Sulaiman Muhammad Ahsan, Ghazni Muhammad Ahmed, Farooq Muhammad Omer, Arshad Khan Muhammad Arbaz, Noor S M Nabeel, Hashmi Pervaiz
Orthopedics, Aga Khan University Hospital, Karachi, PAK.
Cureus. 2024 Jul 28;16(7):e65563. doi: 10.7759/cureus.65563. eCollection 2024 Jul.
Introduction The most common degenerative joint disease in adults is osteoarthritis. The gold standard treatment option for this aging society with greater functional demands is total knee arthroplasty. The Oxford Knee Score (OKS) assesses factors such as stiffness, pain, function, satisfaction, and quality of life, allowing you to quantify treatment success after surgery. According to published research, there isn't a perfect postoperative timepoint to use the OKS to obtain TKA outcomes. Therefore, at the time of evaluation, the OKS should reflect the best possible outcome for the patient group. This study was conducted to see the OKS in patients who underwent simultaneous bilateral knee replacement at six weeks and six months postoperatively and to see if there was a clinically significant difference in the mean OKS. Methods This prospective cross-sectional study was conducted at the Section of Orthopedic Surgery at Aga Khan University Hospital, a tertiary care center in Karachi, Pakistan. Patients who underwent simultaneous bilateral total knee replacement from October 2023 till December 2023 were included; exclusion criteria included patients who had a recent knee infection and extensor mechanism disruption. OKS was calculated at six weeks and six months postoperatively. Results The total number of patients included in the study was 49 with a mean age of 61.9 +/- 6.1. There were 42 (85.7%) females and 7 (14.3%) males. The mean BMI of our patients was 33.3 +/- 3.8. The radiographic Kellgren Lawrence Grading (KLG) was used and 38 (77.6%) patients were placed in Grade IV KLG, and 11 (22.4%) were placed in Grade III KLG. The mean OKS preoperatively was 12.6 +/- 3.5. At six weeks, the OKS showed improvement, with the mean being 20.6 +/- 3.0. At six months postoperatively, there was a significant improvement in the OKS, with the mean now being 42.7 +/- 2.4. At six weeks post-surgery, the mean improvement in the OKS score was 7.9 +/- 2.71, whereas at six months post-surgery, the mean improvement in the OKS score was 30.1 +/- 3.6. This difference was significant (-value=0.03). Conclusion Our study showed a clinically significant difference between the mean OKS at the six-week and six-month timeline, with a significant increase in the mean improvement OKS score at six months. OKS should be utilized six months postoperatively to assess the outcome of simultaneous bilateral knee arthroplasty patients.
引言 成人中最常见的退行性关节疾病是骨关节炎。对于这个功能需求更高的老龄化社会来说，全膝关节置换术是金标准治疗选择。牛津膝关节评分（OKS）评估诸如僵硬、疼痛、功能、满意度和生活质量等因素，使你能够量化手术后的治疗效果。根据已发表的研究，没有一个完美的术后时间点可用于使用OKS来获得全膝关节置换术的结果。因此，在评估时，OKS应反映患者群体可能达到的最佳结果。本研究旨在观察在术后六周和六个月接受同期双侧膝关节置换术的患者的OKS情况，并观察平均OKS是否存在临床显著差异。
方法 这项前瞻性横断面研究在巴基斯坦卡拉奇的三级医疗中心阿迦汗大学医院骨科进行。纳入2023年10月至2023年12月期间接受同期双侧全膝关节置换术的患者；排除标准包括近期有膝关节感染和伸肌机制破坏的患者。在术后六周和六个月计算OKS。
结果 本研究纳入的患者总数为49例，平均年龄为61.9±6.1岁。女性42例（85.7%），男性7例（14.3%）。我们患者的平均体重指数为33.3±3.8。使用放射学Kellgren Lawrence分级（KLG），38例（77.6%）患者被评为IV级KLG，11例（22.4%）被评为III级KLG。术前平均OKS为12.6±3.5。在六周时，OKS显示出改善，平均值为20.6±3.0。术后六个月，OKS有显著改善，平均值现为42.7±2.4。术后六周时，OKS评分的平均改善为7.9±2.71，而术后六个月时，OKS评分的平均改善为30.1±3.6。这种差异具有显著性（P值=0.03）。
结论 我们的研究显示，在六周和六个月时间点的平均OKS之间存在临床显著差异，六个月时OKS评分的平均改善显著增加。应在术后六个月使用OKS来评估同期双侧膝关节置换术患者的结果。
