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There is no clinically important difference in the Oxford knee scores between one and two years after total knee arthroplasty: The one-year score could be used as the benchmark timepoint to assess outcome

Lookup NU author(s): Professor David Deehan


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© 2020 Elsevier B.V.Background: The aim was to assess the whether there was a clinically important change in the Oxford knee score (OKS) between one and two years after total knee arthroplasty (TKA), and to identify predictors associated with a clinically important change. Methods: A retrospective cohort study was undertaken using an established arthroplasty database of 5857 primary TKA. Patient demographics, body mass index, social deprivation, OKS and EuroQoL five-domain (EQ-5D) score were collected preoperatively and at one and two years postoperatively. A clinically important change in the OKS was defined as ≥ 5 points. Results: There was a 0.2 point increase in the OKS between one and two years, which was statistically significant (95% confidence interval (CI) 0.1 to 0.4, p < .0001), but not clinically important. A better preoperative OKS (p < .001) and in contrast a worse one year OKS (p < .001) were independently associated with a greater improvement from one to two years. There were 1006 (17.3%) patients that had a clinically important improvement in the OKS between one and two years. Receiver operating characteristic curve analysis showed that a one year OKS of less than 35 was a reliable predictor of a clinically important improvement between one and two years (area under the curve 0.77, 95% CI 0.76 to 0.78, p < .001). Conclusion: There was not a clinically important change in the OKS from one to two years after TKA when assessed as a group. However, individual patients with a one year OKS of less than 35 may demonstrate a clinically important improvement at two years. Level of evidence: Retrospective diagnostic study, Level III.

Publication metadata

Author(s): Clement ND, Afzal I, Demetriou C, Deehan DJ, Field RE, Kader D

Publication type: Article

Publication status: Published

Journal: Knee

Year: 2020

Volume: 27

Issue: 4

Pages: 1212-1218

Print publication date: 01/08/2020

Online publication date: 25/06/2020

Acceptance date: 26/05/2020

ISSN (print): 0968-0160

ISSN (electronic): 1873-5800

Publisher: Elsevier B.V.


DOI: 10.1016/j.knee.2020.05.015


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