Patient acceptable symptom states after totalhip or knee replacement at mid-term follow-up: Thresholds of the Oxford hip and knee scores

• Published in: Bone & joint research Vol. 3; no. 1; pp. 7 - 13
• Main Authors: Keurentjes, J C, Van Tol, F R, Fiocco, M, So-Osman, C, Onstenk, R, Koopman-Van Gemert, A W M M, Pöll, R G, Nelissen, R G H H
• Format: Journal Article
• Language: English
• Published: England 2014
• Subjects: Patient reported outcome measures; Health-related quality of life; Patient Acceptable Symptom State; Total knee replacement; TKR; Total hip replacement; PROMs; THR
• ISSN: 2046-3758; 2046-3758
• DOI: 10.1302/2046-3758.31.2000141

To define Patient Acceptable Symptom State (PASS) thresholds for the Oxford hip score (OHS) and Oxford knee score (OKS) at mid-term follow-up.
In a prospective multicentre cohort study, OHS and OKS were collected at a mean follow-up of three years (1.5 to 6.0), combined with a numeric rating scale (NRS) for satisfaction and an external validation question assessing the patient's willingness to undergo surgery again. A total of 550 patients underwent total hip replacement (THR) and 367 underwent total knee replacement (TKR).
Receiver operating characteristic (ROC) curves identified a PASS threshold of 42 for the OHS after THR and 37 for the OKS after TKR. THR patients with an OHS ≥ 42 and TKR patients with an OKS ≥ 37 had a higher NRS for satisfaction and a greater likelihood of being willing to undergo surgery again.
PASS thresholds appear larger at mid-term follow-up than at six months after surgery. With- out external validation, we would advise against using these PASS thresholds as absolute thresholds in defining whether or not a patient has attained an acceptable symptom state after THR or TKR. Cite this article: Bone Joint Res 2014;3:7-13.