Everett Brandon Paul, Sherrill Garrett, Nakonezny Paul A, Wells Joel E
Department of Orthopaedic Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Bone Jt Open. 2022 Apr;3(4):332-339. doi: 10.1302/2633-1462.34.BJO-2021-0206.R1.
This study aims to answer the following questions in patients with hip osteoarthritis (OA) who underwent total hip arthroplasty (THA): are patient-reported outcome measures (PROMs) affected by the location of the maximum severity of pain?; are PROMs affected by the presence of non-groin pain?; are PROMs affected by the severity of pain?; and are PROMs affected by the number of pain locations?
We reviewed 336 hips (305 patients) treated with THA for hip OA from December 2016 to November 2019 using pain location/severity questionnaires, modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), international Hip Outcome Tool (iHOT-12) score, and radiological analysis. Descriptive statistics, analysis of covariance (ANCOVA), and Spearman partial correlation coefficients were used.
There was a significant difference in iHOT-12 scores between groups experiencing the most severe pain in the groin and the trochanter (p = 0.039). Additionally, more favourable mHHS scores were related to the presence of preoperative pain in trochanter (p = 0.049), lower back (p = 0.056), lateral thigh (p = 0.034), and posterior thigh (p = 0.005). Finally, the maximum severity of preoperative pain and number of pain locations had no significant relationship with PROMs (maximum severity: HHS: p = 0.928, HOS: p = 0.163, iHOT-12 p = 0.233; number of pain locations: HHS: p = 0.211; HOS: p = 0.801; iHOT-12: p = 0.112).
Although there was a significant difference in iHOT-12 scores between patients with the most severe pain in the groin or trochanter, and the presence of pain in the trochanter, lower back, lateral thigh, or posterior thigh was related to higher mHHS scores, the majority of preoperative pain characteristics did not have a significant impact on outcomes. Therefore, a broad array of patients with hip OA might expect similar, favourable outcomes from THA notwithstanding preoperative pain characteristics. Cite this article: 2022;3(4):332-339.
本研究旨在回答以下问题，这些问题针对接受全髋关节置换术（THA）的髋骨关节炎（OA）患者：患者报告的结局指标（PROMs）是否受疼痛最严重部位的影响？PROMs是否受非腹股沟区疼痛的影响？PROMs是否受疼痛严重程度的影响？以及PROMs是否受疼痛部位数量的影响？
我们回顾了2016年12月至2019年11月期间接受THA治疗髋OA的336例髋关节（305例患者），使用疼痛部位/严重程度问卷、改良Harris髋关节评分（mHHS）、髋关节结局评分（HOS）、国际髋关节结局工具（iHOT-12）评分以及影像学分析。采用描述性统计、协方差分析（ANCOVA）和Spearman偏相关系数。
腹股沟区疼痛最严重和转子区疼痛最严重的两组患者在iHOT-12评分上存在显著差异（p = 0.039）。此外，更有利的mHHS评分与术前转子区疼痛（p = 0.049）、下背部疼痛（p = 0.056）、大腿外侧疼痛（p = 0.034）和大腿后侧疼痛（p = 0.005）的存在有关。最后，术前疼痛的最大严重程度和疼痛部位数量与PROMs无显著关系（最大严重程度：HHS：p = 0.928，HOS：p = 0.163，iHOT-12：p = 0.233；疼痛部位数量：HHS：p = 0.211；HOS：p = 0.801；iHOT-12：p = 0.112）。
尽管腹股沟区或转子区疼痛最严重的患者与iHOT-12评分存在显著差异，并且转子区、下背部、大腿外侧或大腿后侧疼痛的存在与更高的mHHS评分相关，但大多数术前疼痛特征对结局没有显著影响。因此，尽管存在术前疼痛特征，广泛的髋OA患者可能期望从THA获得相似的良好结局。引用本文：2022；3(4)：332 - 339。
