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采用膝关节损伤和骨关节炎疗效评分来解读关节镜下半月板手术后短期治疗结果的临界值。

Cutoff Values to Interpret Short-term Treatment Outcomes After Arthroscopic Meniscal Surgery, Measured With the Knee Injury and Osteoarthritis Outcome Score.

作者信息

Pedersen Julie Rønne, Roos Ewa M, Thorlund Jonas Bloch, Terluin Berend, Ingelsrud Lina Holm

出版信息

J Orthop Sports Phys Ther. 2021 Jun;51(6):281-288. doi: 10.2519/jospt.2021.10149. Epub 2021 Jan 30.

Abstract

OBJECTIVE

To determine the proportions of patients who (1) perceived their symptoms to be satisfactory, (2) perceived their treatment to have failed, or (3) perceived that they improved to an important degree at 3 months after arthroscopic meniscal surgery; and to determine Knee injury and Osteoarthritis Outcome Score (KOOS) subscale scores corresponding to the Patient Acceptable Symptom State (PASS), treatment failure, and the minimal important change (MIC) for improvement.

DESIGN

Prospective cohort study.

METHODS

Patients from the Knee Arthroscopy Cohort Southern Denmark who had arthroscopic meniscal surgery were included. The PASS, treatment failure, and MIC improvement values were calculated for the KOOS subscales with anchor-based approaches, using the adjusted predictive modeling method. Subgroup analyses were performed by stratifying by age (40 years or younger versus older than 40 years) and surgery type.

RESULTS

Six hundred fourteen patients (44% female; mean ± SD age, 50 ± 13 years) were included. At 3 months after arthroscopic meniscal surgery, 45% of patients perceived their symptoms to be satisfactory, 19% perceived the treatment to have failed, and 44% to 60% perceived that they had improved to an important degree across the 5 KOOS subscales (for PASS/treatment failure, respectively: pain, 74 and 60 points; symptoms, 72 and 61 points; function in activities of daily living, 81 and 68 points; sport and recreational function, 43 and 26 points; and knee-related quality of life, 52 and 40 points; for MIC improvement: pain, 12 points; symptoms, 8 points; function in activities of daily living, 12 points; sport and recreational function, 17 points; and knee-related quality of life, 9 points). The PASS values were 6 to 17 points higher for patients 40 years or younger compared to patients older than 40 years.

CONCLUSION

At 3 months after meniscal surgery, approximately half of the patients perceived their symptoms to have improved to an important degree, 4 in every 10 patients perceived their symptoms to be satisfactory, and 2 in every 10 patients perceived the treatment to have failed. .

摘要

目的

确定在关节镜下半月板手术后3个月时,(1)认为其症状令人满意、(2)认为其治疗失败、或(3)认为自己有显著改善的患者比例;并确定与患者可接受症状状态(PASS)、治疗失败及改善的最小重要变化(MIC)相对应的膝关节损伤和骨关节炎疗效评分(KOOS)子量表得分。

设计

前瞻性队列研究。

方法

纳入丹麦南部膝关节镜检查队列中接受关节镜下半月板手术的患者。采用基于锚定的方法,使用调整后的预测建模方法计算KOOS子量表的PASS、治疗失败及MIC改善值。按年龄(40岁及以下与40岁以上)和手术类型进行亚组分析。

结果

纳入614例患者(44%为女性;平均±标准差年龄,50±13岁)。在关节镜下半月板手术后3个月,45%的患者认为其症状令人满意,19%的患者认为治疗失败,44%至60%的患者认为在5个KOOS子量表上有显著改善(分别针对PASS/治疗失败:疼痛,74和60分;症状,72和61分;日常生活活动功能,81和68分;运动和娱乐功能,43和26分;以及膝关节相关生活质量,52和40分;针对MIC改善:疼痛,12分;症状,8分;日常生活活动功能,12分;运动和娱乐功能,17分;以及膝关节相关生活质量9分)。40岁及以下患者的PASS值比40岁以上患者高6至17分。

结论

在半月板手术后3个月,约一半的患者认为其症状有显著改善,十分之四的患者认为其症状令人满意,十分之二的患者认为治疗失败。

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