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Published in: BMC Musculoskeletal Disorders 1/2020

01-12-2020 | Osteoarthrosis | Research article

Minimal important differences for the WOMAC osteoarthritis index and the Forgotten Joint Score-12 in total knee arthroplasty patients

Authors: N. Holtz, D. F. Hamilton, J. M. Giesinger, B. Jost, K. Giesinger

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

Background

Total knee arthroplasty (TKA) is an effective treatment for end-stage osteoarthritis. Patient reported-outcome measures (PROMs) capture the patients’ perception of the success of an intervention. The minimal important difference (MID) is an important characteristic of the PROM, which helps to interpret results. The aim of this study was to identify the MID for the Forgotten Joint Score-12 (FJS-12) and Western Ontario and McMaster Universities (WOMAC) osteoarthritis index.

Methods

Data were collected in a prospective cohort study. Patients were asked to complete the FJS-12, WOMAC osteoarthritis index and transition items evaluating change over time to determine the MID. We employed an anchor-based methodology relating score change to the response categories of the transition items using both binary logistic regression and receiver operating characteristic (ROC) analysis.

Results

Data from 199 patients were analysed. Mean age was 72.3 years, 58% were women. Employing binary logistic regression the MID for the FJS-12 was 10.8 points, for the WOMAC pain score 7.5 points and for the WOMAC function score 7.2 points. ROC analyses found a MID of 13.0 points for the FJS-12, 12.5 points for WOMAC pain and 14.7 points for WOMAC function.

Conclusion

We report MIDs for the FJS-12 and the WOMAC Pain and Function scales in a TKA patient cohort, which can be used to interpret meaningful differences in score. In line with previous research, we found more advanced statistical methods to result in smaller MID estimates for both scores.

Trial registration

Written consent for this study was obtained from all participants and ethical approval was granted by the local ethics committee (Ethikkommission St. Gallen; EKSG 14/973; Registered 03 July 2014; http://​www.​sg.​ch/​home/​gesundheit/​ethikkommission.​html).
Literature
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go back to reference Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15(12):1833–40 http://www.ncbi.nlm.nih.gov/pubmed/3068365. Accessed July 7, 2018.PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15(12):1833–40 http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​3068365. Accessed July 7, 2018.PubMed
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go back to reference Baumann F, Ernstberger T, Loibl M, Zeman F, Nerlich M, Tibesku C. Validation of the German forgotten joint score (G-FJS) according to the COSMIN checklist: does a reduction in joint awareness indicate clinical improvement after arthroplasty of the knee? Arch Orthop Trauma Surg. 2016;136(2):257–64. https://doi.org/10.1007/s00402-015-2372-x.CrossRefPubMed Baumann F, Ernstberger T, Loibl M, Zeman F, Nerlich M, Tibesku C. Validation of the German forgotten joint score (G-FJS) according to the COSMIN checklist: does a reduction in joint awareness indicate clinical improvement after arthroplasty of the knee? Arch Orthop Trauma Surg. 2016;136(2):257–64. https://​doi.​org/​10.​1007/​s00402-015-2372-x.CrossRefPubMed
Metadata
Title
Minimal important differences for the WOMAC osteoarthritis index and the Forgotten Joint Score-12 in total knee arthroplasty patients
Authors
N. Holtz
D. F. Hamilton
J. M. Giesinger
B. Jost
K. Giesinger
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03415-x

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