Thresholds for meaningful improvement in WOMAC scores need to be adjusted to patient characteristics after hip and knee replacement

David KuklinskiMarques, Carlos J.Carlos J.MarquesBohlen, KarinaKarinaBohlenWestphal, Karl C.Karl C.WestphalLampe, FrankFrankLampeGeissler, AlexanderAlexanderGeissler2023-04-132023-04-132022-01-26https://www.alexandria.unisg.ch/handle/20.500.14171/109052Purpose: To calculate unstratiﬁed and patient-speciﬁc meaningful improvement (MI) and patient acceptable symptom states (PASS) for the WOMAC total score in patients after total hip (THR) or total knee replacement (TKR). Methods: A retrospective observational cohort study. Anchor-based receiver operator characteristics curves were used to estimate MI and PASS thresholds. Results: Recovery paths were speciﬁc to individual characteristics of patients. An unstratiﬁed 12-months MI threshold of 28.1 (PASS: 13.3) and 17.8 (PASS: 15.8) for patients after THR and TKR, respectively, would un-fairly detect critical recovery paths. Conclusions: Thresholds for treatment success need to be as patient-speciﬁc as possible.enTotal hip replacementTotal knee replacementWOMACMeaningful improvementPatient-reported outcomesValue-based health careLevel of evidence: level IIIPrognostic studyThresholds for meaningful improvement in WOMAC scores need to be adjusted to patient characteristics after hip and knee replacementjournal article