A comparative analysis of the clinical utility of the Staffelstein-score and the hospital for special surgery knee score (HSS) in monitoring physiotherapy of total knee replacement patients--preliminary study.

INTRODUCTION

Treatment efficacy assessment lies at the basis of Evidence Based Medicine (EMB). Specialised scores have recently been developed to present the patient's functional status to the doctor or physiotherapist in a rapid and accessible manner and to allow treatment efficacy monitoring. The present study aimed to assess the sensitivity and utility of the Staffelstein Score and HSS Knee Score in monitoring the progress of rehabilitation following total knee replacement surgery.

MATERIAL AND METHODS

The study involved 24 patients who underwent knee replacement surgery due to degenerative disease of the knee joint. The HSS Knee Score and the Staffelstein Score (ST-score) were compared. Patients were assessed twice: prior to and after the completion of post-hospital rehabilitation.

RESULTS

The mean results on admission and at discharge were: 50.1 (HSS) and 70.8 (ST), and 74.4 (HSS) and 99.5 (ST), respectively. There was a marked improvement according to both scales (p<0.005) both as regards overall scores as well as individual parameters.

CONCLUSIONS

1. The HSS and ST scores exhibit high sensitivity in assessing pain, difficulty performing activities of daily living and in assessing the results of physical examination of the knee joint in patients who following knee replacement surgery. 2. The sensitivity of the HSS Knee Score may be adversely affected by assessment of instability and varus or valgus deformity of the joint due to a low variability of those parameters over time. 3. The assessment of the ability to perform activities of daily living using the two scores makes it possible to tailor exercises and adjust the rehabilitation programme to solve patients' specific problems.