom had complete baseline data. Eleven cases did not complete a WOMAC at 12 months due to death (n = 5), declined to complete survey (n = 3), and relocated overseas (n = 3). These cases were excluded, leaving 615/626 (98%) with complete baseline and follow-up data for analysis. In total, 90/615 (15%) cases did not achieve the cut point for response to surgery according to the OMERACT-OARSI criteria and were deemed
Discussion
We have created a prognostic nomogram that displays the predictive probabilities of nonresponse to surgery as a source of decision support for health care professionals and patients, about their likely functional outcome from TKA. We constructed our prediction tool in the form of a nomogram given its wide use in many areas of medicine and its superior accuracy in clinical prediction when compared with clinician predictions 23, 24. To our knowledge, however, this is the first tool to accurately
References (33)
- et al.
Economic burden of periprosthetic joint infection in the United States
J Arthroplasty
(2012) - et al.
Patient acceptable symptom state and OMERACT-OARSI set of responder criteria in joint replacement. Identification of cut-off values
Osteoarthritis Cartilage
(2012) - et al.
Latent class growth analysis predicts long term pain and function trajectories in total knee arthroplasty: a study of 689 patients
Osteoarthritis Cartilage
(2015) - et al.
Associations between pre-operative radiographic changes and outcomes after total knee joint replacement for osteoarthritis
Osteoarthritis Cartilage
(2012) - et al.
The SF-12 in the Australian population: cross-validation of item selection
Aust N Z J Public Health
(2002) - et al.
Predicting patient discharge disposition after total joint arthroplasty in the United States
J Arthroplasty
(2010) Nomograms are difficult to beat
Eur Urol
(2008)- et al.
Selecting those to refer for joint replacement: who will likely benefit and who will not?
Best Pract Res Clin Rheumatol
(2014) - et al.
Patient decision aids in knee replacement surgery
Knee
(2012) Australian Orthopaedic Association National Joint Replacement Registry
(2015)
Cost-effectiveness of total knee replacement: a prospective cohort study
Arthritis Care Res (Hoboken)
Antimicrobial resistance. Tackling a crisis for the health and wealth of nations
Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030
J Bone Joint Surg Am
The potential for cost savings through bundled episode payments
N Eng J Med
Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study
Arthritis Rheumatol
Prevalence of clinically significant improvement following total knee replacement
J Rheumatol
Cited by (62)
Instruments to assess appropriateness of hip and knee arthroplasty: a systematic review
2023, Osteoarthritis and CartilageDeveloping and internally validating a prediction model for total knee replacement surgery in patients with osteoarthritis
2022, Osteoarthritis and Cartilage OpenDo Physicians Overestimate Radiographic Findings in Patients Undergoing Knee Arthroplasty?
2022, Arthroplasty TodayA View of the Development of Patient-Reported Outcomes Measures, Their Clinical Integration, Electronification, and Potential Impact on Rehabilitation Service Delivery
2022, Archives of Physical Medicine and RehabilitationSurgery for osteoarthritis
2022, Osteoarthritis Health Professional Training Manual
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2016.02.003.
Michelle M. Dowsey is the recipient of an NHMRC Early Career Australian Clinical Fellowship (APP1035810). Tim Spelman is the recipient of an NHMRC Postgraduate Public Health Scholarship (APP1055761).