Phruetthiphat Ong-Art, Koehler Daniel M, Karam Matthew D, Rungprai Chamnanni, Gao Yubo, Marsh J Lawrence
*Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA; and†Department of Orthopaedic Surgery, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
J Orthop Trauma. 2016 Aug;30(8):e267-72. doi: 10.1097/BOT.0000000000000567.
To investigate whether aerobic fitness as determined by preoperative metabolic equivalents (METS) better predicts postoperative functional outcomes after open reduction and internal fixation (ORIF) of acetabular fractures than chronologic age.
Retrospective review.
Level 1 Trauma Center.
PATIENTS/PARTICIPANTS: A total of 157 patients underwent open surgical treatment for acetabular fracture between January 2005 and December 2013 with age ≥18 years and minimum 1-year follow-up inclusive of imaging, functional outcome scores, and complications.
ORIF of acetabular fracture.
Final postoperative functional outcomes as assessed with the University of California Los Angeles activity score and the Western Ontario and McMaster Universities Osteoarthritis Index.
Multivariate logistic regression analysis demonstrated elevated preinjury METS, female gender, and lower injury severity score (<18) to be significant independent factors predictive of improved functional outcome per the University of California Los Angeles score. Similarly, preinjury METS were identified as significant predictors for improved Western Ontario and McMaster Universities Osteoarthritis Index scores for both the stiffness and physical function components. Chronologic age was not a significant predictor for any functional outcome score. Furthermore, a Pearson correlation analysis demonstrated a weak relationship between preoperative METS and chronologic age (r = -0.346).
Pre-operative aerobic fitness as determined by METS may prove to be a superior prognostic factor for predicting postoperative functional outcome after acetabular fracture fixation than chronologic age. Consideration of aerobic fitness, in addition to other established prognostic factors, may be useful to patients and surgeons for injury counseling purposes.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
探讨术前代谢当量（METS）所确定的有氧适能是否比实际年龄能更好地预测髋臼骨折切开复位内固定术（ORIF）后的术后功能结局。
回顾性研究。
一级创伤中心。
患者/参与者：2005年1月至2013年12月期间，共有157例年龄≥18岁且至少随访1年（包括影像学检查、功能结局评分和并发症）的髋臼骨折患者接受了开放手术治疗。
髋臼骨折切开复位内固定术。
采用加利福尼亚大学洛杉矶分校活动评分和西安大略和麦克马斯特大学骨关节炎指数评估最终术后功能结局。
多因素逻辑回归分析表明，伤前METS升高、女性性别以及较低的损伤严重程度评分（<18）是根据加利福尼亚大学洛杉矶分校评分预测功能结局改善的显著独立因素。同样，伤前METS被确定为西安大略和麦克马斯特大学骨关节炎指数僵硬和身体功能成分评分改善的显著预测因素。实际年龄不是任何功能结局评分的显著预测因素。此外，Pearson相关分析表明术前METS与实际年龄之间存在弱相关性（r = -0.346）。
由METS确定的术前有氧适能可能被证明是预测髋臼骨折固定术后功能结局的比实际年龄更好的预后因素。除其他已确定的预后因素外，考虑有氧适能可能对患者和外科医生进行损伤咨询有用。
预后III级。有关证据水平的完整描述，请参阅作者指南。
