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简明健康状况调查量表-36(Short Form-36)及残疾状态与关节镜下髋臼盂唇清创术结果的相关性

Correlation of Short Form-36 and disability status with outcomes of arthroscopic acetabular labral debridement.

作者信息

Potter Benjamin K, Freedman Brett A, Andersen Romney C, Bojescul John A, Kuklo Timothy R, Murphy Kevin P

机构信息

Orthopaedic Surgery Service, Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, Building 2, Clinic 5A, Washington, DC 20307, USA.

出版信息

Am J Sports Med. 2005 Jun;33(6):864-70. doi: 10.1177/0363546504270567. Epub 2005 Apr 12.

Abstract

BACKGROUND

Arthroscopic debridement is the standard of care for the treatment of acetabular labral tears. The Short Form-36 has not been used to measure hip arthroscopy outcomes, and the impact of disability status on hip arthroscopy outcomes has not been reported.

HYPOTHESIS

Short Form-36 subscale scores will demonstrate good correlation with the modified Harris hip score, but patients undergoing disability evaluation will have significantly worse outcome scores.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

The records of active-duty soldiers who underwent hip arthroscopy at the authors' institution were retrospectively reviewed. Forty consecutive patients who underwent hip arthroscopy for the primary indication of labral tear formed the basis of the study group. Patients completed the modified Harris hip score, the Short Form-36 general health survey, and a subjective overall satisfaction questionnaire.

RESULTS

Thirty-three patients, with a mean age of 34.6 years, were available for follow-up at a mean of 25.7 months postoperatively. Fourteen (43%) patients were undergoing medical evaluation boards (military equivalent of workers' compensation or disability claim). Pearson correlation coefficients for comparing the Short Form-36 Bodily Pain, Physical Function, and Physical Component subscale scores to the modified Harris hip score were 0.73, 0.71, and 0.85, respectively (P < .001). The mean modified Harris hip score was significantly lower in patients on disability status than in those who were not (92.4 vs 61.1; P < .0001). The Short Form-36 subscale scores were significantly lower in disability patients (P < .02). Patient-reported satisfaction rates (70% overall) were 50% for those undergoing disability evaluations and 84% for those who were not (P < .04). There was no significant difference in outcomes based on patient age, surgically proven chondromalacia, or gender for military evaluation board status.

CONCLUSION

The Short Form-36 demonstrated good correlation with the modified Harris hip score for measuring outcomes after arthroscopic partial limbectomy. Arthroscopic debridement yielded a high percentage of good results when patients undergoing disability evaluations were excluded. Disability status may be a negative predictor of success after hip arthroscopy.

摘要

背景

关节镜下清创术是治疗髋臼唇盂撕裂的标准治疗方法。简短健康调查问卷-36(Short Form-36,SF-36)尚未用于评估髋关节镜手术的疗效,且残疾状态对髋关节镜手术疗效的影响尚无报道。

假设

SF-36分量表得分与改良Harris髋关节评分具有良好的相关性,但接受残疾评估的患者其疗效得分会显著更低。

研究设计

病例系列研究;证据等级为4级。

方法

对在作者所在机构接受髋关节镜手术的现役军人的病历进行回顾性分析。连续40例因唇盂撕裂作为主要指征接受髋关节镜手术的患者构成研究组。患者完成改良Harris髋关节评分、SF-36一般健康调查以及一份主观总体满意度问卷。

结果

33例患者可供随访,平均年龄34.6岁,术后平均随访25.7个月。14例(43%)患者正在接受医学评估委员会评估(相当于军队中的工伤赔偿或残疾索赔)。将SF-36身体疼痛、身体功能和身体成分分量表得分与改良Harris髋关节评分进行比较,Pearson相关系数分别为0.73、0.71和0.85(P < 0.001)。残疾状态患者的平均改良Harris髋关节评分显著低于非残疾患者(92.4对61.1;P < 0.0001)。残疾患者的SF-36分量表得分显著更低(P < 0.02)。患者报告的总体满意度为70%,接受残疾评估的患者为50%,未接受残疾评估的患者为84%(P < 0.04)。基于患者年龄、手术证实的软骨软化或性别,在医学评估委员会状态方面,疗效无显著差异。

结论

在测量关节镜下部分肢体切除术的疗效时,SF-36与改良Harris髋关节评分具有良好的相关性。排除接受残疾评估的患者后,关节镜下清创术取得良好效果的比例较高。残疾状态可能是髋关节镜手术后成功的一个负面预测因素。

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