Abstract:
BACKGROUND:In 2012, a new Knee Society Knee Scoring System (KSS) was developed and validated to address the needs for a scoring system that better encompasses the expectations, satisfaction, and physical involvement of a younger, more active population of patients undergoing TKA. Revalidating this tool in a separate population by individuals other than the developers of the scoring system seems important, because such replication would tend to confirm the generalizability of this tool. QUESTIONS/PURPOSES:The purposes of this study were (1) to validate the KSS using a separate sample of patients undergoing primary TKA; and (2) to evaluate the internal consistency of the KSS. METHODS:Intervention and control groups from a randomized controlled trial with no between-group differences were pooled. Preoperative and postoperative (6 weeks and 1 year) data were used. Patients with osteoarthritis undergoing primary TKA completed the patient-reported component of the KSS, Knee Injury and Osteoarthritis Outcome Score (KOOS), SF-12, two independent questions about expectations of surgery, and the Patient Acceptable Symptom State (PASS) single-question outcome. This study included 345 patients with 221 (64%) women, an average (SD) age of 64 (8.6) years, a mean (SD) body mass index of 32.9 (7.5) kg/m, and 225 (68%) having their first primary TKA. Loss to followup in the control group was 18% and loss to followup in the intervention group was 13%. We quantified cross-sectional (preoperative scores) and longitudinal validity (pre- to postoperative change scores) by evaluating associations between the KSS and KOOS subscales using Spearman's correlation coefficient. Preoperative known-group validity of the KSS symptoms and functional activity score was evaluated with a one-way analysis of variance across three levels of physical health status using the SF-12 Physical Component Score. Known-group validity of the KSS expectation score was evaluated with an unpaired t-test by comparing means across known expectation groups. Known-group validity of the KSS satisfaction score was evaluated with an unpaired t-test by comparing means across yes/no response groupings of the PASS single-question outcome. Internal consistency for each KSS subscale was evaluated with Cronbach's α. RESULTS:Cross-sectional validity (ie, associations at a single point in time) was supported because correlation coefficients between KSS symptoms, functional activities, and satisfaction scores and scores on the KOOS pain subscale ranged from 0.60 to 0.73 (all correlations p < 0.01). Values were similar for associations with the KOOS function in the activities of daily living (ADL) subscale (0.66-0.69) and less (0.41-0.58) for correlations with the other three KOOS subscales. Longitudinal validity (ie, associations of change scores between two time points) was also supported because correlation coefficients between KSS symptoms, functional activities, and satisfaction change scores and the KOOS pain and ADL change scores varied from 0.63 to 0.73. Correlation coefficients were lower for the other three KOOS subscale change scores, suggesting a weaker relationship with KOOS symptoms (0.48-0.53), sports (0.47-0.51), and quality of life (0.60-0.65) (all correlations p < 0.01). Known-group validity (ie, differences between groups that are known to differ on a given characteristic) was confirmed by between-group differences for the symptoms and functional activities score comparisons as well as the comparisons with the expectations and satisfaction scores of the KSS (all p < 0.01). Cronbach's α (ie, association among subscale items) varied from 0.68 (discretionary activities) to 0.94 (postoperative expectations) across four KSS subscales. CONCLUSIONS:Moderate-sized correlation coefficients and consistent differences between known groups support the validity of the KSS. Internal consistency values were also acceptable. The patient-reported subscales of the KSS are a valid and internally consistent outcome assessment for TKA.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Culliton SE,Bryant DM,MacDonald SJ,Hibbert KM,Chesworth BMdoi
10.1007/s11999.0000000000000014subject
Has Abstractpub_date
2018-01-01 00:00:00pages
77-84issue
1eissn
0009-921Xissn
1528-1132pii
00003086-201801000-00017journal_volume
476pub_type
杂志文章abstract::The purpose of this study was to quantify precisely aging-induced changes in skeletal perfusion and bone mechanical properties in a small rodent model. Blood flow was measured in conscious juvenile (2 months old), adult (6 months old), and aged (24 months old) male Fischer-344 rats using radiolabeled microspheres. The...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200203000-00036
更新日期:2002-03-01 00:00:00
abstract::In situ hybridization was employed to study cellular phenotypes in the ossification groove of Ranvier in young rabbits. The expression of Type II collagen mRNA was seen in chondrocytes in all layers of the growth plate. Messenger RNA for the cartilage-specific Type II collagen was also detected in cells of the inner l...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::Of 36 fractures of the talar neck without comminution of the body, eight were undisplaced, treated closed, and 28 were displaced and treated by open reduction. Twenty of the operations were less than 12 hours after injury. Nineteen of 20 were performed through a medial approach, six with a medial malleolar osteotomy. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract::This is a report on a University of Illinois Hospital series of cases of extracapsular base of the neck osteotomy for slipped capital femoral epiphyses. The osteotomy was performed on 20 hips in 16 patients, with a 71/2 year average follow-up. The results of this procedure are encouraging and illustrate the advantages...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-05-01 00:00:00
