San Diego, CA—March 14, 2017
Researchers from Hospital for Special Surgery (HSS), a world leader in musculoskeletal research and care, confirmed that a significantly shortened, seven-question patient survey on pain, function and quality of life is a valid and efficient tool for assessing patient outcomes following revision total knee replacement. Results were presented today at the 2017 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting (Abstract #P162).
The previous commonly used knee replacement survey was 42 questions often leaving physicians with partial, unusable information. The shorter survey, known as KOOS JR. (Knee Injury and Osteoarthritis Outcome Score), and its hip replacement counterpart, HOOS JR., have already been adopted for Medicare’s primary total joint replacement bundled payment program. HSS’ research presented at AAOS now provides peer-reviewed data that confirms KOOS JR. is a valid outcomes measure for knee replacement surgery.
"At HSS, we are continually improving how we measure outcomes and KOOS JR. is a direct result of these efforts," said Alexander McLawhorn, MD, MBA, an orthopedic surgeon at HSS. "We saw a need for a shorter, more patient friendly survey in an area where outcomes data are essential to improving quality of care. In fact, knee replacement revisions, which are more complex than primary knee surgery, are under-studied in this regard."
Knee replacement revisions have doubled over the last 10 years, and are expected to grow 600 percent between 2005 and 2030. Approximately 700,000 primary knee replacements are done in the U.S., and approximately 10 percent may require a second operation within 15 to 20 years.
"With the influx of surgeries expected over the next 5 to 10 years, it is essential that we deepen our understanding of revision knee replacement outcomes," said Steven Haas, MD, chief of Knee Service at HSS. "This shorter patient survey will help the orthopedic community obtain necessary measurement information while minimizing the burden on patients and data collection administrators."
In the study presented at AAOS, HSS researchers looked at the results of 314 patients who underwent revision surgery following total knee replacement between May 2007 and December 2011 and completed KOOS JR. patient–reported outcome measure surveys both before surgery and two years later. The KOOS JR. measures proved to be as valid, and have as much internal consistency, external validity and other measures of reliability in determining outcomes for these patients as they did in patients who had primary total knee replacements.
"There are increasing incentives and requirements from the government and private insurers for providing patient-reported outcome measures," said Stephen Lyman, PhD, director of Healthcare Research Institute at HSS. "This short form should reduce the burden and fatigue of patients in busy clinical settings when gathering this information. This study supports extending the use of KOOS JR. to patients having revision knee replacements."
Additional study authors include Yuo-Yu Lee, MS and Michael Cross, MD.
About HSS | Hospital for Special Surgery
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the ninth consecutive year) and No. 3 in rheumatology by U.S.News & World Report (2018-2019). Founded in 1863, the Hospital has one of the lowest infection rates in the country and was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. The global standard total knee replacement was developed at HSS in 1969. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State. In 2017 HSS provided care to 135,000 patients and performed more than 32,000 surgical procedures. People from all 50 U.S. states and 80 countries travelled to receive care at HSS. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was formed in 2016 to realize the potential of new drugs, therapeutics and devices. The culture of innovation is accelerating at HSS as 130 new idea submissions were made to the Global Innovation Institute in 2017 (almost 3x the submissions in 2015). The HSS Education Institute is the world’s leading provider of education on the topic on musculoskeletal health, with its online learning platform offering more than 600 courses to more than 21,000 medical professional members worldwide. Through HSS Global Ventures, the institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally.