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How often is the office visit needed? Predicting total knee arthroplasty revision risk using pain/function scores

Overview of attention for article published in BMC Health Services Research, August 2016
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Title
How often is the office visit needed? Predicting total knee arthroplasty revision risk using pain/function scores
Published in
BMC Health Services Research, August 2016
DOI 10.1186/s12913-016-1669-y
Pubmed ID
Authors

Charles D. Hightower, Lisa S. Hightower, Penny J. Tatman, Patrick M. Morgan, Terence Gioe, Jasvinder A. Singh

Abstract

Most patients have favorable outcomes after primary total knee arthroplasty (TKA). Well-validated methods to predict the risk of poor outcomes have not been developed or implemented. Several patients have annual clinic visits despite well-funcitoning TKA, as a routine practice, to detect early failure requiring revision surgery. It is not known whether assessment of pain and function can be used as a predictive tool for early failure and revision to guide practice. Our objective was to determine whether pain and function can predict revision after TKA. We retrospectively studied data from a large prospectively gathered TKA registry to examine changes in outcome scores for primary TKAs undergoing revision compared to those not requiring revision to determine the factors that are predictive for revision. Of the 1,012 patients, 721 had had a single-sided primary TKA and had American Knee Society (AKS) Scores for three or more visits. 46 patients underwent revision, 23 acutely (fracture, traumatic component failure or acute infection) and 23 for latent causes (late implant loosening, progressive osteolysis, or pain and indolent infection). Mean age was 70 years for the non-revision patients, and 64 years for those revised. Both AKS Clinical and AKS Function Scores for non-revised patients were higher than in revision patients, higher in acute revision compared to latent revision patients. Significant predictors of revision surgery were preoperative, 3- and 15-month postoperative AKS Clinical Scores and 3-month AKS Function Scores. At 15-month post-TKA, a patient with a low calculated probability of revision, 32 % or less, was unlikely to require revision surgery with a negative predictive value of 99 %. Time dependent interval evaluation post-TKA with the AKS outcome scores may provide the ability to assign risk of revision to patients at the 15-month follow-up visit. If these findings can be replicated using a patient-reported measure, a virtual follow-up with patient-reported outcomes and X-ray review may be an alternative to clinic visit for patients doing well.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 53 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 53 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 10 19%
Student > Bachelor 10 19%
Student > Doctoral Student 5 9%
Student > Ph. D. Student 5 9%
Researcher 4 8%
Other 10 19%
Unknown 9 17%
Readers by discipline Count As %
Medicine and Dentistry 23 43%
Nursing and Health Professions 4 8%
Psychology 4 8%
Engineering 3 6%
Agricultural and Biological Sciences 2 4%
Other 4 8%
Unknown 13 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 August 2016.
All research outputs
#6,286,823
of 8,286,032 outputs
Outputs from BMC Health Services Research
#2,531
of 3,081 outputs
Outputs of similar age
#179,537
of 252,710 outputs
Outputs of similar age from BMC Health Services Research
#184
of 210 outputs
Altmetric has tracked 8,286,032 research outputs across all sources so far. This one is in the 13th percentile – i.e., 13% of other outputs scored the same or lower than it.
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