[二、肌肉骨骼功能评估问卷在原发性膝关节炎和全关节置换术中的有效性及对变化的敏感性]

[II. Validity and sensitivity to change of the Musculoskeletal Functional Assessment Questionnaire in primary gonarthrosis and total endoprosthetic joint replacement].

作者信息

König A, Walther M, Matzer M, Heesen T, Kirschner S, Faller H

机构信息

Orthopädische Universitätsklinik König-Ludwig-Haus Würzburg.

出版信息

Z Orthop Ihre Grenzgeb. 2000 Jul-Aug;138(4):302-5. doi: 10.1055/s-2000-10152.

DOI:10.1055/s-2000-10152

PMID:11033896

Abstract

INTRODUCTION

Scoring systems used so far in total knee arthroplasty are limited by their non-fulfillment of basic test criteria. The aim of the study was to demonstrate the validity and responsiveness of a German version of the new short musculoskeletal function assessment questionnaire (SMFA-D) in patients with primary osteoarthritis and total knee arthroplasty.

METHODS

66 patients with a tricompartmental cemented PFC-Sigma total knee arthroplasty completed the SMFA-D and the WOMAC questionnaire preoperatively and at 12 to 16 weeks follow-up. Preoperatively, physicians' rating of function of the leg, patients' self-selected walking speed, pain and arthritis severity score were registered for demonstration of criterion validity. Construct validity was evaluated with the WOMAC. Discriminant validity was assessed by comparing patients with or without previous surgery at the knee, use of pain medication and use of walking aids. The function and bother indexes of the SMFA-D were correlated with these parameters. Standardized response means were calculated.

RESULTS

The function index correlated with physicians' rating (r = 0.51), walking speed (r = 0.61), pain (r = 0.36) and the arthritis severity index (r = 0.36). The bother index correlated with pain (r = 0.37) and the arthritis severity index (r = 0.25). The function and bother index correlated with the WOMAC (r = 0.77) and (r = 0.81), respectively. Patient groups with or without walking aids (p = 0.02) and with or without pain medication (p = 0.001) differed in the function index. The bother index of patients with or without pain medication (p < 0.001) and with or without walking aids (p < 0.006) differed. Function and bother index improved from 46 (SD 17) to 34 (SD 19, p < 0.001) and 43 (SD 18) to 33 (SD 22 p < 0.001), respectively. The standardized response mean was 0.86 for the function index and 0.53 for the bother index.

CONCLUSIONS

The SMFA-D questionnaire is valid and responsive in patients with primary osteoarthritis of the knee and total knee arthroplasty. It measures function and bother from the perspective of these patients.

摘要

引言

迄今为止，全膝关节置换术中使用的评分系统因未满足基本测试标准而受到限制。本研究的目的是证明新版简短肌肉骨骼功能评估问卷德文版（SMFA-D）在原发性骨关节炎和全膝关节置换术患者中的有效性和反应性。

方法

66例行三室骨水泥型PFC-Sigma全膝关节置换术的患者在术前以及术后12至16周完成了SMFA-D和WOMAC问卷。术前，记录医生对腿部功能的评分、患者自行选择的步行速度、疼痛和关节炎严重程度评分，以证明效标效度。用WOMAC评估结构效度。通过比较有或没有膝关节既往手术史、使用止痛药物和使用助行器的患者来评估区分效度。将SMFA-D的功能和困扰指数与这些参数进行关联。计算标准化反应均值。

结果

功能指数与医生评分（r = 0.51）、步行速度（r = 0.61）、疼痛（r = 0.36）和关节炎严重程度指数（r = 0.36）相关。困扰指数与疼痛（r = 0.37）和关节炎严重程度指数（r = 0.25）相关。功能和困扰指数分别与WOMAC相关（r = 0.77）和（r = 0.81）。使用或未使用助行器的患者组（p = 0.02）以及使用或未使用止痛药物的患者组（p = 0.001）在功能指数上存在差异。使用或未使用止痛药物的患者（p < 0.001）以及使用或未使用助行器的患者（p < 0.006）的困扰指数存在差异。功能和困扰指数分别从46（标准差17）改善至34（标准差19，p < 0.001）和从43（标准差18）改善至33（标准差22，p < 0.001）。功能指数的标准化反应均值为0.86，困扰指数的标准化反应均值为0.53。