Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Aomori, Japan,
Int Orthop. 2014 Feb;38(2):373-8. doi: 10.1007/s00264-013-2064-5. Epub 2013 Aug 24.
Evaluations for knee osteoarthritis (OA) or post-operative total knee arthroplasty (TKA) have mainly been assessed by objective scales. Though the Knee injury and Osteoarthritis Outcome Score (KOOS) is attracting attention as a patient-based outcome score, the relationship with conventional objective scales after TKA remains controversial. The purpose of this study was to investigate the relationship between KOOS and conventional objective scales and evaluate the features of patient-based outcome scores.
Subjects were 130 post-operative patients involving 186 knees treated with TKA. Their mean age was 74.0 ± 8.0 years, and the follow-up period was 43 months. Japanese Orthopaedic Association (JOA) score, original Knee Society Score (KSS) and surgeon's satisfaction score were scored as conventional objective scales besides KOOS. Spearman's correlation coefficient was estimated between these scales. Comparisons between OA and rheumatoid arthritis (RA) as well as primary and revision surgery were performed by the Mann-Whitney U test.
There were strong correlations between KOOS activities of daily living (ADL) and JOA score (r = 0.806), KSS function score (r = 0.803) and between KOOS pain and KSS knee score (r = 0.689). However, there was a poor correlation between KOOS and surgeon's satisfaction score (r = 0.188-0.321). TKA for RA showed poorer results only in KOOS pain (p = 0.003), and revision surgery showed poorer results in KSS function, KOOS symptoms and KOOS quality of life (QOL).
This study suggested that conventional objective scales reflected mainly ADL disturbances in post-operative TKA patients. Furthermore, patient-based outcome scores made it possible to evaluate and detect a minute change of knee pain and QOL in TKA patients. The Japanese KOOS was a useful tool to evaluate conditions after TKA.
膝关节骨关节炎（OA）或全膝关节置换术后（TKA）的评估主要通过客观量表进行。虽然膝关节损伤和骨关节炎结果评分（KOOS）作为一种基于患者的结果评分受到关注，但 TKA 后与传统客观量表的关系仍存在争议。本研究旨在探讨 KOOS 与传统客观量表的关系，并评估基于患者的结果评分的特点。
研究对象为 130 例接受 TKA 治疗的术后患者，共涉及 186 膝。患者平均年龄为 74.0±8.0 岁，随访时间为 43 个月。除 KOOS 外，日本矫形协会（JOA）评分、原始膝关节协会评分（KSS）和外科医生满意度评分也被评为传统客观量表。采用 Spearman 相关系数估计这些量表之间的相关性。采用 Mann-Whitney U 检验比较 OA 和类风湿关节炎（RA）、初次和翻修手术之间的差异。
KOOS 日常生活活动（ADL）与 JOA 评分（r=0.806）、KSS 功能评分（r=0.803）之间存在较强相关性，KOOS 疼痛与 KSS 膝关节评分（r=0.689）之间也存在较强相关性。然而，KOOS 与外科医生满意度评分之间的相关性较差（r=0.188-0.321）。RA 患者的 TKA 仅在 KOOS 疼痛方面表现较差（p=0.003），而翻修手术在 KSS 功能、KOOS 症状和 KOOS 生活质量（QOL）方面表现较差。
本研究表明，传统客观量表主要反映了术后 TKA 患者的日常生活活动障碍。此外，基于患者的结果评分可以评估和发现 TKA 患者膝关节疼痛和 QOL 的微小变化。日本 KOOS 是评估 TKA 后情况的有用工具。
