A study published in “The Bone & Joint Journal” depicted that the preoperative OKS is an independent predictor of attaining a postoperative ceiling score following knee surgery.

An analysis was performed to determine if the postoperative OKS displayed a ceiling effect at 1 and/or 2 years after knee surgery. This study also aimed to explore the preoperative independent predictors for knee osteoarthritis subjects that attained a maximal scores/ceiling score after total knee arthroplasty.

From a prospectively compiled arthroplasty database, a retrospective cohort of 5,857 knee osteoarthritis subjects undergoing knee arthroplasty was recognized. The following outcomes were gathered preoperatively and at one and two years postoperatively: (i) Body mass index, (ii) Patient demographics, (iii) EuroQoL five-dimension (EQ-5D) general health scores, and (iv) OKS.

To recognize the independent preoperative predictors of patients attaining postoperative ceiling scores, the logistic regression analysis was utilized. To find a preoperative OKS that forecasted a postoperative ceiling score, the receiver operating characteristic curve was utilized.

The ceiling effect at 1 year considerably raised (odds ratio [OR] 40.3) at 2 years when defined as those with a maximal score of 48 points. If the ceiling effect was defined as an OKS of 44 points or more, this was found to raise at 1 year and also at 2 years (OR 21.6), as shown in the following table:

A presurgery OKS of 23 or more and 22 or more were found to be predictive of attaining a postsurgery ceiling OKS at 1 and 2 years when defined as a maximal score or a score of 44 or more, respectively. The postsurgery OKS displayed a small ceiling effect when defined by a maximal score of 48 points. However, when defined by a postsurgery OKS of 44 or more, the ceiling effect was found to be moderate and was unsuccessful in fulfilling the standards.

Thus, the presurgery OKS was an independent and robust predictor of attaining a ceiling score and those with a score of 22 or more may benefit from alternative or additional evaluation to estimate their real improvement.