Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Oct 21;11(10):e046169.
doi: 10.1136/bmjopen-2020-046169.

Patient-reported outcome measures following revision knee replacement: a review of PROM instrument utilisation and measurement properties using the COSMIN checklist

Shiraz A Sabah  1 , Elizabeth A Hedge  2 , Simon G F Abram  2 , Abtin Alvand  2 , Andrew J Price  2 , Sally Hopewell  2
Affiliations
Review

Patient-reported outcome measures following revision knee replacement: a review of PROM instrument utilisation and measurement properties using the COSMIN checklist

Shiraz A Sabah et al. BMJ Open. .

Abstract

Objectives: To identify: (1) patient-reported outcome measures (PROMs) used to evaluate symptoms, health status or quality of life following discretionary revision (or re-revision) knee joint replacement, and (2) validated joint-specific PROMs, their measurement properties and quality of evidence.

Design: (1) Scoping review; (2) systematic review following the COnsensus-based Standards for selection of health status Measurement INstruments (COSMIN) checklist.

Data sources: MEDLINE, Embase, AMED and PsycINFO were searched from inception to 1 July 2020 using the Oxford PROM filter unlimited by publication date or language.

Eligibility criteria for selecting studies: Studies reporting on the development, validation or outcome of a joint-specific PROM for revision knee joint replacement were included.

Results: 51 studies reported PROM outcomes using eight joint-specific PROMs. 27 out of 51 studies (52.9%) were published within the last 5 years. PROM development was rated 'inadequate' for each of the eight PROMs studied. Validation studies were available for only three joint-specific PROMs: Knee Injury and Osteoarthritis Outcome Score (KOOS), Lower Extremity Activity Scale (LEAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC). 25 out of 27 (92.6%) measurement properties were rated insufficient, indeterminate or not assessed. The quality of supporting evidence was mostly low or very low. Each of the validated PROMs was rated 'B' (potential for recommendation but require further evaluation).

Conclusion: Joint-specific PROMs are increasingly used to report outcomes following revision knee joint replacement, but these instruments have insufficient evidence for their validity. Future research should be directed toward understanding the measurement properties of these instruments in order to inform clinical trials and observational studies evaluating the outcomes from joint-specific PROMs.

Keywords: adult orthopaedics; knee; musculoskeletal disorders.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
PRISMA flow diagram. The full search strategy is provided in online supplemental appendix 2. PROM, patient-reported outcome measure.
See this image and copyright information in PMC

References

    1. Price AJ, Alvand A, Troelsen A, et al. . Knee replacement. Lancet 2018;392:1672–82. 10.1016/S0140-6736(18)32344-4 - DOI - PubMed
    1. NHS Digital . Patient Reported Outcome Measures (PROMs) [Internet]. Available: https://digital.nhs.uk/data-and-information/data-tools-and-services/data... [Accessed 23 Jun 2021].
    1. Scott CEH, Oliver WM, MacDonald D, et al. . Predicting dissatisfaction following total knee arthroplasty in patients under 55 years of age. Bone Joint J 2016;98-B:1625–34. 10.1302/0301-620X.98B12.BJJ-2016-0375.R1 - DOI - PubMed
    1. Niinimäki TT, Murray DW, Partanen J, et al. . Unicompartmental knee arthroplasties implanted for osteoarthritis with partial loss of joint space have high re-operation rates. Knee 2011;18:432–5. 10.1016/j.knee.2010.08.004 - DOI - PubMed
    1. Wylde V, Howells N, Bertram W, et al. . Development of a complex intervention for people with chronic pain after knee replacement: the StAR care pathway. Trials 2018;19:61. 10.1186/s13063-017-2391-8 - DOI - PMC - PubMed

Publication types

LinkOut - more resources