DO PATIENT-REPORTED OUTCOME MEASURES IN HIP AND KNEE ARTHROPLASTY REHABILITATION HAVE ROBUST MEASUREMENT ATTRIBUTES? A SYSTEMATIC REVIEW

Objective: The aim of this study was to systematically review and compare the measurement attributes of multidimensional, patient-reported outcome measures used in hip and knee arthroplasty rehabilitation. Methods: A search of PubMed, CINAHL, Cochrane Central Registry, SCOPUS and PEDro databases up to December 2009 identified the validation studies. The quality of the measurement properties were assessed based on the Terwee and Bot criteria, and Scientific Advisory Committee of the Medical Outcomes Trust guidelines. Results: A total of 68 studies examining 28 instruments were identified. Three instruments had positive ratings for content validity. None of the instruments satisfied both factor analysis and Cronbach's alpha criteria for internal consistency. Four measures were positively-rated for agreement. Nine tools had positive ratings for construct validity. Twenty-four of the instruments had indeterminate ratings for responsiveness to clinical change. Only certain subscales of 2 instruments were positively-rated for responsiveness to clinical change. Conclusion: A wide variety of multidimensional patient-reported instruments has been used to assess rehabilitation outcomes after hip and knee arthroplasty, but information about their measurement attributes in these populations is inadequate. More data are needed to clarify their reproducibility and responsiveness to clinical change.