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6 分钟计时跳测试是预测接受运动疗法或关节镜下半月板部分切除术治疗的半月板撕裂患者结局的一个预后因素:奥登塞-奥斯陆半月板切除术与运动(OMEX)试验的二次、探索性分析。

The 6-m timed hop test is a prognostic factor for outcomes in patients with meniscal tears treated with exercise therapy or arthroscopic partial meniscectomy: a secondary, exploratory analysis of the Odense-Oslo meniscectomy versus exercise (OMEX) trial.

机构信息

Orthopaedic Department, Martina Hansens Hospital, PO-box 823, 1306, Sandvika, Norway.

Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2019 Aug;27(8):2478-2487. doi: 10.1007/s00167-018-5241-7. Epub 2018 Nov 16.

Abstract

PURPOSE

To identify the prognostic factors for 2-year patient-reported outcomes in middle-aged patients with degenerative meniscal tears treated with exercise therapy (ET) or arthroscopic partial meniscectomy (APM).

METHODS

One hundred and seven patients, with mean age 49.6 (SD 6.2) years and BMI 25.7 (SD 3.7), were included in this analysis of data from the OMEX trial ( http://www.clinicaltrials.gov NCT01002794). Linear and Poisson regression models were built to explore the associations between potential prognostic factors (patient characteristics, knee function-related and disease-related factors) and 2-year patient-reported outcomes: the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales Pain, Symptoms, ADL, Sport/Rec, QoL and 5-point Global Rating of Change scales for knee pain (GRC Pain) and function (GRC Function). Analyses were performed for the whole cohort and for the two treatment groups (n = 55 and 52) with adjustments for age, sex, BMI and baseline KOOS.

RESULTS

For the whole cohort, a 1-s better baseline 6-m timed hop test result was associated with 3.1-7.1 points better 2-year scores for all KOOS subscales (95% CIs 1.1-5.2 to 4.1-10.1 points). A 1.61-2.80 s better test was associated with scores equivalent to previously calculated clinical relevant differences for each KOOS subscale. For the groups of patients treated with ET and APM, respectively, 2.09-3.60 s and 0.63-1.99 s better tests were associated with clinical relevant differences. For the whole cohort, a 1-s better test was associated with 26% (95% CI 15-38%) and 22% (95% CI 11-34%) higher possibility for better or much better GRC Pain and Function scores. Patients treated with ET had 17% (95% CI 2-33%) increased possibility for better or much better GRC Pain score, and patients treated with APM had 65% (95% CI 32-108%) and 70% (95% CI 38-109%) increased possibility for better or much better GRC Pain and Function scores.

CONCLUSIONS

The 6-m timed hop test result was a significant prognostic factor for 2-year patient-reported outcomes in middle-aged patients with degenerative meniscal tears, especially in those treated with APM.

LEVEL OF EVIDENCE

II.

摘要

目的

确定中年退行性半月板撕裂患者接受运动疗法(ET)或关节镜下部分半月板切除术(APM)治疗后 2 年患者报告结局的预后因素。

方法

对 OMEX 试验(http://www.clinicaltrials.gov NCT01002794)的数据进行了 107 名患者的分析,平均年龄 49.6(SD 6.2)岁,BMI 25.7(SD 3.7)。线性和泊松回归模型用于探索潜在预后因素(患者特征、膝关节功能相关和疾病相关因素)与 2 年患者报告结局之间的关系:膝关节损伤和骨关节炎结果评分(KOOS)子量表疼痛、症状、ADL、运动/恢复、生活质量和膝关节疼痛(GRC 疼痛)和功能(GRC 功能)的 5 分总体变化量表。为整个队列和两个治疗组(n=55 和 52)进行了分析,调整了年龄、性别、BMI 和基线 KOOS。

结果

对于整个队列,基线 6 米定时跳跃测试结果提高 1 秒,与所有 KOOS 子量表 2 年评分提高 3.1-7.1 分相关(95%CI 1.1-5.2 至 4.1-10.1 分)。测试提高 1.61-2.80 秒与每个 KOOS 子量表的先前计算的临床相关差异相当。对于接受 ET 和 APM 治疗的患者组,分别为 2.09-3.60 秒和 0.63-1.99 秒的更好测试与临床相关差异相关。对于整个队列,测试提高 1 秒与 GRC 疼痛和功能评分更好或明显更好的可能性增加 26%(95%CI 15-38%)和 22%(95%CI 11-34%)相关。接受 ET 治疗的患者,GRC 疼痛评分更好或明显更好的可能性增加 17%(95%CI 2-33%),接受 APM 治疗的患者,GRC 疼痛和功能评分更好或明显更好的可能性增加 65%(95%CI 32-108%)和 70%(95%CI 38-109%)。

结论

6 米定时跳跃测试结果是中年退行性半月板撕裂患者 2 年患者报告结局的重要预后因素,尤其是接受 APM 治疗的患者。

证据水平

II。

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