{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T18:28:27Z","timestamp":1781375307969,"version":"3.54.1"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The rising demand for unicompartmental knee arthroplasty (UKA) in the United States has led to high 1-year patient satisfaction rates. However, some patients experience substantial declines in patient-reported outcome measures (PROMs) postoperatively, which we refer to as \u201cminimal clinically important difference for worsening\u201d (MCID-W). We sought to define MCID-W values for specific PROMs and identify risk factors associated with PROMIS Physical Function Short Form 10a (PROMIS PF-10a) declines after UKA. We conducted a retrospective study of 760 patients undergoing UKA at our institution between 2016 and 2023. Preoperative and postoperative PROMIS PF-10a, PROMIS global physical, and knee injury and osteoarthritis outcome score-physical function short-form (KOOS-PS) scores were collected. Patients were stratified upon reaching minimal clinically importance difference for improvement (MCID-I), MCID-W, or \u201cno significant change\u201d (score between MCID-W and MCID-I). MCID-W and MCID-I values were determined using a distribution-based method. Logistic regression was performed to identify risk factors for scoring below MCID-W. We established the following MCID-I and MCID-W thresholds: PROMIS PF-10a (+3.00 and \u22121.64), KOOS-PS (+6.25 and \u22123.42), and PROMIS Global-Physical (+2.72 and \u22121.55). Bivariate analysis revealed differences in terms of revision (p\u2009=\u20090.02), reoperation (p\u2009=\u20090.03), postoperative complications (p\u2009=\u20090.002), deep venous thrombosis (DVT; p\u2009&lt;\u20090.001), and pneumonia (p\u2009=\u20090.01) between cohorts. Body mass index &gt;35 (odds ratio [OR]\u2009=\u20092.49), postoperative complications (OR\u2009=\u20095.09), pneumonia (OR\u2009=\u200922.39), DVT (OR\u2009=\u20099.27), and preoperative PROMIS PF-10a scores (OR\u2009=\u20091.07) were risk factors for scoring below the MCID-W threshold, whereas age\u2009&gt;\u200980 (OR\u2009=\u20092.89) and preoperative PROMIS PF-10a scores (OR\u2009=\u20091.05) were risk factors for failing to achieve MCID-I. Our study established MCID-W values for pivotal PROMs after primary UKAs. We found that 8.8% of patients scored below MCID-W, highlighting the need to improve patient selection and perioperative care in UKA.<\/jats:p>","DOI":"10.1055\/a-2555-1941","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T21:02:26Z","timestamp":1741726946000},"page":"525-532","source":"Crossref","is-referenced-by-count":3,"title":["Risk Factors and Thresholds for Minimal Clinically Important Difference in Worsening after Unicompartmental Knee Arthroplasty"],"prefix":"10.1055","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3496-8433","authenticated-orcid":false,"given":"Perry L.","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos R.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hany S.","family":"Bedair","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Melnic","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1302\/0301-620X.97B6.35155","article-title":"Patient-reported outcomes after total and unicompartmental knee arthroplasty: a study of 14,076 matched patients from the National Joint Registry for England and Wales","volume":"97-B","author":"A D Liddle","year":"2015","journal-title":"Bone Joint J"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1016\/j.arth.2003.12.082","article-title":"Sagittal plane kinematics of a mobile-bearing unicompartmental knee arthroplasty at 10 years: a comparative in vivo fluoroscopic analysis","volume":"19","author":"A J Price","year":"2004","journal-title":"J 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the Kinemax total knee replacement","volume":"90","author":"V Wylde","year":"2008","journal-title":"J Bone Joint Surg Br"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/s12891-017-1455-y","article-title":"Patient-reported health outcomes after total hip and knee surgery in a Dutch University Hospital Setting: results of twenty years clinical registry","volume":"18","author":"P J van der Wees","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"101096","DOI":"10.1016\/j.artd.2023.101096","article-title":"Changes over a decade in patient-reported outcome measures and minimal clinically important difference reporting in total joint arthroplasty","volume":"20","author":"B Goldberg","year":"2023","journal-title":"Arthroplast Today"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.arth.2022.08.014","article-title":"Should we aim to help 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information system physical function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis outcome score for joint reconstruction in orthopaedics","volume":"9","author":"M Hung","year":"2018","journal-title":"World J Orthop"}],"container-title":["The Journal of Knee 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