Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Deutschland.
Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Germany.
Z Orthop Unfall. 2023 Dec;161(6):637-647. doi: 10.1055/a-1753-9968. Epub 2022 Apr 4.
The subjective evaluation of the patient's state of health with the help of Patient-reported Outcome Measurements (PROMs) provides valuable information for assessing the treatment outcome and for treatment planning. However, the use of PROMs in the field of arthroplasty is not mandatory, so that there is a lack of standardised recording and interpretation. The present study aims to identify patients, who have not achieved the intended treatment goals with regard to pain, function and quality of life after total knee arthroplasty, more easily in the future on the basis of postoperative PROMs.
Data collection (for 3-month postoperative follow-up) included a standardised clinical follow-up (NU) and a questionnaire of different PROMs (Oxford Knee Score [OKS], OKS Pain Score [OKSS] and EndoCert Risk Score [ERS]). During the specialist follow-up examination, it was decided whether further medical therapy had to be initiated. Accordingly, patients were grouped into four post-treatment categories (NU not required/further diagnostics/new prescription/revision required).
For individual scores and questions, there were significant differences between the respective groups of consequences resulting from the follow-up examination. The OKS, OKS Pain Score and the ERS are suitable for detecting thresholds to determine the need for a follow-up examination. The postoperative thresholds of the scores are 24 for the OKS total score, 52 for the OKS pain score and 4 for the ERS pain intensity score.
In the initial three months after knee arthroplasty, certain PROMs are suitable for identifying patients for whom further diagnostics and therapy are indicated. In particular, the OKS and the pain intensity score of the ERS are suitable for detecting a potentially unfavourable development in rehabilitation after total knee arthroplasty.
借助患者报告的结果测量（PROMs）对患者的健康状况进行主观评估，可以为评估治疗效果和治疗计划提供有价值的信息。然而，在关节置换领域，PROM 的使用并非强制性的，因此缺乏标准化的记录和解释。本研究旨在基于术后 PROM，更轻松地识别出那些在全膝关节置换术后疼痛、功能和生活质量方面未达到预期治疗目标的患者。
数据收集（用于术后 3 个月随访）包括标准化的临床随访（NU）和不同 PROM 的问卷（牛津膝关节评分[OKS]、OKS 疼痛评分[OKSS]和 EndoCert 风险评分[ERS]）。在专科随访检查期间，决定是否需要启动进一步的医疗治疗。因此，患者被分为四个治疗后类别（无需 NU/进一步诊断/新处方/需要修订）。
对于个别评分和问题，在随访检查的各个后果组之间存在显著差异。OKS、OKS 疼痛评分和 ERS 适用于检测确定随访检查必要性的阈值。评分的术后阈值为：OKS 总分 24 分、OKS 疼痛评分 52 分和 ERS 疼痛强度评分 4 分。
在膝关节置换术后的最初三个月，某些 PROM 适用于识别需要进一步诊断和治疗的患者。特别是 OKS 和 ERS 的疼痛强度评分适用于检测全膝关节置换术后康复中潜在的不利发展。
