Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Republic of Singapore.
Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore, Republic of Singapore.
J Arthroplasty. 2017 Aug;32(8):2531-2534. doi: 10.1016/j.arth.2017.03.013. Epub 2017 Mar 16.
There is little known in the literature about whether preoperative patient-reported outcome measures (PROMs) would affect the risk of periprosthetic fractures (PPFs) after primary total knee arthroplasty (TKA). Our study aims to evaluate the predictive values of PROMs on PPF after primary TKA. We hypothesize that poorer PROMs are associated with a higher risk of PPF after primary TKA.
We reviewed prospectively collected data in our hospital arthroplasty registry. Patients who sustained PPF after primary TKA between 2000 and 2015 were identified. Forty-two patients were identified and matched for gender, age, and body mass index to a control group of 84 patients who had primary TKA without PPF in a 2:1 ratio. Preoperative demographics, Short Form-36 (SF-36) scores, Oxford Knee score and Knee Society Score were evaluated. Variables of PROMs were entered into a multivariate logistic regression model. A variable was considered to be a significant predictor if its odds ratio was significant at P < .05.
After multivariate regression analysis, SF-36 subdomains of physical functioning (PF) and vitality (VT) were identified as significant predictors for PPFs after primary TKA. A lower SF-36 PF and VT scores were associated with higher risks of sustaining a PPF after primary TKA.
From our study, low preoperative SF-36 PF and VT scores are associated with a higher risk of PPFs after primary TKA. These results can allow the preoperative identification of patients at higher risk of PPF, and appropriate preoperative counseling, optimization, and close follow-up can be instituted for this at-risk group.
文献中对于术前患者报告的结局测量（PROMs）是否会影响初次全膝关节置换（TKA）后假体周围骨折（PPF）的风险知之甚少。我们的研究旨在评估 PROMs 对初次 TKA 后 PPF 的预测价值。我们假设较差的 PROMs 与初次 TKA 后 PPF 的风险增加相关。
我们回顾了我院关节置换登记处前瞻性收集的数据。确定了 2000 年至 2015 年间初次 TKA 后发生 PPF 的患者。按照性别、年龄和体重指数，以 2:1 的比例将 42 例患者与初次 TKA 无 PPF 的对照组 84 例患者进行匹配。评估术前人口统计学、SF-36（健康调查简表）评分、牛津膝关节评分和膝关节协会评分。将 PROMs 的变量纳入多变量逻辑回归模型。如果其优势比在 P <.05 时具有统计学意义，则认为该变量是显著的预测因子。
经过多变量回归分析，SF-36 子领域的身体功能（PF）和活力（VT）被确定为初次 TKA 后 PPF 的显著预测因子。SF-36 PF 和 VT 评分较低与初次 TKA 后发生 PPF 的风险增加相关。
根据我们的研究，术前 SF-36 PF 和 VT 评分较低与初次 TKA 后 PPF 的风险增加相关。这些结果可以让我们在术前识别出发生 PPF 风险较高的患者，并为这一高危人群提供适当的术前咨询、优化和密切随访。
