{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:32:19Z","timestamp":1790703139601,"version":"4.1.0"},"reference-count":54,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP-312807"],"award-info":[{"award-number":["MOP-312807"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,3,22]]},"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>One-fifth of total knee arthroplasty (TKA) recipients experience a suboptimal outcome. Incorporation of patients\u2019 preferences in TKA assessment may improve outcomes. We determined the discriminant ability of preoperative measures of TKA need, readiness\/willingness and expectations for a good TKA outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In patients with knee osteoarthritis (OA) undergoing primary TKA, we preoperatively assessed TKA need (Western Ontario-McMaster Universities OA Index (WOMAC) Pain Score and Knee injury and Osteoarthritis Outcome Score (KOOS) function, arthritis coping), health status, readiness (Patient Acceptable Symptom State, depressive symptoms), willingness (definitely yes\u2014yes\/no) and expectations (outcomes deemed \u2018very important\u2019). A good outcome was defined as symptom improvement (met Outcome Measures in Rheumatology and Osteoarthritis Research Society International (OMERACT\u2013OARSI) responder criteria) and satisfaction with results 1 year post TKA. Using logistic regression, we assessed independent outcome predictors, model discrimination (area under the receiver operating characteristic curve, AUC) and the predicted probability of a good outcome for different need, readiness\/willingness and expectations scenarios.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 1,053 TKA recipients (mean age 66.9 years (SD 8.8); 58.6% women), 78.1% achieved a good outcome. With TKA need alone (WOMAC pain subscale, KOOS physical function short-form), model discrimination was good (AUC 0.67, 95%\u2009CI 0.63 to 0.71). Inclusion of readiness\/willingness, depressive symptoms and expectations regarding kneeling, stair climbing, well-being and performing recreational activities improved discrimination (p=0.01; optimism corrected AUC 0.70, 0.66\u20130.74). The predicted probability of a good outcome ranged from 44.4% (33.9\u201355.5) to 92.4% (88.4\u201395.1) depending on level of TKA need, readiness\/willingness, depressive symptoms and surgical expectations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Although external validation is required, our findings suggest that incorporation of patients\u2019 TKA readiness, willingness and expectations in TKA decision-making may improve the proportion of recipients that experience a good outcome.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2022-002808","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T10:41:11Z","timestamp":1681728071000},"page":"e002808","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Patient appropriateness for total knee arthroplasty and predicted probability of a good outcome"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6358-1197","authenticated-orcid":false,"given":"Gillian A","family":"Hawker","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Bohm","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Dunbar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Faris","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C Allyson","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Noseworthy","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bheeshma","family":"Ravi","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda J","family":"Woodhouse","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada"},{"name":"Department of Public Health and Community Medicine, Tufts University, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah A","family":"Marshall","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"key":"2025090313424915000_9.2.e002808.1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.01617"},{"key":"2025090313424915000_9.2.e002808.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2012.07.014"},{"key":"2025090313424915000_9.2.e002808.3","unstructured":"Canadian Institute of Health Information . 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