Results from the TRIO study

When a knee is severely damaged by arthritis, and medications or walking supports are no longer helpful, some patients look into total knee arthroplasty (TKA). However, there might be patients that have a high risk of a poor outcome after TKA. In a study published in Rheumatology Advances in Practice, researchers aim to develop and validate a simple clinical prediction model, based on easily collected preoperative information, to identify patients at high risk of pain and functional disability 6 months after TKA.

Development of a clinical risk score for pain and function following total knee #arthroplasty https://t.co/VcUNrIB5WS @AberdeenEpi #rheumatology

— Rheumatology & Rheumatology Advances in Practice (@RheumJnl) September 17, 2018

 The study was a multicenter cohort of patients from nine centers across the U.K.; patients enrolled in the study were undergoing a primary TKA for osteoarthritis (OA). “The primary outcome measure for this analysis was the Oxford knee score (OKS), measured 6 months postoperatively by postal questionnaire,” the researchers said. “Multivariable logistic regression was used to develop the model. Model performance (discrimination and calibration) and internal validity were assessed, and a simple clinical risk score was developed.” 

Hot off the printing press…https://t.co/NDAU50yjvU The first prediction model for TKA outcome to include both clinical and patient attitudes and behaviours to self-management. Take home: Model highlights the importance of biopsychosocial assessment in patients undergoing TKA

— UoAEpidemiology (@UoAEpi) August 10, 2018

Out of 721 participants that presented data for the analysis, 14% had a poor outcome at 6 months. Key predictors were: 

• Poor clinical status 
• Widespread body pain 
• High expectation of postoperative pain 
• Lack of active coping 

Possibly useful consideration for management of post op TKRs in @TherapiesRLI @BfwMsk https://t.co/QGm4XQreda

— Clare Longton (@ClareLongton) June 13, 2018

“We have developed and validated a clinical prediction model that can be used to identify patients at high risk of a poor outcome after TKA,” the researchers concluded. “This clinical risk score may be an aid to shared decision-making between patient and clinician.” 

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SOURCE: Rheumatology Advances in Practice