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关节镜下半月板手术后3个月和12个月时膝关节损伤与骨关节炎疗效评分的解读阈值。有哪些变化,哪些保持不变?

Knee Injury and Osteoarthritis Outcome Score Interpretation Thresholds at 3 and 12 Months After Arthroscopic Meniscal Surgery. What Changes, and What Stays the Same?

作者信息

Ingelsrud Lina Holm, Terluin Berend, Thorlund Jonas Bloch, Pedersen Julie Rønne, Roos Ewa M

出版信息

J Orthop Sports Phys Ther. 2023 Nov;53(11):685-702. doi: 10.2519/jospt.2023.11993.

DOI:10.2519/jospt.2023.11993
PMID:37787579
Abstract

To evaluate the change in minimal important change (MIC), patient acceptable symptom state (PASS), and treatment failure (TF) thresholds for the Knee injury and Osteoarthritis Outcome Score (KOOS) from 3 to 12 months following arthroscopic meniscus surgery. Retrospective cohort study. We included patients from the Knee Arthroscopy Cohort Southern Denmark who had meniscus surgery between 2013 and 2015. We calculated the interpretation threshold values for MIC, PASS, and TF using an anchor-based adjusted predictive modeling method. Thresholds at 3 and 12 months postoperatively were compared to evaluate changes over time. The proportions of people who reported a clinically relevant improvement, or their symptoms being acceptable, increased by 10% to 15% points from 3 to 12 months after surgery. MIC thresholds for the 5 KOOS subscales remained stable from 3 to 12 months with statistically nonsignificant differences (95% confidence intervals) ranging from -0.3 (-3.0, 2.6) to -2.4 (-6.1, 1.3). All PASS thresholds except for quality of life (QOL) decreased by -6.5 (-11.8, -1.5) to -3.7 (-7.1, -0.4) points, indicating that higher symptom levels were accepted at 12 months. In contrast, the proportion reporting their treatment to have failed remained stable over time (19% and 17%). For QOL, a 7.4 (2.0, 13.2) higher TF threshold at 12 months suggested that improved QOL was required to not consider that the treatment had failed. More patients reported being improved at 1 year compared to at 3 months following meniscus surgery. The KOOS MIC thresholds were stable over time, whereas time-specific PASS values should be applied after meniscus surgery. .

摘要

为评估关节镜下半月板手术后3至12个月时,膝关节损伤和骨关节炎疗效评分(KOOS)的最小重要变化(MIC)、患者可接受症状状态(PASS)及治疗失败(TF)阈值的变化。进行回顾性队列研究。我们纳入了2013年至2015年间在丹麦南部膝关节镜检查队列中接受半月板手术的患者。我们使用基于锚定的调整预测建模方法计算了MIC、PASS和TF的解释阈值。比较术后3个月和12个月时的阈值,以评估随时间的变化。报告有临床相关改善或症状可接受的人群比例在术后3至12个月增加了10%至15个百分点。5个KOOS子量表的MIC阈值在3至12个月期间保持稳定,差异无统计学意义(95%置信区间),范围从-0.3(-3.0,2.6)至-2.4(-6.1,1.3)。除生活质量(QOL)外,所有PASS阈值均下降了-6.5(-11.8,-1.5)至-3.7(-7.1,-0.4)分,表明12个月时可接受更高的症状水平。相比之下,报告治疗失败的比例随时间保持稳定(19%和17%)。对于QOL,12个月时TF阈值高7.4(2.0,13.2)表明需要改善QOL才不认为治疗失败。与半月板手术后3个月相比,更多患者在1年时报告病情有所改善。KOOS的MIC阈值随时间稳定,而半月板手术后应应用特定时间的PASS值。

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