abstract::Pigmented villonodular synovitis, bursitis and tenosynovitis may present a variable picture depended upon the site and whether they are localized or diffuse. In the localized form of the disease occurring in association with tendon sheaths, complete surgical excision should result in a cure. Local recurrences probably...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1976-01-01 00:00:00
abstract::Three patients were treated for pathologic fractures of the thoracolumbar spine causing progressive neurologic deficit. An anterior decompression with partial removal of the diseased vertebra was performed with improvement of neurologic function in each patient. Active tumor was not found, but necrotic bone with colla...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND:Management of the cuff-deficient arthritic shoulder has long been challenging. Early unconstrained shoulder arthroplasty systems were associated with high complication and implant failure rates. The evolution toward the modern reverse shoulder arthroplasty includes many variables of constrained shoulder arth...
journal_title:Clinical orthopaedics and related research
pub_type: 历史文章,杂志文章
doi:10.1007/s11999-010-1733-6
更新日期:2011-09-01 00:00:00
abstract::Plugs of cartilage and subchondral bone from patellae were subjected to cyclic compression consisting of rapid ramp loading for 0.3 seconds followed by a 2.7 second pause. At 1000 psi cyclic load, surface abrasion of the cartilage was noted at 250 cycles of compression. Primary fissures, which penetrated to the calcif...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract::The oncologic outcome in the treatment of pelvic sarcomas is not comparable with that in the extremity. Particular problems arise when the tumor involves the posterior pelvis and the sacrum or even the lower lumbar spine. Because of the difficulty in achieving local control and the major functional deficits after exte...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200204000-00003
更新日期:2002-04-01 00:00:00
abstract::Nonoperative treatment of patellofemoral pain has a long-standing tradition of success. I will discuss the scientific background and practical application of such treatment. Evaluation and treatment should include lower extremity flexibility, muscular control, and careful evaluation of tender structures. Avoiding pain...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Open reduction and stabilization of dorsal pelvic ring injuries is accompanied by a high rate of soft tissue complications. Minimally invasive techniques have the potential to decrease soft tissue trauma, but the risk of iatrogenic nerve and vessel damage through the reduced surgical exposure should be consi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-1922-y
更新日期:2011-11-01 00:00:00
abstract::Terrorist blasts and landmine injuries have become more common in the past several decades generating thousands of casualties. Preventive and prognostic measures are limited by the lack of knowledge of these complex events. Previous blast research has focused on primary blast injuries that involve the lung, despite mu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:2004-05-01 00:00:00
abstract::Periacetabular osteotomy is an extremely effective treatment for the spherical dysplastic hip without significant secondary osteoarthrosis. Yet, the reliability of the procedure in patients with some degree of secondary osteoarthritis, asphericity, or associated deformities remains undefined. The purpose of the curren...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:2002-12-01 00:00:00
abstract::One hundred seventy-five patients with 243 consecutive primary Press Fit Condylar cruciate-substituting total knee replacements were evaluated at a mean of 5.5 years. One hundred thirteen knees had modular metal-backed tibial components and 130 had all-polyethylene tibial components. The mean knee score and functional...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200111000-00021
更新日期:2001-11-01 00:00:00
abstract::Vascular injury is one of the drastic complications that can arise from internal fixation of acetabular fractures. A 29-year-old, obese man sustained multiple trauma, including a displaced transverse acetabular fracture. Extreme obesity made adequate exposure to the posterior acetabular area difficult, causing placeme...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-04-01 00:00:00
abstract::A simple but efficient way to secure the biceps tendon after it has been detached at its upper end by either trauma, attrition or surgical interference is the use of the keyhole in the upper humerus. A tied or rolled knot of tendon inserted into a keyhole shaped opening in the bicipital groove permits firm attachment ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1975-10-01 00:00:00
abstract:BACKGROUND:Bone quality should play an important role in decision-making for orthopaedic treatment options, implant selection, and affect ultimate surgical outcomes. The development of decision-making tools, currently typified by clinical guidelines, is highly dependent on the precise definition of the term(s) and the ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-011-1838-6
