Seki Kazushige, Seki Toshihiro, Imagama Takashi, Okazaki Tomoya, Kaneoka Takehiro, Yamazaki Kazuhiro, Sakai Takashi
Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 Japan.
Indian J Orthop. 2024 Jul 16;58(10):1395-1401. doi: 10.1007/s43465-024-01186-4. eCollection 2024 Oct.
The aim of this study was to investigate the factors affecting patient-reported outcomes after bicruciate-stabilized total knee arthroplasty (BCS TKA) in patients.
We retrospectively examined 122 knees with primary varus knee osteoarthritis that underwent BCS TKA. This study analyzed preoperative, intraoperative, and postoperative predictors of patient satisfaction and persistent postsurgical pain following BCS TKA at 1 year after surgery. We evaluated persistent postsurgical pain using Knee Injury and Osteoarthritis Outcome Score (KOOS) pain subscale and patient satisfaction using a visual analog scale.
The univariate analysis showed a significant negative correlation between the KOOS pain subscale and three factors: the preoperative central sensitization inventory (CSI) score, medial joint laxity at 90° flexion, and acute postsurgical pain. Patient satisfaction was significantly positively correlated with lateral joint laxity at 90° flexion and postoperative extension angle. Acute postsurgical pain had a significant negative correlation with patient satisfaction. The multiple regression analysis revealed preoperative CSI score and medial joint laxity at 90° flexion influenced patients' KOOS pain subscale responses. Only lateral joint laxity at 90° flexion had an impact on patient satisfaction.
The acquisition of adequate soft tissue balance according to the concept of BCS TKA and preoperative central sensitization syndrome affects the clinical outcomes in BCS TKA.
本研究旨在调查影响双交叉韧带稳定型全膝关节置换术（BCS TKA）患者术后患者报告结局的因素。
我们回顾性检查了122例接受BCS TKA的原发性膝内翻骨关节炎患者的膝关节。本研究分析了术后1年BCS TKA患者满意度和术后持续疼痛的术前、术中和术后预测因素。我们使用膝关节损伤和骨关节炎结局评分（KOOS）疼痛子量表评估术后持续疼痛，并使用视觉模拟量表评估患者满意度。
单因素分析显示，KOOS疼痛子量表与三个因素之间存在显著负相关：术前中枢敏化量表（CSI）评分、90°屈曲时的内侧关节松弛度和术后急性疼痛。患者满意度与90°屈曲时的外侧关节松弛度和术后伸展角度显著正相关。术后急性疼痛与患者满意度显著负相关。多元回归分析显示，术前CSI评分和90°屈曲时的内侧关节松弛度影响患者的KOOS疼痛子量表反应。只有90°屈曲时的外侧关节松弛度对患者满意度有影响。
根据BCS TKA的概念获得足够的软组织平衡以及术前中枢敏化综合征会影响BCS TKA的临床结局。
