Data Validate a Shorter, More Patient-Friendly Outcomes Assessment for Revision TKA

    Researchers from Hospital for Special Surgery (HSS) have confirmed that a significantly shortened, 7-question patient survey on pain, function, and quality of life is a valid and efficient tool for assessing patient outcomes following revision total knee arthroplasty (TKA).

    The findings were presented at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons.

    The previous commonly used knee replacement survey was 42 questions long, often leaving physicians with partial, unusable information. The shorter survey, known as KOOS JR. (Knee Injury and Osteoarthritis Outcome Score), and its hip replacement counterpart, HOOS JR., have already been adopted for Medicare’s primary total joint replacement bundled payment program.

    Research presented by HSS provides peer-reviewed data demonstrating that KOOS JR. is a valid outcomes measure for knee replacement surgery.

    “At HSS, we are continually improving how we measure outcomes and KOOS JR. is a direct result of these efforts,” said Alexander McLawhorn, MD, MBA, an orthopedic surgeon at HSS.

    “We saw a need for a shorter, more patient-friendly survey in an area where outcomes data are essential to improving quality of care. In fact, knee replacement revisions, which are more complex than primary knee surgery, are under-studied in this regard.”

    Revision TKA procedures have doubled over the last 10 years, and are expected to grow 600% between 2005 and 2030. Approximately 700,000 primary knee replacements are done in the US, and approximately 10% may require a second operation within 15 to 20 years.

    “With the influx of surgeries expected over the next 5 to 10 years, it is essential that we deepen our understanding of revision knee replacement outcomes,” said Steven Haas, MD, chief of Knee Service at HSS.

    “This shorter patient survey will help the orthopedic community obtain necessary measurement information while minimizing the burden on patients and data collection administrators.”

    For the study, HSS researchers looked at the results of 314 patients who underwent revision TKA between May 2007 and December 2011 and completed KOOS JR. patient–reported outcome measure surveys before surgery and 2 years later.

    The KOOS JR. measures proved to be as valid, and have as much internal consistency, external validity, and other measures of reliability, in determining outcomes for these patients as they did in patients who had primary TKA.
    “There are increasing incentives and requirements from the government and private insurers for providing patient-reported outcome measures,” said Stephen Lyman, PhD, director of Healthcare Research Institute at HSS.

    “This short form should reduce the burden and fatigue of patients in busy clinical settings when gathering this information. This study supports extending the use of KOOS JR. to patients having revision knee replacements.”