Primary ArthroplastyUsing Cluster Analysis to Identify Patient Factors Linked to Differential Functional Gains After Total Knee Arthroplasty
Section snippets
Data Sources
This is a prospective cohort study. FORCE-TJR (Functional and Outcomes Research for Comparative Effectiveness in Total Joint Replacement), centered at the University of Massachusetts Medical School, is a national, prospective, cohort of total joint arthroplasty patients [30], [31]. Parallel to the current US surgical practice, 75% of patients are enrolled from community-based surgeons, including fellowship-trained and general orthopedists in urban and rural locations, as well as teaching and
Results
Hierarchical clustering yielded 2 statistically significantly distinct clusters among the 656 total patients at a between-cluster distance of −0.15 (Pearson correlation coefficient). Cluster 1 contained 550 patients (84% of the cohort) and, on average, exhibited a clinically important improvement in PCS at 6 months postoperatively followed by no further improvement at 12 months postoperatively (Table 2, Fig. 2) [36]. Cluster 2 contained 106 patients (16% of the cohort) and, on average,
Discussion
This study identified 2 significantly different physical function outcome trajectories within the first year following TKA, in the patient cohort analyzed. One trajectory was marked by sustained functional gains, and the other was marked by delayed functional gains. We demonstrated the efficacy of cluster analysis in identifying post-TKA outcome trajectories, which has not been reported previously to our knowledge. In addition, we were able to demonstrate that the identified outcome
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2022, Journal of Hand SurgeryCitation Excerpt :Cluster analyses make it possible to determine groups along with continuous variables, unlike arbitrary groups, which may divide and eliminate statistically significant data. Cluster analyses have been previously used in orthopedic studies to assess preoperative and postoperative ROM.9,20,21 For example, Ritter et al,20 through their cluster analysis of 4727 total knee arthroplasties, found that the principal predictive factor of postoperative ROM was preoperative ROM.
Social risk and patient-reported outcomes after total knee replacement: Implications for Medicare policy
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Investigation was performed at the University of Massachusetts Medical School, Worcester, MA
Ethical Approval: This study was approved by the UMass Medical School Institutional Review Board, Docket #H00008642.
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2019.08.039.