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Comparative assessment of outcome in osteoarthritis of the knee: the utility of knee scores.

PURPOSE OF THE STUDY
The utility of scoring systems, which are used to determine health status or treatment benefit in patients with knee osteoarthritis is under discussion. Therefore it was the purpose of our investigation to evaluate the reliability and the concordance of two established knee scoring systems.


METHODS
Thirty-eight patients with unilateral knee osteoarthritis were scored by the Hospital for Special Surgery score and the Knee Society score. Two blinded observers rated the patients independently in order to determine the concordance of the scores, the correlation between the overall scores and their subscales such as "pain", "function" and "range of motion" and the inter-observer and intra-observer reliability.


RESULTS
There was a high correlation between the overall scores (r= 0.80) and between the scores and their subscales "range of motion" (r=0.89) and "function" (r=0.74). The correlation of scores for "pain" was slightly less (r=0.61). Mean inter-observer reliability ranged between r=0.58 and r=0.61. Mean intra-observer reliability was high for the overall scores as well as for the subscales of both scoring systems (r=0.64 to r=0.93 and r=0.73 to r=0.92).


CONCLUSION
We have found that the assessment of overall scores as well as of their main subscales is concordant and reliable in our patient sample. The application of these scoring systems in measuring health status in patients with knee osteoarthritis appears to be an acceptable method of audit. However, we feel that presentation of the results of knee scoring systems should include detailed information on the main subscales, since this allows for a better understanding of results.