术前功能影响全膝关节置换术患者实现一年最小临床重要差异的能力。

Preoperative Function Affects Ability to Achieve One-Year Minimum Clinically Important Difference for Patients Undergoing Total Knee Arthroplasty.

作者信息

Albright Patrick, Huyke-Hernández Fernando A, Ormseth Andrew, Doxey Stephen A, Banks Evan, Only Arthur J, Horst Patrick K, Cunningham Brian P

机构信息

Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Department of Orthopaedic Surgery, Park Nicollet Methodist Hospital, St. Louis Park, MN, USA.

出版信息

Arthroplast Today. 2024 Apr 16;27:101377. doi: 10.1016/j.artd.2024.101377. eCollection 2024 Jun.

Abstract

BACKGROUND

Minimum clinically important difference (MCID) values are commonly used to measure treatment success for total knee arthroplasty (TKA). MCID values vary according to calculation methodology, and prior studies have shown that patient factors are associated with failure to achieve MCID thresholds. The purpose of this study was to determine if anchor-based 1-year Knee Injury and Osteoarthritis Outcome Score Joint Replacement (KOOS-JR) MCID values varied among patients undergoing TKA based on patient-specific factors.

METHODS

This was a retrospective review of patients undergoing TKA from 2017-2018. Patients without baseline or 1-year KOOS-JR or Patient-Reported Outcome Measurement Information System Global Health data or that underwent procedures other than primary TKA were excluded. MCIDs were calculated and compared between patient groups according to preoperative characteristics.

RESULTS

Among the included 976 patients, 1-year KOOS-JR MCIDs were 26.6 for men, 28.2 for women, 30.7 for patients with a diagnosis of anxiety and/or depression, and 26.7 for patients without a diagnosis. One-year MCID values did not differ significantly according to gender ( = .379) or mental health diagnosis ( = .066), nor did they correlate with body mass index ( = -0.034,  = .822). Preoperative KOOS-JR decile demonstrated an inverse relationship with 1-year MCID values and attainment of MCID.

CONCLUSIONS

The proportion of patients attaining KOOS-JR MCID values demonstrated an inverse relationship with preoperative baseline function. Future investigation may identify patient factors that allow surgeons to better capture patient satisfaction with their procedure despite failure to attain a 1-year MCID.

摘要

背景

最小临床重要差异(MCID)值常用于衡量全膝关节置换术(TKA)的治疗效果。MCID值因计算方法而异,先前的研究表明患者因素与未达到MCID阈值有关。本研究的目的是确定基于锚定的1年膝关节损伤和骨关节炎疗效评分关节置换(KOOS-JR)MCID值在接受TKA的患者中是否因患者特定因素而有所不同。

方法

这是一项对2017年至2018年接受TKA患者的回顾性研究。排除没有基线或1年KOOS-JR或患者报告的结局测量信息系统全球健康数据的患者,以及接受除初次TKA以外手术的患者。根据术前特征计算MCID并在患者组之间进行比较。

结果

在纳入的976例患者中,男性的1年KOOS-JR MCID为26.6,女性为28.2,诊断为焦虑和/或抑郁的患者为30.7,未诊断的患者为26.7。1年MCID值在性别方面(P = 0.379)或心理健康诊断方面(P = 0.066)无显著差异,也与体重指数无相关性(r = -0.034,P = 0.822)。术前KOOS-JR十分位数与1年MCID值及达到MCID呈负相关。

结论

达到KOOS-JR MCID值的患者比例与术前基线功能呈负相关。未来的研究可能会确定一些患者因素,使外科医生能够更好地了解患者对手术的满意度,尽管未达到1年MCID。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e25/11035092/7007b3d6eb61/gr1.jpg

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