Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
Int Orthop. 2021 Jul;45(7):1761-1766. doi: 10.1007/s00264-020-04919-w. Epub 2021 Jan 4.
Comparing symptoms of patients with focal cartilage defects of the knee to those with knee osteoarthritis.
Prospectively maintained databases identified patients with focal cartilage defects (FCD group) who underwent osteochondral allograft transplantation and patients with osteoarthritis (OA group) undergoing arthroplasty. Patients between 18 and 55 years of age were included and matched based on age. Baseline patient demographics, symptoms, and patient-reported outcomes including the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR), SF-12, and VR-12 questionnaires were recorded. Patient symptoms and individual responses of the KOOS JR were compared between groups. Regression analysis was used to evaluate the association between pre-operative factors that significantly differed between groups and the KOOS JR questionnaire.
Sixty-four patients were included: 32 patients in each group. The FCD group had a significantly lower body mass index (BMI) (p = 0.04) and greater number of workers' compensation cases (p = 0.027) when compared to the OA group. Patients in the OA group complained more frequently of medial-sided pain (p = 0.02) and knee swelling (p = 0.003). The OA cohort also had greater pain with fully straightening the knee (p = 0.012), pain with standing upright (p = 0.016), and pain with rising from sitting (p = 0.003). Patients in the FCD group had greater KOOS JR outcome scores (51.5 ± 12.9 vs. 41.5 ± 20.5; p = 0.023).
When compared to patients with focal cartilage defects, adults with knee osteoarthritis scheduled for knee arthroplasty have a more severe presentation of symptoms, particularly medial-sided pain, swelling of the knee, pain associated with straightening the knee, standing upright, and rising from sitting.
比较膝关节局灶性软骨缺损患者与膝骨关节炎患者的症状。
前瞻性维护的数据库确定了接受骨软骨同种异体移植的局灶性软骨缺损（FCD 组）患者和接受关节置换术的骨关节炎（OA）患者。纳入年龄在 18 至 55 岁之间的患者，并根据年龄进行匹配。记录基线患者人口统计学、症状和患者报告的结果，包括膝关节骨关节炎评分（KOOS JR）、SF-12 和 VR-12 问卷。比较两组患者的症状和 KOOS JR 问卷的个体反应。回归分析用于评估组间存在显著差异的术前因素与 KOOS JR 问卷之间的关联。
共纳入 64 例患者：每组 32 例。与 OA 组相比，FCD 组的体重指数（BMI）明显较低（p = 0.04），且有更多的工人赔偿病例（p = 0.027）。OA 组患者更频繁地抱怨内侧疼痛（p = 0.02）和膝关节肿胀（p = 0.003）。OA 组患者在完全伸直膝关节时疼痛（p = 0.012）、直立时疼痛（p = 0.016）和从座位起身时疼痛（p = 0.003）也更为严重。FCD 组患者的 KOOS JR 结局评分更高（51.5 ± 12.9 比 41.5 ± 20.5；p = 0.023）。
与局灶性软骨缺损患者相比，计划行膝关节置换术的膝骨关节炎成年患者的症状表现更为严重，尤其是内侧疼痛、膝关节肿胀、伸直膝关节、直立和从座位起身时疼痛。
