Evidence map›Paper›PMID 31111184›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020

Minimal clinically important differences and substantial clinical benefits for Knee Society Scores.

Alejandro Lizaur-Utrilla, Santiago Gonzalez-Parreño, Daniel Martinez-Mendez, Francisco A Miralles-Muñoz, Fernando A Lopez-Prats

Abstract read
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In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
104citing papers in PubMed, 14 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

104 citing papers in PubMed, 14 syntheses or guidelines pooled it.

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  9. Interventions for treating fractures of the distal femur in adults.The Cochrane database of systematic reviews · 2022
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  10. No difference between mobile and fixed bearing in primary total knee arthroplasty: a meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022
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  11. Equivalent outcomes of ultra-congruent and standard cruciate-retaining inserts in total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022
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44 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alejandro Lizaur-UtrillaDepartment of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, 03600, Elda, Alicante, Spain. lizaur1@telefonica.net.ORCID http://orcid.org/0000-0003-4798-2702
Santiago Gonzalez-ParreñoDepartment of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, 03600, Elda, Alicante, Spain.
Daniel Martinez-MendezDepartment of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, 03600, Elda, Alicante, Spain.
Francisco A Miralles-MuñozDepartment of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, 03600, Elda, Alicante, Spain.
Fernando A Lopez-PratsDepartment of Traumatology and Orthopaedia, Miguel Hernandez University, Elche, Alicante, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThere is a paucity of literature defining the minimal clinically important difference (MCID) for the Knee Society Scores (KSS) after total knee arthroplasty (TKA), and no data on the substantial clinical benefit (SCB) for KSS have been reported. The purpose of this study was to determine MCID and SCB for the KSS in patients with primary TKA.

methodsThe median age of patients was 71.6 (range 50-88) years, and 60.3% were females 507 patients with TKA were prospectively enrolled. Patients completed the KSS before surgery and at second postoperative year. The MCID values of the KSS were estimated using anchor-based method, distribution-based method and receiver operating characteristic (ROC) curve analysis with calculation of the area under curve (AUC). SCB was estimated using ROC.

resultsThe MCID for KSS-knee score was 7.2 points by the anchor-based method, 7.2 by the distribution-based method, and using a ROC analysis the cutoff point was 8.9 points with an AUC of 0.75. For KSS-function score, the MCID values were 9.7, 6.3, and 10.3 (AUC 0.71), respectively. SCB values were 39.7 points (AUC 0.74) for the KSS-knee score, and 38.6 (AUC 0.76) for the KSS-function score. Logistic regression showed age and Charlson index to negatively affect the changes in KSS.

conclusionDifferent methods for MCID calculation lead to different results. With the use of ROC curve analysis, patients with an improvement of at least 9 points for KSS-knee and 10 points for KSS-function scores experience a clinically important change, whereas those who have at least an improvement of 40 points for KSS-knee and 39 points for KSS-function scores experience a substantial clinical benefit. These findings can ensure clinical improvement from the patient's perspective and also aid in interpreting results from clinical studies. LEVEL OF EVIDENCE: III.

Indexed as

Minimal Clinically Important DifferenceAgedAged, 80 and overArthroplasty, Replacement, KneeFemaleFollow-Up StudiesHealth Status IndicatorsHumansMaleMiddle AgedOsteoarthritis, KneePrognosisROC CurveTreatment OutcomeFunctional outcomeKnee Society ScoresMCIDMinimal clinically important differencePatient-related outcomeTotal knee arthroplasty

Identifiers

PMID31111184

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.