Bisson Leslie J, Goldstein Brett S, Levy Benjamin J
Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, The State University of New York at Buffalo, Buffalo, New York, U.S.A.
Global Asset Allocation at Putnam Investments, Boston Massachusetts, U.S.A.
Arthrosc Sports Med Rehabil. 2022 Dec 5;5(1):e51-e57. doi: 10.1016/j.asmr.2022.10.007. eCollection 2023 Feb.
The purposes of this study were to 1) calculate the minimal clinically important difference (MCID) in a population of patients undergoing arthroscopic partial meniscectomy (APM) based on Knee Injury and Osteoarthritis Outcomes Scores (KOOS), 2) quantify the difference between the proportion of patients reaching MCID based on KOOS versus the proportion who considered surgery to be successful based on a "yes" answer to a patient acceptable symptom state (PASS) question, and 3) calculate the percentage of patients experiencing treatment failure (TF).
A large, single-institution clinical database was queried for patients undergoing isolated APM (>40 years of age). Data were collected at regular time intervals, including KOOS and PASS outcome measures. Calculation of MCID using a distribution-based model was performed using preoperative KOOS scores as baseline. Comparison of the proportion of patients surpassing MCID was made to the proportion of patients answering "yes" to a tiered PASS question at 6 months after APM. Proportion of patients experiencing TF was calculated using patients who responded "no" to a PASS question and "yes" to a TF question.
Three-hundred and fourteen of 969 patients met inclusion criteria. At 6 months following APM, the percentage of patients meeting or exceeding the MCID for each respective KOOS subscore ranged from 64 to 72% compared to 48% who achieved a PASS ( < .0001 for each subscore). Fourteen percent of patients experienced TF.
Six months after APM, approximately one half of the patients achieved a PASS and 15% experienced TF. The difference between achieving MCID based on each of the KOOS subscores and achieving success via PASS ranged from 16% to 24%. Thirty-eight percent of patients undergoing APM did not fit neatly into overt success or failure categorization.
Level III, retrospective cohort study.
本研究的目的是：1）基于膝关节损伤和骨关节炎疗效评分（KOOS），计算接受关节镜下部分半月板切除术（APM）患者群体的最小临床重要差异（MCID）；2）量化基于KOOS达到MCID的患者比例与基于患者可接受症状状态（PASS）问题的“是”答案认为手术成功的患者比例之间的差异；3）计算经历治疗失败（TF）的患者百分比。
查询一个大型单机构临床数据库中接受单纯APM（年龄>40岁）的患者。定期收集数据，包括KOOS和PASS结局指标。使用基于分布的模型，以术前KOOS评分作为基线计算MCID。将超过MCID的患者比例与APM后6个月对分层PASS问题回答“是”的患者比例进行比较。使用对PASS问题回答“否”且对TF问题回答“是”的患者计算经历TF的患者比例。
969例患者中有314例符合纳入标准。APM后6个月，各KOOS子评分达到或超过MCID的患者百分比在64%至72%之间，而达到PASS的患者为48%（各子评分均P<0.0001）。14%的患者经历了TF。
APM后6个月，约一半患者达到PASS，15%经历TF。基于各KOOS子评分达到MCID与通过PASS取得成功之间的差异在16%至24%之间。38%接受APM的患者不属于明显的成功或失败类别。
III级，回顾性队列研究。
