A Systematic Review of Measurement Properties of Patient-Reported Outcome Measures Used in Patients Undergoing Total Knee Arthroplasty.
While clinical research on total knee arthroplasty (TKA) outcomes is prevalent in the literature, studies often have poor methodological and reporting quality. A high-quality patient-reported outcome instrument is reliable, valid, and responsive. Many studies evaluate these properties, but none have done so with a systematic and accepted method. The objectives of this study were to identify patient-reported outcome measures (PROMs) for TKA, and to critically appraise, compare, and summarize their psychometric properties using accepted methods.



MEDLINE, EMBASE, SCOPUS, Web of Science, PsycINFO, and SPORTDiscus were systematically searched for articles with the following inclusion criteria: publication before December 2014, English language, non-generic PRO, and evaluation in the TKA population. Methodological quality and evidence of psychometric properties were assessed with the COnsensus-based standards for the selection of health Status Measurement INstruments (COSMIN) checklist and criteria for psychometric evidence proposed by the COSMIN group and Terwee et al.



One-hundred fifteen studies on 32 PROMs were included in this review. Only the Work, Osteoarthritis or joint-Replacement Questionnaire, the Oxford Knee Score, and the Western Ontario and McMaster Universities Arthritis Index had 4 or more properties with positive evidence.



Most TKA PROMs have limited evidence for their psychometric properties. Although not all the properties were studied, the Work, Osteoarthritis or joint-Replacement Questionnaire, with the highest overall ratings, could be a useful PROM for evaluating patients undergoing TKA. The methods and reporting of this literature can improve by following accepted guidelines.
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Joel J
JJ
Gagnier
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Megan
M
Mullins
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
Hsiaomin
H
Huang
Division of Epidemiology, Center for Devices & Radiological Research, Food and Drug Administration, Silver Spring, Maryland.
Danica
D
Marinac-Dabic
Division of Epidemiology, Center for Devices & Radiological Research, Food and Drug Administration, Silver Spring, Maryland.
Anna
A
Ghambaryan
Division of Epidemiology, Center for Devices & Radiological Research, Food and Drug Administration, Silver Spring, Maryland.
Benjamin
B
Eloff
OrthoSynthesis, Inc, San Jose, California.
Faisal
F
Mirza
Division of Epidemiology, Center for Devices & Radiological Research, Food and Drug Administration, Silver Spring, Maryland.
Manuel
M
Bayona
D019645:Arthroplasty, Replacement, Knee; D057189:Checklist; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010003:Osteoarthritis; D000071066:Patient Reported Outcome Measures; D011594:Psychometrics; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
COSMIN; outcomes; patient-reported outcome measures; psychometric properties; questionnaires; total knee arthroplasty