Abstract
Objective
To determine whether good versus poor outcome trajectories and predictors of poor outcome obtained in a derivation study could be replicated in an independent sample of persons undergoing knee arthroplasty (KA).
Methods
We used data from TRIO-POPULAR, a prospective cohort study of 926 participants who underwent KA in the United Kingdom. The participants were assessed preoperatively and 6-weeks, 6- and 12-months postoperatively. The Oxford Knee Score was the primary outcome and a variety of pre-operative predictors of outcome were selected. The outcome measure and the predictors were selected to most closely align with a previously published derivation study of good versus poor outcome. Confirmatory two-piece latent class growth curve analyses were used to model outcome and regression was used to identify predictors of outcome class.
Results
Trajectories for the Oxford Knee Scores from TRIO-POPULAR replicated trajectories for WOMAC Pain and Function scores from the previously published derivation study. Multivariable predictors of poor outcome were pain catastrophizing (odds ratio = 1.125, 95% CI = 1.048, .206, p=0.001) and comorbidity (odds ratio = 1.134, 95%CI = 1.049, 1.227, p=0.002. Pain catastrophizing also predicted poor outcome in the derivation study.
Conclusions
Good and poor outcome trajectories replicated those found in the previously published derivation study. Our model-based method produces stable outcome trajectories despite using data from different countries and participants with substantively different characteristics. Predictors of poor outcome were somewhat inconsistent between the cross-validation and derivation studies. Pain catastrophizing was the only consistent poor outcome predictor.
To determine whether good versus poor outcome trajectories and predictors of poor outcome obtained in a derivation study could be replicated in an independent sample of persons undergoing knee arthroplasty (KA).
Methods
We used data from TRIO-POPULAR, a prospective cohort study of 926 participants who underwent KA in the United Kingdom. The participants were assessed preoperatively and 6-weeks, 6- and 12-months postoperatively. The Oxford Knee Score was the primary outcome and a variety of pre-operative predictors of outcome were selected. The outcome measure and the predictors were selected to most closely align with a previously published derivation study of good versus poor outcome. Confirmatory two-piece latent class growth curve analyses were used to model outcome and regression was used to identify predictors of outcome class.
Results
Trajectories for the Oxford Knee Scores from TRIO-POPULAR replicated trajectories for WOMAC Pain and Function scores from the previously published derivation study. Multivariable predictors of poor outcome were pain catastrophizing (odds ratio = 1.125, 95% CI = 1.048, .206, p=0.001) and comorbidity (odds ratio = 1.134, 95%CI = 1.049, 1.227, p=0.002. Pain catastrophizing also predicted poor outcome in the derivation study.
Conclusions
Good and poor outcome trajectories replicated those found in the previously published derivation study. Our model-based method produces stable outcome trajectories despite using data from different countries and participants with substantively different characteristics. Predictors of poor outcome were somewhat inconsistent between the cross-validation and derivation studies. Pain catastrophizing was the only consistent poor outcome predictor.
Original language | English |
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Pages (from-to) | 61-68 |
Number of pages | 8 |
Journal | Osteoarthritis and Cartilage |
Volume | 30 |
Issue number | 1 |
Early online date | 22 Dec 2021 |
DOIs | |
Publication status | Published - 2022 |
Bibliographical note
Funding:The TRIO-POPULAR study was a component of the Targeted Rehabilitation to Improve Outcome after Knee Replacement (TRIO) project, supported by Versus Arthritis (grant no. 20100). The funders were not involved with the study design, collection, analysis or interpretation of data, or the writing or submission of this manuscript
Keywords
- knee
- outcome
- arthroplasty