Morrissey Matthew C, Goodwin Peter C, Klarneta Maria, McAuliffe Thomas B, El-Zebdeh Mustafa, King John B
Division of Applied Biomedical Research, School of Biomedical and Health Sciences, King's College London, Shepherd's House, Guy's Campus, London SE1 1UL, United Kingdom.
Orthopedics. 2008 Aug;31(8):752.
A main role of clinicians treating patients after orthopedic surgery is to inform patients about their anticipated recovery rate and recovery endpoint. In estimating recovery rate, clinicians consider a series of potentially influencing factors, including the type and severity of injury and the characteristics of the patient. Unfortunately, this is done largely without evidence to support factors believed to be important in recovery rate. To our knowledge, no studies exist where factors that might influence recovery rate after arthroscopic partial meniscectomy have been evaluated. Eighty-three patients (11 women and 72 men) were evaluated 4 days after and then again 6 weeks after knee arthroscopic partial meniscectomy surgery. Recovery rate was calculated by dividing the change in a patient's Hughston Clinic knee self-assessment questionnaire during this period by his or her baseline Hughston score and relationships to independent variables (gender, age, body mass index [BMI], injury chronicity, affected meniscus, Hughston Clinic knee self-assessment score at baseline, knee flexion passive range of motion, and knee circumference). These were evaluated using backward stepwise regression analysis. The relationship between recovery rate and the independent variables was statistically significant (P,.05) for the following variables: injury chronicity, gender, and gender/injury type combination. The most unexpected finding in this study was the statistically nonsignificant relationship between recovery rate and the following variables: age, Hughston score, BMI, knee swelling, and knee flexion passive range of motion loss.
骨科手术后治疗患者的临床医生的主要职责是告知患者预期的恢复率和恢复终点。在估计恢复率时,临床医生会考虑一系列潜在影响因素,包括损伤的类型和严重程度以及患者的特征。不幸的是,这样做很大程度上缺乏证据支持那些被认为对恢复率很重要的因素。据我们所知,尚无研究评估过关节镜下部分半月板切除术后可能影响恢复率的因素。83例患者(11名女性和72名男性)在膝关节镜下部分半月板切除术后4天接受评估,然后在6周后再次评估。恢复率的计算方法是,用患者在此期间休斯顿诊所膝关节自我评估问卷的变化除以其基线休斯顿评分,并分析其与自变量(性别、年龄、体重指数[BMI]、损伤慢性程度、受影响的半月板、基线时休斯顿诊所膝关节自我评估评分、膝关节被动屈曲活动范围和膝关节周长)的关系。使用向后逐步回归分析对这些因素进行评估。恢复率与自变量之间的关系在以下变量上具有统计学意义(P <.05):损伤慢性程度、性别以及性别/损伤类型组合。本研究中最意外的发现是恢复率与以下变量之间无统计学意义的关系:年龄、休斯顿评分、BMI、膝关节肿胀和膝关节被动屈曲活动范围丧失。