复发性髌骨脱位患者诺维奇髌骨不稳定评分的心理测量学特性。
Psychometric properties of the Norwich Patellar Instability Score in people with recurrent patellar dislocation.
作者信息
Smith T O, Choudhury A, Navratil R, Hing C B
机构信息
Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Windmill Road, Oxford, UK.
Department of Trauma and Orthopaedics, St George's Hospital, St George's University Hospitals NHS Foundation Trust, Tooting, London, UK; St George's University of London, Tooting, London, UK.
出版信息
Knee. 2019 Dec;26(6):1192-1197. doi: 10.1016/j.knee.2019.10.021. Epub 2019 Nov 23.
BACKGROUND
Patellar dislocations account for two percent of all knee injuries with a 17% chance of re-dislocation. There are few validated scores specific to instability. One of these is the Norwich Patellar Instability Score. There has been limited assessment of the validity, floor-ceiling effect and responsiveness of the Norwich Patellar Instability (NPI) Score from an independent centre. The purpose of this paper is to address this limitation.
METHODS
Data from 90 patients referred to a tertiary referral patellofemoral clinic were analysed. All routinely completed data including NPI Score, Kujala Patellofemoral Disorder Score, and demographic outcomes during appointments, up to 36 months following initial clinical assessment was analysed. Convergent validity was assessed by correlating outcomes of the Kujala Patellofemoral Disorder Score to the NPI Score. Effect size (ES) was determined between baseline to 12-month and 12 to 36-month assessments to determine responsiveness. Floor-ceiling effect was evaluated at baseline, 12-month and 12 to 36-month follow-up.
RESULTS
NPI Score demonstrated good convergent validity to the Kujala Patellofemoral Disorder Score (p < .001; 95% confidence interval (CI): -0.71 to -0.52). NPI Score demonstrated good responsiveness to change both between baseline to 12 months (ES: 0.43; 95% CI: 0.42 to 0.10) and 12 to 36 months (ES: 0.67; 95% CI: 0.60 to 0.15). Whilst the NPI Score did not demonstrate a ceiling effect, there was moderate risk of a floor-effect where 13% of the cohort reported the lowest levels of NPI scores.
CONCLUSIONS
The NPI Score is a valid and responsive outcome for people with recurrent patellar dislocation.
背景
髌骨脱位占所有膝关节损伤的2%，再次脱位的几率为17%。针对膝关节不稳的有效评分较少，其中之一是诺维奇髌骨不稳评分。来自独立中心对诺维奇髌骨不稳（NPI）评分的有效性、地板效应和反应性的评估有限。本文旨在解决这一局限性。
方法
分析了90例转诊至三级转诊髌股关节诊所患者的数据。分析了所有常规填写的数据，包括NPI评分、库亚拉髌股关节疾病评分以及初次临床评估后36个月内就诊时的人口统计学结果。通过将库亚拉髌股关节疾病评分的结果与NPI评分进行相关性分析来评估收敛效度。确定基线至12个月以及12至36个月评估之间的效应大小（ES）以确定反应性。在基线、12个月以及12至36个月随访时评估地板效应。
结果
NPI评分与库亚拉髌股关节疾病评分显示出良好的收敛效度（p<0.001；95%置信区间（CI）：-0.71至-0.52）。NPI评分在基线至12个月（ES：0.43；95%CI：0.42至0.10）以及12至36个月（ES：0.67；95%CI：0.60至0.15）之间均显示出良好的变化反应性。虽然NPI评分未显示出天花板效应，但存在中度地板效应风险，即13%的队列报告了最低水平的NPI评分。
结论
NPI评分是复发性髌骨脱位患者的有效且具有反应性的结果指标。
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