Makhni Eric C, Meyer Maximilian A, Saltzman Bryan M, Cole Brian J
Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, U.S.A..
Department of Sports Medicine, Rush University Medical Center, Chicago, Illinois, U.S.A.
Arthroscopy. 2016 Oct;32(10):2133-2139. doi: 10.1016/j.arthro.2016.04.009. Epub 2016 Jun 17.
To assess the comprehensiveness of outcome reporting after treatment of focal articular cartilage defects in the knee.
A systematic review of literature published over the past 5 years (October 2010 to October 2015) in 5 high-impact orthopaedic journals was completed to identify all recent clinical studies tracking outcomes after surgery for focal articular cartilage defects in the knee. A metric reporting score was calculated for each study, according to reporting of 6 cardinal domains: pain, satisfaction, osteoarthritis progression, subjective knee function, objective knee function, and patient-reported outcomes.
Of the 122 studies included for review, 117 (96%) tracked patient-reported outcomes during follow-up. Nearly two-thirds of studies (63%) monitored progression of osteoarthritis at follow-up. Fewer than half of studies (39%) specifically monitored pain outcomes in patients. One-third of studies (30%) tracked patient satisfaction. Only 21% of studies monitored subjective knee function using proxies such as return to play, and only 17% of studies reported on objective knee function during return visits to the clinic. The average metric reporting score of all studies was 2.6, and nearly half of studies (48%) reported on only 1 or 2 domains of interest.
There is substantial variability in outcome reporting after cartilage surgery in high-impact orthopaedic journals. Furthermore, most studies do not comprehensively track outcomes across domains. Both factors hinder comparison of results across studies. Future outcome metrics should focus on patient-centered factors to improve both accuracy of results reporting and standardization across studies.
Level IV, systematic review of Level I-IV studies.
评估膝关节局灶性关节软骨缺损治疗后结果报告的全面性。
对过去5年（2010年10月至2015年10月）在5种高影响力骨科期刊上发表的文献进行系统综述，以确定所有追踪膝关节局灶性关节软骨缺损手术后结果的近期临床研究。根据6个主要领域的报告情况，为每项研究计算一个指标报告得分，这6个领域分别为：疼痛、满意度、骨关节炎进展、主观膝关节功能、客观膝关节功能以及患者报告的结果。
纳入综述的122项研究中，117项（96%）在随访期间追踪了患者报告的结果。近三分之二的研究（63%）在随访时监测了骨关节炎的进展。不到一半的研究（39%）专门监测了患者的疼痛结果。三分之一的研究（30%）追踪了患者满意度。只有21%的研究使用诸如恢复运动等替代指标监测主观膝关节功能，只有17%的研究在患者复诊时报告了客观膝关节功能。所有研究的平均指标报告得分为2.6，近一半的研究（48%）仅报告了1个或2个感兴趣的领域。
高影响力骨科期刊上软骨手术后的结果报告存在很大差异。此外，大多数研究并未全面追踪各领域的结果。这两个因素都阻碍了不同研究结果之间的比较。未来的结果指标应侧重于以患者为中心的因素，以提高结果报告的准确性和研究间的标准化程度。
IV级，I-IV级研究的系统综述。