更新日期:2011-08-01 00:00:00
abstract::Fifty-two chronic osteomyelitis patients treated with gentamicin-polymethylmethacrylate (Septopal) antibiotic bead chains were observed retrospectively to explore the relationship between the duration of bead implantation and clinical results. Group A contained 35 asymptomatic patients who had elective bead removal ba...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::Mature female rhesus monkeys were used to evaluate the effects of a one-year course of tetracycline (50 mg/kg/day, intramuscularly) on the formation, maturation, and mineralization of mandibular bone. The bones from the treated group contained normal concentrations of calcium (Ca), inorganic phosphorus (Pi), and hydro...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract::The goal of this study is to examine whether porcine small intestine submucosa (SIS) exhibits antimicrobial properties in a standard in vitro system, without pretreatment with acetic acid or extraction of soluble proteins. Previous animal studies suggest that porcine SIS may have inherent antibiotic properties. Using ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000143573.03645.b4
更新日期:2004-10-01 00:00:00
abstract::The erythrocyte sedimentation rate (ESR) was analyzed in 176 patients treated with cemented total hip arthroplasty (THA) for primary osteoarthritis and correlated with the degree of heterotopic bone formation (HBF) one year after the THA. Ninety patients were treated with indomethacin in the first six postoperative we...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-11-01 00:00:00
abstract::Arthrographic study of the knee was performed in six patients for diagnosis of acute rupture of the quadriceps tendon. All of the patients gave a history of attempting to recover from a fall. Pain and tenderness over the suprapatellar area were common findings in all patients. Four patients had a positive arthrogram d...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-05-01 00:00:00
abstract::Histomorphologic analyses of artificial joint components implanted into bone need special technology for processing and for documentation; published histological work systematically done therefore is rare. The histopathology, three-dimensionally analyzed in a complete sequence of sections is, however, the only precise...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000150424.59854.7b
更新日期:2005-01-01 00:00:00
abstract::The absolute treatment of extensively involved cases of Legg-Calvé-Perthes disease (LCPD) remains unsolved. The basic principle of adequate containment of the capital femoral epiphysis in its acetabulum while minimizing the disability time is widely accepted, but the definition of adequate containment and methods of a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-07-01 00:00:00
abstract::Osteogenic protein-1 (also known as bone morphogenetic protein-7) is a member of the bone morphogenetic protein family. Several of the bone morphogenetic proteins, including osteogenic protein-1, have been shown to form bone at an ectopic site. However, optimal dosing regimens for the use of osteogenic protein-1 and o...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000129161.54751.8c
更新日期:2004-06-01 00:00:00
abstract::Segmentation and intramedullary rod fixation of the tibia have been found to be safe and effective procedures in osteogenesis imperfecta. An extensible rod is more difficult to insert than a solid rod due to the problem of obtaining an adequate fit distally, so the practical advantage of one type over the other is not...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1981-09-01 00:00:00
abstract::Osteonecrosis (aseptic or avascular necrosis of bone) is an entity with many causes that can occur at a variety of sites. It is a known complication of corticosteroid therapy, either alone or combined with other drugs in the treatment of malignancy. Osteonecrosis associated with chemotherapy that does not include cort...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-03-01 00:00:00
abstract::In the lateral malleolar ankle fracture without talar shift there is much uncertainty regarding the diagnosis of deltoid ligament injury severe enough to require surgical treatment. The current study evaluated the mechanical integrity of the ankle using a novel gravity-stress mortise radiographic view, which is practi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200106000-00024
更新日期:2001-06-01 00:00:00
abstract::The cases of 11 patients with the syndrome of thrombocytopenia and absent radius (TAR syndrome) who presented at two institutions between 1970 and 1996 were reviewed. Knee deformities have been well documented in thrombocytopenia and absent radius syndrome, but an inordinate frequency of other lower extremity problems...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200006000-00024
更新日期:2000-06-01 00:00:00
abstract::Several lines of evidence suggest that the insulinlike growth factors play a role in fracture healing. They promote cell proliferation and matrix synthesis by chondrocytes and osteoblasts, the two cell types largely responsible for the formation of fracture callus. Circulating levels of insulinlike growth factor I and...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-199810001-00031
更新日期:1998-10-01 00:00:00