Ackermann Jakob, Ogura Takahiro, Duerr Robert A, Mestriner Alexandre Barbieri, Gomoll Andreas H
Sports Medicine Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
Sports Medicine Center, Funabashi Orthopaedic Hospital, Funabashi, Japan.
Orthop J Sports Med. 2018 Dec 10;6(12):2325967118812363. doi: 10.1177/2325967118812363. eCollection 2018 Dec.
Patient-reported outcome (PRO) measures are progressively utilized as evaluation tools in preoperative and postoperative assessments in orthopaedic practice. Identifying the potential utility of psychosocial factors to predict patient-reported pain and functional outcomes is of increasing interest to determine which patients will derive the greatest benefit from surgical treatment.
PURPOSE/HYPOTHESIS: The purpose of this study was to determine potential predictive associations between the preoperative 12-Item Short Form Health Survey Mental Component Summary (SF-12 MCS) score, patient characteristics or osteochondral allograft (OCA) morphology, and PROs in patients who underwent OCA transplantation. We hypothesized that poor preoperative mental health is associated with diminished PROs at final follow-up.
Case-control study; Level of evidence, 3.
A total of 67 patients with a mean follow-up of 2.7 ± 1.0 years (range, 2-6 years) with complete preoperative and at least 24-month postoperative SF-12 MCS, Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner, Lysholm, and International Knee Documentation Committee (IKDC) scores were included in this study. Pearson correlation coefficients and linear regression models were used to distinguish associations between age, sex, smoking status, body mass index, workers' compensation, previous surgery, concomitant surgery, number of grafts, defect location, total graft size, SF-12 MCS score, and postoperative PRO scores as well as their improvement from baseline (delta).
The SF-12 MCS showed significant correlation with the KOOS Activities of Daily Living subscale ( = .015), KOOS Sport/Recreation subscale ( = .024), and IKDC ( = .039). In the multivariable linear regression models, the SF-12 MCS had no predictive association with any PRO measure. Patient sex contributed significantly to the final regression models of the KOOS Sport/Recreation ( = .042), Tegner score ( = .024), and Lysholm score ( = .031). The SF-12 MCS showed no bivariate correlation with changes in any PRO score (delta) ( > .05).
Preoperative mental health status did not predict perceived functional outcomes as assessed by PRO measures at final follow-up. Female sex was negatively correlated with KOOS Sport/Recreation, Tegner, and Lysholm scores.
患者报告结局（PRO）测量方法在骨科实践的术前和术后评估中越来越多地被用作评估工具。确定心理社会因素对预测患者报告的疼痛和功能结局的潜在效用，对于确定哪些患者将从手术治疗中获得最大益处越来越受到关注。
目的/假设：本研究的目的是确定术前12项简短健康调查问卷心理成分总结（SF-12 MCS）评分、患者特征或骨软骨异体移植（OCA）形态与接受OCA移植患者的PRO之间的潜在预测关联。我们假设术前心理健康状况不佳与最终随访时PRO降低有关。
病例对照研究；证据等级，3级。
本研究共纳入67例患者，平均随访2.7±1.0年（范围2 - 6年），这些患者术前和术后至少24个月有完整的SF-12 MCS、膝关节损伤和骨关节炎结局评分（KOOS）、特格纳评分、利肖姆评分以及国际膝关节文献委员会（IKDC）评分。采用Pearson相关系数和线性回归模型来区分年龄、性别、吸烟状况、体重指数、工伤赔偿、既往手术、同期手术、移植物数量、缺损位置、移植物总大小、SF-12 MCS评分与术后PRO评分之间的关联，以及它们相对于基线的改善情况（差值）。
SF-12 MCS与KOOS日常生活活动子量表（ = 0.015）、KOOS运动/娱乐子量表（ = 0.024）和IKDC（ = 0.039）显示出显著相关性。在多变量线性回归模型中，SF-12 MCS与任何PRO测量指标均无预测关联。患者性别对KOOS运动/娱乐（ = 0.042）、特格纳评分（ = 0.024）和利肖姆评分（ = 0.031）的最终回归模型有显著贡献。SF-12 MCS与任何PRO评分的变化（差值）均无双变量相关性（ > 0.05）。
术前心理健康状况并不能预测最终随访时通过PRO测量评估的感知功能结局。女性性别与KOOS运动/娱乐、特格纳和利肖姆评分呈负相关。
