Department of Orthopaedic Surgery, Martina Hansens Hospital, Baerum, Norway.
Am J Sports Med. 2010 Feb;38(2):231-7. doi: 10.1177/0363546509352157. Epub 2009 Dec 30.
Patients with focal cartilage defects in the knee may suffer from both pain and functional impairment. Treatment options are often insufficient. It is not known, however, to what extent their complaints affect quality of life, compared with other knee disorders. Knee Injury and Osteoarthritis Outcome Score (KOOS) is a validated global knee score suitable for comparison of patients with knee complaints attributable to different causes. Hypothesis Complaints because of localized cartilage defects in the knee reduce quality of life measured by KOOS to a different extent than those due to anterior cruciate ligament deficiency and osteoarthritis, when comparing patients within the working population scheduled for surgery.
Cross-sectional study; Level of evidence, 3. Methods Previously registered KOOS baseline data on patients enrolled in different knee treatment studies were included in the present study; the patients were 18 to 67 years of age (working population) at data registration. The different patient categories were (1) patients with knee osteoarthritis enrolled for knee arthroplasty, (2) patients with knee osteoarthritis enrolled for osteotomies around the knee, (3) patients with focal cartilage lesions enrolled for cartilage repair, and (4) patients with anterior cruciate ligament-deficient knees enrolled for anterior cruciate ligament reconstruction. The KOOS subscale quality of life was the main parameter for comparison of complaints.
At preoperative baseline, patients with focal cartilage defects in the knee scored 27.5 on the KOOS subscale quality of life, not significantly different from the 28.8 and 27.2 in the patients with osteoarthritis enrolled for knee osteotomies and arthroplasties, respectively. For all the subscales of KOOS, the cartilage patients scored significantly lower than the patients with anterior cruciate ligament deficiency.
Patients with focal cartilage lesions have major problems with pain and functional impairment. Their complaints are worse than those of patients with anterior cruciate ligament-deficient knees, and quality of life is affected to the same extent as in patients scheduled for knee replacement.
膝关节局灶性软骨缺损的患者可能同时存在疼痛和功能障碍。治疗选择往往不够充分。然而，与其他膝关节疾病相比，尚不清楚其症状在多大程度上影响生活质量。膝关节损伤和骨关节炎结果评分（KOOS）是一种经过验证的膝关节整体评分，适用于比较因不同原因导致膝关节疾病的患者。假设膝关节局灶性软骨缺损引起的症状会降低生活质量，其程度比前交叉韧带缺失和骨关节炎引起的症状更严重，比较的对象是计划接受手术的工作人群中的患者。
横断面研究；证据水平，3 级。方法：本研究纳入了不同膝关节治疗研究中登记的患者的已注册 KOOS 基线数据；患者在数据登记时年龄为 18 至 67 岁（工作人群）。不同的患者类别包括：（1）登记接受膝关节置换术的膝关节骨关节炎患者；（2）登记接受膝关节周围截骨术的膝关节骨关节炎患者；（3）登记接受软骨修复术的局灶性软骨病变患者；（4）登记接受前交叉韧带重建术的前交叉韧带缺失的膝关节患者。KOOS 亚量表生活质量是比较症状的主要参数。
术前基线时，膝关节局灶性软骨缺损患者的 KOOS 亚量表生活质量评分为 27.5，与登记接受膝关节截骨术和关节置换术的骨关节炎患者的 28.8 和 27.2 相比，无显著差异。在 KOOS 的所有亚量表中，软骨患者的评分均明显低于前交叉韧带缺失患者。
局灶性软骨病变患者存在严重的疼痛和功能障碍问题。他们的症状比前交叉韧带缺失的膝关节患者更严重，对生活质量的影响程度与计划接受膝关节置换术的患者相同。
