Ulivi Michele, Orlandini Luca, Meroni Valentina, D'Errico Mario, Fontana Arianna, Viganò Marco, Mangiavini Laura, D'Anchise Roberto, Parente Franco, Pozzoni Roberto, Sansone Valerio, Zagra Luigi, Peretti Giuseppe M
IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy.
Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy.
Healthcare (Basel). 2021 Sep 29;9(10):1296. doi: 10.3390/healthcare9101296.
In 2020, due to the outbreak of the COVID-19 (Coronavirus Disease 2019) pandemic, patients who underwent total joint arthroplasty were not able to undergo the proper postoperative surgical and rehabilitative care. This study aims to evaluate the potential of a web-cloud-based database on patients' follow-up in extraordinary situations, when a traditional in-person follow-up cannot be warranted.
Patients who underwent joint arthroplasty at our Institute between 21 February and 16 March 2020 were included in the study group and were matched to a similar population undergoing joint arthroplasty in February/March 2019. All patients routinely complete questionnaires before and after treatment, including patient-reported outcome measures such as the Visual Analogues Scale (VAS), Knee/Hip Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS/HOOS-PS) and Short-Form Health Survey (SF-12) for the monitoring of clinical improvements.
56 (study group) and 144 (control group) patients were included in the study. Both groups demonstrated significant improvements at 3 months. HOOS-PS improvement was significantly reduced in the 2020 group compared to 2019 (21.7 vs. 33.9, < 0.001). This reduction was related to intense physical activities. Similarly, the functional score improvement related to these activities was reduced for patients undergoing knee replacement (8 vs. 10, < 0.05).
The web-based Institute Registry emerged as a meaningful and sensitive tool during an extraordinary situation such as the COVID-19 pandemic to monitor patients' progression after total joint arthroplasties. Thanks to this tool, it was possible to observe that the prevention of usual postoperative care due to pandemic-related restrictions did not alter the benefits observed after joint replacement surgeries, even if this condition reduced the postoperative improvements in the most burdensome physical activities. A broader use of this kind of tool would improve and potentially reduce the burden and costs of postoperative patients' monitoring in standard and extraordinary conditions. In addition, the systematic remote collection of data would allow for the identification of relevant differences in clinical outcomes in specific conditions or following the modification of treatment and rehabilitation protocols.
2020年，由于新型冠状病毒肺炎（COVID-19）大流行爆发，接受全关节置换术的患者无法获得适当的术后手术和康复护理。本研究旨在评估基于网络云数据库在特殊情况下对患者进行随访的潜力，此时无法保证进行传统的面对面随访。
2020年2月21日至3月16日期间在我院接受关节置换术的患者纳入研究组，并与2019年2月/3月接受关节置换术的类似人群进行匹配。所有患者在治疗前后常规完成问卷，包括患者报告的结局指标，如视觉模拟量表（VAS）、膝关节/髋关节损伤和骨关节炎结局评分身体功能简表（KOOS-PS/HOOS-PS）以及简短健康调查问卷（SF-12），以监测临床改善情况。
56例（研究组）和144例（对照组）患者纳入研究。两组在3个月时均有显著改善。与2019年相比，2020年组HOOS-PS的改善显著降低（21.7对33.9，<0.001）。这种降低与剧烈的体力活动有关。同样，膝关节置换患者与这些活动相关的功能评分改善也降低（8对10，<0.05）。
在COVID-19大流行等特殊情况下，基于网络的机构登记系统成为监测全关节置换术后患者进展的一种有意义且敏感的工具。借助该工具，可以观察到由于大流行相关限制而导致的常规术后护理预防并未改变关节置换手术后观察到的益处，即使这种情况降低了最繁重体力活动的术后改善程度。更广泛地使用这种工具将改善并可能减轻标准和特殊情况下术后患者监测的负担和成本。此外，系统地远程收集数据将有助于识别特定条件下或治疗与康复方案修改后的临床结局相关差异。
