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关节镜部分半月板切除术 4 至 6 年后年轻和老年患者报告结局的变化。

Variation in Patient-Reported Outcomes in Young and Old Patients Up to 4 to 6 Years After Arthroscopic Partial Meniscectomy.

机构信息

Sports and Exercise Medicine, Queen Mary University of London, London, United Kingdom.

Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Faculty of Medicine, Lund University, Lund, Sweden.

出版信息

Clin J Sport Med. 2022 Sep 1;32(5):523-530. doi: 10.1097/JSM.0000000000001011. Epub 2022 Jan 6.

Abstract

OBJECTIVE

To assess the variation in changes in patient-reported outcomes 4 to 6 years after arthroscopic partial meniscectomy (APM).

DESIGN

Prospective cohort study.

SETTING

Orthopedic departments at public hospitals.

PATIENTS

Patients (n = 447) from the Knee Arthroscopy Cohort Southern Denmark undergoing APM.

INTERVENTIONS

All patients underwent APM.

MAIN OUTCOME MEASURES

Change in KOOS4 scores from baseline before surgery to ∼5 years (range 4-6 years) after surgery. KOOS4 is the average aggregated score of 4 of 5 of the Knee injury and Osteoarthritis Outcome Score (KOOS) excluding the activities of daily living subscale (minimal clinical important improvement ∼10 points). A mixed linear model adjusted for sex and body mass index was used to assess change from baseline to ∼5-year follow-up. Change in KOOS4 was divided into 5 categories based on change from baseline to ∼5-year follow-up: <0 points, 0 to 9 points, 10 to 19 points, 20 to 29 points, and ≥30 points.

RESULTS

On average, patient-reported outcomes continued to improve from baseline to ∼5-year follow-up (mean KOOS4 change: 26, 95% CI, 24-28). Proportions in the different response groups were <0 points (12%), 0 to 9 points (13%), 10 to 19 points (16%), 20 to 29 points (19%), and ≥30 points (40%), with no difference between younger (≤40 years, n = 75) and older (>40 years, n = 337) patients (P = 0.898).

CONCLUSIONS

Patient-reported outcomes on average improved up to ∼5 years after APM; however, large variability was observed. The similar variability in younger and older patients questions the assumption that younger patients with traumatic injuries experience larger benefits from APM.

摘要

目的

评估关节镜下半月板部分切除术(APM)后 4 至 6 年患者报告结局的变化。

设计

前瞻性队列研究。

地点

公立医院的骨科系。

患者

来自丹麦南部膝关节镜队列的患者(n=447),行 APM。

干预措施

所有患者均行 APM。

主要观察指标

手术前基线时 KOOS4 评分与术后约 5 年(4-6 年)的变化。KOOS4 是膝关节损伤和骨关节炎结局评分(KOOS)的 5 项中的 4 项(不包括日常生活活动量表)的平均综合评分(最小临床重要改善约 10 分)。采用混合线性模型,根据性别和体重指数调整,评估从基线到 5 年随访的变化。根据从基线到 5 年随访的变化,将 KOOS4 的变化分为 5 类:<0 分、0 至 9 分、10 至 19 分、20 至 29 分和≥30 分。

结果

平均而言,患者报告的结果从基线到 5 年随访持续改善(平均 KOOS4 变化:26,95%CI,24-28)。不同反应组的比例分别为<0 分(12%)、0 至 9 分(13%)、10 至 19 分(16%)、20 至 29 分(19%)和≥30 分(40%),年轻患者(≤40 岁,n=75)和年长患者(>40 岁,n=337)之间无差异(P=0.898)。

结论

APM 后平均 5 年内患者报告的结局有所改善;然而,观察到很大的变异性。年轻和年长患者的变异性相似,这对年轻创伤性损伤患者从 APM 中获得更大益处的假设提出了质疑。

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