全膝关节置换术后外科医生报告的结果与患者报告的结果相关吗？一项队列研究。

Does the Surgeon-reported Outcome Correlate with Patient-reported Outcome after Total Knee Arthroplasty? A Cohort Study.

作者信息

Raju Sivashanmugam, Chinnakkannu Karthikeyan, Selvaraj Ashok, Balakumar Balasubramanian, Puttaswamy Mohan K, Jayasankar P V

机构信息

Wake Forest University Baptist Medical Center, Department of Orthopedics and Sports Medicine, Medical Center Boulevard, Winston Salem, NC, USA.

Department of Orthopaedics Sundaram Medical Foundation Dr. Rangarajan Memorial Hospital, Kanchipuram, Tamil Nadu, India.

出版信息

Indian J Orthop. 2018 Jul-Aug;52(4):387-392. doi: 10.4103/ortho.IJOrtho_359_16.

DOI:10.4103/ortho.IJOrtho_359_16

PMID:30078897

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6055453/

Abstract

BACKGROUND

Total knee arthroplasty (TKA) has been proved to be a successful and cost-effective treatment for improving pain and function in patients with knee arthritis. Total knee arthroplasty (TKA) is one of the most common orthopaedic surgeries performed worldwide and advancement in surgical techniques and prosthetic designs have improved the patient outcomes. However, concerns and priorities of patients and surgeons relating to joint replacement may differ.

MATERIALS AND METHODS

306 TKAs in 223 patients were evaluated for functional outcome using surgeon reported American Knee Society Knee Score (KS)/Functional Score (FS) and patient-reported Oxford Knee Score (OKS). We have also assessed the correlation between FS and OKS at midterm follow up.

RESULTS

The mean preoperative KS, FS, and OKS in 223 patients were 42.76, 42.4, and 38.84 and the midterm mean KS, FS, and OKS were 84.29, 73.40, and 30.26, respectively. There was a statistically significant improvement in the KS, FS, and OKS at midterm follow up in Category A (CAT A) (bilateral TKA or unilateral with asymptomatic contralateral knee), CAT B (unilateral TKA with symptomatic other knee) and CAT C (inflammatory arthritis). Overall, the correlation between the midterm FS and OKS was fair. However, in CAT A and CAT B, there was no significant correlation between FS and OKS, but CAT C had a strong correlation. There was a statistically significant improvement in the KS, FS, and OKS when midterm follow up scores were compared with preoperative scores. However, no significant correlation between the American knee society FS and OKS in osteoarthritic patients at midterm follow up signifies acceptable outcome may vary between patients and physicians.

CONCLUSION

All patients should be counseled preoperatively to assess their expectations and sensitize them to information regarding the expected functional outcome following TKA in their cultural context.

摘要

背景

全膝关节置换术（TKA）已被证明是一种成功且具有成本效益的治疗方法，可改善膝关节炎患者的疼痛和功能。全膝关节置换术（TKA）是全球范围内最常见的骨科手术之一，手术技术和假体设计的进步改善了患者的治疗效果。然而，患者和外科医生在关节置换方面的关注点和优先事项可能有所不同。

材料与方法

对223例患者的306例全膝关节置换术进行功能结果评估，采用外科医生报告的美国膝关节协会膝关节评分（KS）/功能评分（FS）和患者报告的牛津膝关节评分（OKS）。我们还评估了中期随访时FS和OKS之间的相关性。

结果

223例患者术前KS、FS和OKS的平均值分别为42.76、42.4和38.84，中期KS、FS和OKS的平均值分别为84.29、73.40和30.26。在A类（双侧TKA或单侧伴对侧无症状膝关节）、B类（单侧TKA伴对侧有症状膝关节）和C类（炎性关节炎）患者的中期随访中，KS、FS和OKS有统计学意义的改善。总体而言，中期FS和OKS之间的相关性一般。然而，在A类和B类患者中，FS和OKS之间无显著相关性，但C类患者有很强的相关性。将中期随访评分与术前评分比较时，KS、FS和OKS有统计学意义的改善。然而，中期随访时骨关节炎患者的美国膝关节协会FS和OKS之间无显著相关性，这表明患者和医生对可接受结果的认知可能存在差异。