Triana Jairo, DeClouette Brittany, Montgomery Samuel R, Avila Amanda, Shankar Dhruv S, Alaia Michael J, Strauss Eric J, Campbell Kirk A
Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, New York, USA.
Knee Surg Sports Traumatol Arthrosc. 2024 Feb;32(2):490-498. doi: 10.1002/ksa.12067. Epub 2024 Jan 31.
The purpose of this study is to describe the postoperative psychological state of patients following osteochondral allograft (OCA) transplantation in the knee and to determine whether patient-perceived kinesiophobia is associated with the rate of return to sport (RTS).
A retrospective review of the electronic medical record at a single institution was conducted for all patients that underwent OCA transplantation from January 2010 to 2020. Patient-reported outcomes including the visual analog scale (VAS), knee injury and osteoarthritis outcome score (KOOS) and the Tampa scale of kinesiophobia-11 (TSK-11) were collected. Patients were surveyed regarding their postoperative RTS status.
A total of 38 patients (52.6% female) were included in our analysis. Overall, 24 patients (63.2%) returned to sport with 12 (50%) of these patients returning at a lower level of play. When comparing patients that return to sport to those that did not, patients that return had significantly superior KOOS pain (p = 0.019) and KOOS QOL (p = 0.011). Measures of kinesiophobia (TSK-11) were significantly higher among patients that did not return to sport (p = 0.014), while satisfaction (n.s.) and pain intensity (n.s.) were comparable between groups. Logistic regression models controlling for demographic factors, VAS pain scores and lesion size showed that for every one-point increase in TSK-11 kinesiophobia score, patients were 1.33 times more likely to return to sport at a lower level (p = 0.009). For every one-point increase in TSK-11 scores KOOS QOL decreased by 2.4 points (p < 0.001).
Fear of reinjury decreases the likelihood that patients will return to their preoperative level of sport after OCA transplantation. Patients that do not return to sport report significantly greater fear of reinjury and inferior clinical outcomes, despite similar levels of satisfaction and pain compared to those that return.
Level III.
本研究旨在描述膝关节同种异体骨软骨移植（OCA）术后患者的心理状态，并确定患者感知的运动恐惧是否与恢复运动（RTS）率相关。
对2010年1月至2020年在单一机构接受OCA移植的所有患者的电子病历进行回顾性分析。收集患者报告的结果，包括视觉模拟量表（VAS）、膝关节损伤和骨关节炎结局评分（KOOS）以及坦帕运动恐惧量表-11（TSK-11）。就患者术后RTS状态进行调查。
共有38例患者（52.6%为女性）纳入分析。总体而言，24例患者（63.2%）恢复运动，其中12例（50%）以较低运动水平恢复。将恢复运动的患者与未恢复运动的患者进行比较，恢复运动的患者在KOOS疼痛方面显著更好（p = 0.019），在KOOS生活质量方面也显著更好（p = 0.011）。未恢复运动的患者运动恐惧（TSK-11）测量值显著更高（p = 0.014），而两组之间的满意度（无显著差异）和疼痛强度（无显著差异）相当。控制人口统计学因素、VAS疼痛评分和病变大小的逻辑回归模型显示，TSK-11运动恐惧评分每增加1分，患者以较低水平恢复运动的可能性增加1.33倍（p = 0.009）。TSK-11评分每增加1分，KOOS生活质量下降2.4分（p < 0.001）。
对再次受伤的恐惧降低了OCA移植术后患者恢复到术前运动水平的可能性。未恢复运动的患者报告的再次受伤恐惧明显更大，临床结局更差，尽管与恢复运动的患者相比，满意度和疼痛水平相似。
三级。
