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Comparison of the responsiveness of the SF-36, the Oxford Knee Score, and the Knee Society Clinical Rating System in patients undergoing total knee replacement

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Abstract

Objectives

To compare the responsiveness of the Knee Society (KS) Clinical Rating System, the general health status measure Short Form 36 (SF-36), and both the raw and Rasch-based scores of the condition-specific Oxford Knee Score (OKS) in patients undergoing total knee replacement (TKR)

Methods

Data were prospectively collected as part of routine care from adult patients who underwent TKR between 2001 and 2006. OKS data fit the Rasch partial credit model after removing items regarding limping and kneeling. Responsiveness was assessed using effect size (ES), standardised response mean (SRM), and relative validity (RV).

Results

Among 702 patients with complete data at baseline and two follow-ups, the pain subscale of the KS (KS-P), raw-OKS, and Rasch-OKS consistently had higher levels of responsiveness than all eight SF-36 and the other KS subscales. At 6-month follow-up, Rasch-OKS had the largest ES and KS-P had the largest SRM (2.7 and 2.0, respectively). When compared to raw-OKS, the RVs of KS-P, Rasch-OKS, SF-36 bodily pain, and SF-36 physical functioning were 1.1, 0.66, 0.49, and 0.36, respectively. A similar ordering of responsiveness was observed at 24-month follow-up.

Conclusion

The OKS and KS-P are more responsive than most SF-36 subscales in TKR patients. Raw-OKS and Rasch-OKS have comparable responsiveness. Different responsiveness indices may give different results.

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Abbreviations

OA:

Osteoarthritis

TKR:

Total knee replacement

SF-36:

Short Form 36

WOMAC:

Western Ontario and McMaster Universities Osteoarthritis Index

OKS:

Oxford Knee Score

Rasch-OKS:

Rasch-based OKS score

ES:

Effect size

SRM:

Standardised response mean

RV:

Relative validity

BP:

Bodily pain

PF:

Physical functioning

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Author information

Authors and Affiliations

  1. Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 18 Science Drive 4, Singapore, 117543, Singapore

    Yu Ko

  2. Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore

    Ngai-Nung Lo, Seng-Jin Yeo & Kuang-Ying Yang

  3. Orthopaedic Diagnostic Center, Singapore General Hospital, Singapore, Singapore

    William Yeo & Hwei-Chi Chong

  4. Department of Rheumatology & Immunology, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Julian Thumboo

  5. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Julian Thumboo

Authors
  1. Yu Ko
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  2. Ngai-Nung Lo
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  3. Seng-Jin Yeo
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  4. Kuang-Ying Yang
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  5. William Yeo
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  6. Hwei-Chi Chong
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  7. Julian Thumboo
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Corresponding authors

Correspondence to Yu Ko or Julian Thumboo.

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Ko, Y., Lo, NN., Yeo, SJ. et al. Comparison of the responsiveness of the SF-36, the Oxford Knee Score, and the Knee Society Clinical Rating System in patients undergoing total knee replacement. Qual Life Res 22, 2455–2459 (2013). https://doi.org/10.1007/s11136-013-0376-y

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  • DOI: https://doi.org/10.1007/s11136-013-0376-y

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