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Minimal Clinically Important Difference (MCID) In WOMAC Score And Factors Related To Achievement Of WOMAC Score MCID After Medial Opening Wedge High Tibial Osteotomy For Knee Osteoarthritis


Dong-Chul Park, MD
KOREA, REPUBLIC OF

Minimal Clinically Important Difference (MCID) In WOMAC Score And Factors Related To Achievement Of WOMAC Score MCID After Medial Opening Wedge High Tibial Osteotomy For Knee Osteoarthritis

Dong-Chul Park, MD, KOREA, REPUBLIC OF Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Yong Gyu Sung, MD, KOREA, REPUBLIC OF Jae Jung Kim, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF

Seoul St. Mary's Hospital, Seoul, KOREA, REPUBLIC OF

2021 Congress   ePoster Presentation     rating (1)

 

Anatomic Location

Knee

Anatomic Structure

Bones

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Osteotomy

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Summary: The MCID for WOMAC scores in patients who underwent MOWHTO were 4.2 points for pain, 1.9 points for stiffness, 10.1 points for function, and 16.1 points for total WOMAC score. Lower preoperative WOMAC score, severe OA, and under- or over-correction were related to failure to achieve MCID

Introduction

Many approaches have been used to determine minimal clinically important differences (MCID) in total knee arthroplasty patients, but MCID in outcome measures after medial opening wedge high tibial osteotomy (MOWHTO) for the treatment of medial compartment knee osteoarthritis (OA) have not been reported. The purpose of this study was to define MCID for Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores after MOWHTO and to identify risk factors for not achieving MCID.

Methods

Among patients with medial compartment knee OA who underwent MOWHTO, 174 patients who were followed-up for 2 years were included in the study. MCID of WOMACs was measured using the anchor-based method with a 15-item anchor questionnaire. MCID were calculated as the difference in WOMAC scores between the minimal improvement group and no change group. Preoperative OA severity was measured by Kellgren-Lawrence grade, and the acceptable range of the postoperative weight bearing line (WBL) ratio was defined as 50 - 70%. Patients were divided into two groups based on whether MCID was achieved, and then factors related to the failure to achieve MCID were analyzed using multivariate logistic regression analysis.

Results

MCID in WOMAC scores were 4.2 points for the pain score, 1.9 points for the stiffness score, 10.1 points for the function score, and 16.1 points for the total score. 116 (66.7%), 99 (56.9%), 127 (73.0%) and 128 (73.6%) patients achieved the MCID for WOMAC pain, stiffness, function, and total scores after MOWHTO. The odds of not achieving the MCID in WOMAC total score were 1.09 times greater (95% CI: 1.05 - 1.13, p < 0.001) in individuals with a low preoperative WOMAC total score (cut-off values: 10.5 for pain, 3.5 for stiffness, 34.5 for function, and 51.0 for total score), 11.77 times greater (95% CI: 3.68 – 37.70, p < 0.001) in patients with K-L grade 4 OA compared to K-L grades 2 or 3 OA, and 8.39 times greater (95% CI: 2.98 – 23.63, p < 0.001) in patients with under- or over-correction.

Conclusions

The MCID for WOMAC scores in patients who underwent MOWHTO were 4.2 points for pain, 1.9 points for stiffness, 10.1 points for function, and 16.1 points for total WOMAC score. Lower preoperative WOMAC score, severe OA, and under- or over-correction were related to failure to achieve MCID.

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