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Development and validation of a clinical prediction model of patient-reported pain and function after primary total knee replacement surgery

Development and validation of a clinical prediction model of patient-reported pain and function after primary total knee replacement surgery
Development and validation of a clinical prediction model of patient-reported pain and function after primary total knee replacement surgery
To develop and validate a clinical prediction model of patient-reported pain and function after undergoing total knee replacement (TKR). We used data of 1,649 patients from the Knee Arthroplasty Trial who received primary TKR across 34 centres in the UK. The external validation included 595 patients from Southampton University Hospital, and Nuffield Orthopaedic Centre (Oxford). The outcome was the Oxford Knee Score (OKS) 12-month after TKR. Pre-operative predictors including patient characteristics and clinical factors were considered. Bootstrap backward linear regression analysis was used. Low pre-operative OKS, living in poor areas, high body mass index, and patient-reported anxiety or depression were associated with worse outcome. The clinical factors associated with worse outcome were worse pre-operative physical status, presence of other conditions affecting mobility and previous knee arthroscopy. Presence of fixed flexion deformity and an absent or damaged pre-operative anterior cruciate ligament (compared with intact) were associated with better outcome. Discrimination and calibration statistics were satisfactory. External validation predicted 21.1% of the variance of outcome. This is the first clinical prediction model for predicting self-reported pain and function 12 months after TKR to be externally validated. It will help to inform to patients regarding expectations of the outcome after knee replacement surgery.
2045-2322
1-9
Sanchez-Santos, M.T.
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Garriga, C.
5403565c-65fd-448f-904f-e41df634c888
Judge, A.
c6a83964-1d7c-4aa8-b2bf-9c264d1e487d
Batra, R.N.
1dcf5c66-3a03-4e58-8f59-c07b48044257
Price, A.
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Liddle, A.D.
d3593e1f-3cfc-4d4e-9a4b-c184dec6fe6f
Javaid, M. K.
8841650b-9deb-4d23-933b-6be97763ba65
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Murray, D.
d808d670-836b-42e7-a8b6-5229c8cfa21e
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Sanchez-Santos, M.T.
31b97d12-d959-400e-8a98-3b0be20559ed
Garriga, C.
5403565c-65fd-448f-904f-e41df634c888
Judge, A.
c6a83964-1d7c-4aa8-b2bf-9c264d1e487d
Batra, R.N.
1dcf5c66-3a03-4e58-8f59-c07b48044257
Price, A.
0544e71a-16ce-48b4-afb2-4ef3e448cbc5
Liddle, A.D.
d3593e1f-3cfc-4d4e-9a4b-c184dec6fe6f
Javaid, M. K.
8841650b-9deb-4d23-933b-6be97763ba65
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Murray, D.
d808d670-836b-42e7-a8b6-5229c8cfa21e
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f

Sanchez-Santos, M.T., Garriga, C., Judge, A., Batra, R.N., Price, A., Liddle, A.D., Javaid, M. K., Cooper, C., Murray, D. and Arden, N.K. (2018) Development and validation of a clinical prediction model of patient-reported pain and function after primary total knee replacement surgery. Scientific Reports, 8 (1), 1-9. (doi:10.1038/s41598-018-21714-1).

Record type: Article

Abstract

To develop and validate a clinical prediction model of patient-reported pain and function after undergoing total knee replacement (TKR). We used data of 1,649 patients from the Knee Arthroplasty Trial who received primary TKR across 34 centres in the UK. The external validation included 595 patients from Southampton University Hospital, and Nuffield Orthopaedic Centre (Oxford). The outcome was the Oxford Knee Score (OKS) 12-month after TKR. Pre-operative predictors including patient characteristics and clinical factors were considered. Bootstrap backward linear regression analysis was used. Low pre-operative OKS, living in poor areas, high body mass index, and patient-reported anxiety or depression were associated with worse outcome. The clinical factors associated with worse outcome were worse pre-operative physical status, presence of other conditions affecting mobility and previous knee arthroscopy. Presence of fixed flexion deformity and an absent or damaged pre-operative anterior cruciate ligament (compared with intact) were associated with better outcome. Discrimination and calibration statistics were satisfactory. External validation predicted 21.1% of the variance of outcome. This is the first clinical prediction model for predicting self-reported pain and function 12 months after TKR to be externally validated. It will help to inform to patients regarding expectations of the outcome after knee replacement surgery.

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Accepted/In Press date: 22 January 2018
e-pub ahead of print date: 21 February 2018

Identifiers

Local EPrints ID: 418413
URI: https://eprints.soton.ac.uk/id/eprint/418413
ISSN: 2045-2322
PURE UUID: 7db8c852-e575-4237-9492-4540a8fef81e
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 07 Mar 2018 17:30
Last modified: 10 Dec 2019 01:53

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Contributors

Author: M.T. Sanchez-Santos
Author: C. Garriga
Author: A. Judge
Author: R.N. Batra
Author: A. Price
Author: A.D. Liddle
Author: M. K. Javaid
Author: C. Cooper ORCID iD
Author: D. Murray
Author: N.K. Arden

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