Bouras Theodoros, Tzanos Ioannis-Alexandros, Forster Mark, Panagiotopoulos Elias
Department of Rehabilitation, Patras University Hospital, Patras, Greece.
Department of Trauma and Orthopaedics, Cardiff and Vale UHB, University Hospital Llandough, Llandough, Wales, UK.
Eur J Orthop Surg Traumatol. 2021 Aug;31(6):1171-1177. doi: 10.1007/s00590-020-02867-0. Epub 2021 Jan 8.
The relationship between instrumented knee measurements and patient-reported outcome measures is a newer field that continues to evolve. The aim of this study was to evaluate long-term quality of life (QoL) post-total knee arthroplasty (TKA) surgery correlating validated self-reported questionnaires, clinical examination and instrumented analysis, using baropodometry and accelerometry.
Thirty-six patients who underwent primary unilateral TKA between 1999 and 2006 were evaluated at 11.3 ± 2.3 years following surgery. Clinical examination included range of motion (ROM) and instrumented knee laxity measurements with the Rolimeter device. The visual analogue scale (VAS) for pain was also recorded. The utilised subjective outcome scores were the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the short form of World Health Organisation Quality of Life (WHOQOL-BREF). Instrumented analysis was performed with baropodometry and accelerometry. QoL was assessed correlating clinical, subjective and instrumented results. Univariate analysis included the Spearman's Rho correlation coefficient and Mann-Whitney tests.
At the long-term follow-up all patients had relatively high quality of life measurements, as well as functional scores, except for the Sport/Rec dimension of the KOOS score. Only cadence (p = 0.008) and velocity (p = 0.026) affected the WHOQOL psychology domain no matter the age, follow-up and gender of the patients. The domain was unaffected by VAS and Rolimeter measurements. WHOQOL Social domain was unaffected by all instrumentation measurements except for stance phase (p = 0.025), VAS (p = 0.005) and ROM (p = 0.028). KOOS physical domain was not affected by any parameter. KOOS pain was reversely affected by VAS (p = 0.004), KOOS symptom by ROM (p = 0.000 and median maximum pressure (p = 0.033).
Quality of life for the TKA patient can be correlated and assessed reliably with instrumented analysis using pedobarography and accelerometry, at the long-term follow-up.
III.
仪器化膝关节测量与患者报告的结局指标之间的关系是一个不断发展的新领域。本研究的目的是通过压力平板步行测试和加速度测量，评估全膝关节置换术（TKA）后长期的生活质量（QoL），并将经过验证的自我报告问卷、临床检查和仪器化分析相关联。
对1999年至2006年间接受初次单侧TKA的36例患者在术后11.3±2.3年进行评估。临床检查包括使用Rolimeter装置测量活动范围（ROM）和仪器化膝关节松弛度。还记录了疼痛视觉模拟量表（VAS）。使用的主观结局评分是膝关节损伤和骨关节炎结局评分（KOOS）以及世界卫生组织生活质量简表（WHOQOL-BREF）。通过压力平板步行测试和加速度测量进行仪器化分析。通过关联临床、主观和仪器化结果来评估生活质量。单因素分析包括Spearman等级相关系数和Mann-Whitney检验。
在长期随访中，除KOOS评分的运动/娱乐维度外，所有患者的生活质量测量值和功能评分相对较高。无论患者的年龄、随访时间和性别如何，只有步频（p = 0.008）和速度（p = 0.026）影响WHOQOL心理领域。该领域不受VAS和Rolimeter测量的影响。WHOQOL社会领域除了站立期（p = 0.025）、VAS（p = 0.005）和ROM（p = 0.028）外，不受所有仪器测量的影响。KOOS身体领域不受任何参数影响。KOOS疼痛受VAS反向影响（p = 0.004），KOOS症状受ROM（p = 0.000）和中位最大压力（p = 0.033）影响。
在长期随访中，TKA患者的生活质量可以通过使用足底压力分析和加速度测量的仪器化分析进行可靠的关联和评估。
III级。
