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

Sanchez-Santos, MT; Garriga, C; Judge, A; Batra, RN; Price, AJ; Liddle, AD; Javaid, MK; ... Arden, NK; + view all (2018) Development and validation of a clinical prediction model for patient-reported pain and function after primary total knee replacement surgery. Scientific Reports , 8 , Article 3381. 10.1038/s41598-018-21714-1. Green open access

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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.

Type: Article
Title: Development and validation of a clinical prediction model for patient-reported pain and function after primary total knee replacement surgery
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/s41598-018-21714-1
Publisher version: http://dx.doi.org/10.1038/s41598-018-21714-1
Language: English
Additional information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Keywords: Science & Technology, Multidisciplinary Sciences, Science & Technology - Other Topics, Quality-Of-Life, Total Joint Arthroplasty, Outcome Measures, Total Hip, Age, Satisfaction, Osteoarthritis, Gender, Impact, TKA
URI: http://discovery.ucl.ac.uk/id/eprint/10046639
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