Clement N D, MacDonald D, Simpson A H R W
Royal Infirmary of Edinburgh, Little France, Edinburgh, EH16 4SA, UK,
Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1933-9. doi: 10.1007/s00167-013-2776-5. Epub 2013 Nov 20.
The aim of this study was to identify the minimal clinically important difference (MCID) in the Oxford knee score (OKS) and Short Form (SF-) 12 score after total knee arthroplasty (TKA).
Prospective pre-operative and 1 year post-operative OKS and SF-12 scores for 505 patients undergoing a primary TKA for osteoarthritis were collected during a one-year period. Patient satisfaction with their (1) patient relief and (2) functional outcome was used as the anchor questions. Their response to each question was recorded using a 5-point Likert scale: excellent, very well, well, fair, and poor. Simple linear regression was used to calculate the MCID for improvement in the OKS and physical component of the SF-12 score according to the level of patient satisfaction with their pain relief and function.
The OKS improved by 15.5 (95 % CI 14.7-16.4) points and the SF-12 physical component score improved by 10.1 (95 % CI 9.1-11.2) points for the study cohort. The level of patient satisfaction with their pain relief and function correlated with the improvement in the OKS (r = 0.56; p < 0.001, and r = 0.56; p < 0.001) and the physical component of the SF-12 score (r = 0.51; p < 0.001, and r = 0.60; p < 0.001), respectively. The MCID for the OKS was 5.0 (95 % CI 4.4-5.5) and 4.3 (95 % CI 3.8-4.8) points and for the physical component of the SF-12, it was 4.5 (95 % CI 3.9-5.2) and 4.8 (95 % CI 4.2-5.4) points for pain relief and function, respectively.
The MCID identified for the OKS and SF-12 physical component score after TKA is the best available estimate and can be used to power studies and ensure that a statistical difference is also recognised by a patient.
本研究旨在确定全膝关节置换术（TKA）后牛津膝关节评分（OKS）和简短健康调查问卷（SF-12）评分的最小临床重要差异（MCID）。
在一年时间内收集了505例因骨关节炎接受初次TKA患者术前及术后1年的OKS和SF-12评分。患者对其（1）疼痛缓解情况和（2）功能结果的满意度被用作锚定问题。使用5点李克特量表记录他们对每个问题的回答：优秀、非常好、好、一般、差。根据患者对疼痛缓解和功能的满意度水平，采用简单线性回归计算OKS和SF-12评分身体成分部分改善的MCID。
研究队列中，OKS提高了15.5（95%CI 14.7 - 16.4）分，SF-12身体成分评分提高了10.1（95%CI 9.1 - 11.2）分。患者对疼痛缓解和功能的满意度水平分别与OKS的改善（r = 0.56；p < 0.001，以及r = 0.56；p < 0.001）和SF-12评分身体成分部分的改善（r = 0.51；p < 0.001，以及r = 0.60；p < 0.001）相关。OKS的MCID分别为5.0（95%CI 4.4 - 5.5）分和4.3（95%CI 3.8 - 4.8）分，对于SF-12身体成分部分，疼痛缓解和功能方面的MCID分别为4.5（95%CI 3.9 - 5.2）分和4.8（95%CI 4.2 - 5.4）分。
TKA后确定的OKS和SF-12身体成分评分的MCID是目前可得的最佳估计值，可用于研究效能分析，并确保患者也能识别出统计学差异。
