Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland.
J Knee Surg. 2022 Apr;35(5):521-528. doi: 10.1055/s-0040-1716360. Epub 2020 Sep 8.
The purpose of this study was to evaluate Patient-Reported Outcomes Measurement Information System physical function (PROMIS PF) 2 years following knee surgery, and identify preoperative factors associated with postoperative PROMIS PF. Three hundred and sixty-five patients, age 17 years and older, undergoing knee surgery at one institution were studied. Patients completed multiple questionnaires prior to surgery and again 2 years postoperatively including PROMIS PF, International Knee Documentation Committee (IKDC), joint and body numeric pain scales (NPS), Tegner's activity scale (TAS), and Marx's activity rating scale (MARS). Mean PROMIS PF improved from 41.4 to 50.9 at 2 years postoperatively ( < 0.001) and was strongly correlated with 2-year IKDC scores. Older age, female gender, non-Hispanic ethnicity, unemployment, lower income, government insurance, smoking, preoperative opioid use, having a legal claim, comorbidities, previous surgeries, higher body mass index (BMI), and knee arthroplasty were associated with worse 2-year PROMIS PF. Multivariable analysis confirmed that lower BMI, less NPS body pain, and higher MARS were independent predictors of greater 2-year PROMIS PF and better improvement in PROMIS PF. In this large, broad cohort of knee surgery patients, multiple preoperative factors were associated with PROMIS PF 2 years postoperatively. PROMIS PF scores improved significantly, but worse 2 year PROMIS PF scores and less improvement from baseline were independently predicted by higher BMI, greater NPS body pain, and lower MARS activity level. PROMIS PF can be implemented as an efficient means to assess outcomes after knee surgery.
本研究旨在评估膝关节手术后 2 年患者报告结局测量信息系统(PROMIS)的身体机能,并确定与术后 PROMIS 身体机能相关的术前因素。在一个机构中,对 365 名年龄在 17 岁及以上、接受膝关节手术的患者进行了研究。患者在术前和术后 2 年完成了多项问卷,包括 PROMIS 身体机能、国际膝关节文献委员会(IKDC)、关节和身体数字疼痛量表(NPS)、Tegner 活动量表(TAS)和 Marx 活动评分量表(MARS)。术后 2 年,PROMIS 身体机能从 41.4 分提高到 50.9 分(<0.001),与 2 年 IKDC 评分呈强相关性。年龄较大、女性、非西班牙裔、失业、收入较低、政府保险、吸烟、术前使用阿片类药物、有法律诉求、合并症、既往手术、较高的体重指数(BMI)和膝关节置换术与术后 2 年 PROMIS 身体机能较差相关。多变量分析证实,较低的 BMI、较低的 NPS 身体疼痛和较高的 MARS 是 2 年 PROMIS 身体机能更好和 PROMIS 身体机能改善更大的独立预测因素。在这个大型、广泛的膝关节手术患者队列中,多个术前因素与术后 2 年的 PROMIS 身体机能相关。PROMIS 身体机能显著改善,但较高的 BMI、更大的 NPS 身体疼痛和较低的 MARS 活动水平独立预测了较差的 2 年 PROMIS 身体机能和较小的改善。PROMIS 身体机能可以作为一种有效的手段来评估膝关节手术后的结果。