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亚洲人内侧单髁膝关节置换术后中期结果的预测因素

Predictors of Midterm Outcomes after Medial Unicompartmental Knee Arthroplasty in Asians.

作者信息

Bin Abd Razak Hamid Rahmatullah, Acharyya Sanchalika, Tan Shi-Ming, Pang Hee-Nee, Tay Keng-Jin Darren, Chia Shi-Lu, Lo Ngai-Nung, Yeo Seng-Jin

机构信息

Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.

Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore.

出版信息

Clin Orthop Surg. 2017 Dec;9(4):432-438. doi: 10.4055/cios.2017.9.4.432. Epub 2017 Nov 10.

Abstract

BACKGROUND

This study was designed to evaluate predictors of good outcomes following medial unicompartmental knee arthroplasty (UKA) in Asian patients.

METHODS

Registry data of patients who underwent primary unilateral medial UKA from 2006 to 2011 were collected. Outcomes studied were the Oxford Knee Score (OKS) and the Physical Component Score (PCS) of the Short Form 36 (SF-36) questionnaire. These outcome scores were collected prospectively, pre- and postoperatively up to 5 years. Good outcome was defined as an overall improvement in score greater than or equal to the minimal clinically important difference (MCID). The MCID for the OKS was 5 while the MCID for the PCS was 10. Regression analysis was used to identify predictors of good outcomes following medial UKA.

RESULTS

Primary medial UKA was performed in 1,075 patients. Higher (poorer) preoperative OKS (odds ratio [OR], 1.27; < 0.001), lower (poorer) preoperative PCS (OR, 1.08; < 0.001), lower (poorer) preoperative Knee Society Knee Score (KSKS; OR, 1.02; < 0.001) and higher (better) preoperative SF-36 Mental Component Score (MCS; OR, 1.02; < 0.001) were significant predictors of good outcomes.

CONCLUSIONS

Patients with poorer OKS, PCS and KSKS and better SF-36 MCS preoperatively tended to achieve good outcomes by the MCID criterion at 5 years following the index surgery.

摘要

背景

本研究旨在评估亚洲患者行内侧单髁膝关节置换术(UKA)后良好预后的预测因素。

方法

收集2006年至2011年接受初次单侧内侧UKA患者的登记数据。研究的结果指标为牛津膝关节评分(OKS)和简短健康调查问卷36项(SF-36)中的生理健康评分(PCS)。这些结果评分在术前及术后长达5年的时间内进行前瞻性收集。良好预后定义为评分总体改善大于或等于最小临床重要差异(MCID)。OKS的MCID为5,而PCS的MCID为10。采用回归分析确定内侧UKA后良好预后的预测因素。

结果

1075例患者接受了初次内侧UKA。术前OKS较高(较差)(比值比[OR],1.27;<0.001)、术前PCS较低(较差)(OR,1.08;<0.001)、术前膝关节协会膝关节评分(KSKS)较低(较差)(OR,1.02;<0.001)以及术前SF-36心理健康评分(MCS)较高(较好)(OR,1.02;<0.001)是良好预后的显著预测因素。

结论

术前OKS、PCS和KSKS较差且SF-36 MCS较好的患者在初次手术后5年往往根据MCID标准获得良好预后。

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