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膝关节损伤与骨关节炎疗效评分在美国健康人群中的应用。

Use of the Knee Injury and Osteoarthritis Outcome Score in a Healthy United States Population.

作者信息

Williamson Tyler, Sikka Robby, Tompkins Marc, Nelson Bradley J

机构信息

TRIA Orthopaedic Center, Bloomington, Minnesota, USA.

TRIA Orthopaedic Center, Bloomington, Minnesota, USA

出版信息

Am J Sports Med. 2016 Feb;44(2):440-6. doi: 10.1177/0363546515616812. Epub 2015 Dec 10.

Abstract

BACKGROUND

Patient-reported outcome instruments are frequently used for assessing clinical outcomes after injury and surgery. Previously reported normative data for the Knee injury and Osteoarthritis Outcome Score (KOOS) are limited to a narrow subset of ages and demographics or have not included patients who do not participate in sporting activities.

PURPOSE

To provide normative data for the KOOS in an 18- to 64-year-old population in the United States.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

The KOOS was administered to 999 patients or accompanying family members seen in July 2014 at an outpatient orthopaedic clinic in a suburban metropolitan city for an orthopaedic issue unrelated to their knee. Participants were eligible if they self-reported a medical history negative for knee, ankle, or hip surgery and if they did not have a current issue with their knee, ankle, or hip. Means, SDs, medians, ranges, interquartile ranges, and percentiles on the KOOS were calculated by sex, age range, laterality, and history of knee injuries in the past year. Nonparametric statistical analysis and regression analysis were used to evaluate differences in KOOS values between 5 age ranges and between those with a history of knee injuries compared with uninjured participants.

RESULTS

There were 402 men and 597 women in the final study cohort. Men scored lower on the Symptoms subscale compared with other subscales (median score: 96.4 for Symptoms, 100.0 for all other subscales) in all age cohorts except the 56- to 64-year age group. Women also reported lower scores in the Symptoms subscale (median score: 96.4 for women aged 18-55 years, 92.9 for women aged 56-64 years). Median scores for the Pain and Knee-related Quality of Life subscales were lower in the 56- to 64-year female cohort (97.2 and 93.8, respectively), compared with the 18- to 55-year female cohort. The Symptoms, Pain, and Knee-related Quality of Life subscales showed the greatest variability for patients of both sexes, particularly in the youngest and oldest cohorts. Three percent of all participants reported a history of knee injuries in the past year, and all KOOS results were significantly lower (P < .05) in this population compared with uninjured participants.

CONCLUSION

This study provides normative reference values for the KOOS in an 18- to 64-year-old metropolitan United States population. Study findings can aid surgeons in counseling patients and in developing expectations after the treatment of injuries.

摘要

背景

患者报告结局工具常用于评估受伤和手术后的临床结局。先前报道的膝关节损伤和骨关节炎结局评分(KOOS)的规范数据仅限于年龄和人口统计学的狭窄子集,或者未纳入不参加体育活动的患者。

目的

为美国18至64岁人群的KOOS提供规范数据。

研究设计

横断面研究;证据等级,3级。

方法

对2014年7月在一个大都市郊区的门诊骨科诊所就诊的999名患者或陪同家属进行KOOS评估,这些患者的骨科问题与膝关节无关。如果参与者自我报告膝关节、踝关节或髋关节手术病史为阴性,且目前膝关节、踝关节或髋关节无问题,则符合入选条件。根据性别、年龄范围、侧别和过去一年的膝关节损伤史,计算KOOS的均值、标准差、中位数、范围、四分位数间距和百分位数。采用非参数统计分析和回归分析评估5个年龄范围之间以及有膝关节损伤史的参与者与未受伤参与者之间KOOS值的差异。

结果

最终研究队列中有402名男性和597名女性。在所有年龄组中,除56至64岁年龄组外,男性在症状子量表上的得分低于其他子量表(症状子量表中位数得分:96.4,其他所有子量表中位数得分:100.0)。女性在症状子量表上的得分也较低(18至55岁女性中位数得分:96.4,56至64岁女性中位数得分:92.9)。56至64岁女性队列中疼痛和膝关节相关生活质量子量表的中位数得分低于18至55岁女性队列(分别为97.2和93.8)。症状、疼痛和膝关节相关生活质量子量表在男女患者中表现出最大的变异性,尤其是在最年轻和最年长的队列中。所有参与者中有3%报告在过去一年中有膝关节损伤史,与未受伤参与者相比,该人群的所有KOOS结果均显著较低(P < 0.05)。

结论

本研究为美国18至64岁大都市人群的KOOS提供了规范参考值。研究结果有助于外科医生为患者提供咨询,并在损伤治疗后制定预期。

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