Penrose Colin T, George Steven Z, Bolognesi Michael P, Bhavsar Nrupen A, Horn Maggie E
Division of Adult Reconstruction, Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
Department of Orthopaedic Surgery and Duke Clinical Research Institute, Duke University, Durham, NC, USA.
Arthroplast Today. 2023 Sep 19;23:101208. doi: 10.1016/j.artd.2023.101208. eCollection 2023 Oct.
Physical function and pain outcomes vary after arthroplasty. We investigated differences in postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) and pain interference (PI) scores for patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA). We aimed to identify preoperative factors that predict postoperative PROMIS scores.
Patients who underwent TKA and THA from 2014-2020 were eligible. Preoperative variables including demographics, comorbidities, and pain scores were obtained from the medical record. Patients completed surveys measuring postoperative PF and PI. Descriptive statistics and separate linear regression models for each anatomical location were performed to examine factors predicting postoperative PROMIS PF and PI scores.
Surveys were completed by 2411 patients (19.5% response rate). Unadjusted mean PF postoperative scores were 47.2 for TKA and 48.8 for THA. Preoperative predictors of lower PF included female sex; body mass index and comorbidities for TKA and THA; and age, tobacco use, and non-White race for THA. Mean PI scores were 47.9 for THA and 49.0 for TKA. Preoperative predictors of increased PI included non-White race and increased body mass index for TKA and THA; higher preoperative pain for TKA; and female sex and increased comorbidity for THA.
Postoperative PROMIS scores were similar for TKA and THA, with THA having slightly higher PF and lower PI scores. Regression models using preoperative variables showed similar performance for TKA compared with THA. These findings suggest areas for future development of clinical decision support tools.
关节置换术后身体功能和疼痛结果各不相同。我们调查了接受全膝关节置换术（TKA）和全髋关节置换术（THA）的患者术后患者报告结局测量信息系统（PROMIS）身体功能（PF）和疼痛干扰（PI）评分的差异。我们旨在确定预测术后PROMIS评分的术前因素。
2014年至2020年接受TKA和THA的患者符合条件。从病历中获取术前变量，包括人口统计学、合并症和疼痛评分。患者完成测量术后PF和PI的调查。进行描述性统计以及针对每个解剖部位的单独线性回归模型，以检查预测术后PROMIS PF和PI评分的因素。
2411名患者完成了调查（回复率为19.5%）。TKA术后未调整的平均PF评分为47.2，THA为48.8。PF较低的术前预测因素包括女性；TKA和THA的体重指数和合并症；以及THA的年龄、吸烟和非白人种族。THA的平均PI评分为47.9，TKA为49.0。PI增加的术前预测因素包括TKA和THA的非白人种族和体重指数增加；TKA术前疼痛较高；以及THA的女性和合并症增加。
TKA和THA术后的PROMIS评分相似，THA的PF略高，PI评分略低。使用术前变量的回归模型显示，与THA相比，TKA的表现相似。这些发现为临床决策支持工具的未来发展指明了方向。
