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短版 KOOS 量表(JR 版)适用于膝关节翻修术。

The Short Form KOOS, JR Is Valid for Revision Knee Arthroplasty.

机构信息

Department of Orthopedic Surgery, Indiana University School of Medicine, Fishers, IN.

Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY.

出版信息

J Arthroplasty. 2020 Sep;35(9):2543-2549. doi: 10.1016/j.arth.2020.04.016. Epub 2020 Apr 13.

Abstract

BACKGROUND

The Knee Injury Osteoarthritis Outcome Survey, Joint Replacement (KOOS, JR) is a reliable, responsive, and validated patient-reported outcome measure (PROM) of knee health in patients with knee osteoarthritis undergoing unilateral primary total knee arthroplasty (TKA). The validity of the KOOS, JR for revision TKA remains unknown.

METHODS

We identified 314 patients who underwent revision TKA and had completed preoperative and 2-year postoperative PROMs. Validation included assessment of local dependence, unidimensionality, internal consistency, external construct validity, responsiveness, and floor effects preoperatively and ceiling effects at 2 years postoperatively.

RESULTS

Among patients undergoing revision TKA, the KOOS, JR demonstrated an absence of residual item correlation, adequate unidimensionality, high internal consistency (Person Separation Index: 0.897), and high external construct validity with existing validated PROMs, including KOOS Pain (Spearman's correlation coefficient 0.89) and KOOS activities of daily living (0.90) domains. The KOOS, JR was more responsive (standardized response means: 1.14) to revision TKA than other common knee PROMs. Three percent of revision TKA patients were at the floor (lowest score) preoperatively and 9% reached the ceiling (highest possible score) postoperatively.

CONCLUSIONS

KOOS, JR performs well in revision TKA patients with regard to internal consistency, external validity, responsiveness, and floor and ceiling effects. Our results support extending its use to revision TKA in both clinical and research settings.

摘要

背景

膝关节骨关节炎结局调查(KOOS,JR)是一种可靠、敏感且经过验证的膝关节健康患者报告结局测量(PROM),用于接受单侧初次全膝关节置换术(TKA)的膝关节骨关节炎患者。KOOS,JR 在翻修 TKA 中的有效性尚不清楚。

方法

我们确定了 314 名接受翻修 TKA 且术前和术后 2 年完成 PROM 的患者。验证包括术前评估局部依赖性、单维性、内部一致性、外部结构有效性、反应性和地板效应,以及术后 2 年的天花板效应。

结果

在接受翻修 TKA 的患者中,KOOS,JR 显示出不存在残余项目相关性、足够的单维性、高内部一致性(个体分离指数:0.897)和与现有验证的 PROM 高度的外部结构有效性,包括 KOOS 疼痛(Spearman 相关系数 0.89)和 KOOS 日常生活活动(0.90)领域。与其他常见的膝关节 PROM 相比,KOOS,JR 对翻修 TKA 的反应性更高(标准化反应均值:1.14)。术前有 3%的翻修 TKA 患者处于地板(最低评分),术后有 9%的患者达到天花板(最高可能评分)。

结论

KOOS,JR 在翻修 TKA 患者的内部一致性、外部有效性、反应性以及地板和天花板效应方面表现良好。我们的结果支持在临床和研究环境中将其扩展用于翻修 TKA。

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