Department of Orthopedic Surgery, St. Olav's Hospital HF, Trondheim; Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology NTNU, Trondheim, Norway.
Department of Orthopedic Surgery, St. Olav's Hospital HF, Trondheim, Norway.
Acta Orthop. 2024 Nov 12;95:639-644. doi: 10.2340/17453674.2024.42098.
Physical function and pain are the most important outcomes following total knee arthroplasty (TKA). These can be evaluated by patient-reported outcome measures (PROMs), or by an anchor question. The primary aim of the study was to evaluate whether a simple anchor question can replace KOOS-PS in assessing postoperative knee function until 1-year follow-up, evaluated by analyzing the agreement between the 2 methods using the diagnostic odds ratio (DOR). Secondary aims were pain (NRS) at rest and during mobilization.
This is a diagnostic accuracy study with primary TKAs performed between 2010 and 2022. The surgeries were categorized as improved (I) or worsened (W) based on a dichotomized anchor question related to self-perceived change in physical function, and the dichotomized change in KOOS-PS until 1-year follow-up. This led to 4 groups: (II, IW, WI, and WW).
Agreement was found with a DOR of 11.3 (CI 7.9-16.2). 2,335 (94%) reported improved function on the anchor question and 143 (6%) worsened function. Among those with improved anchor 2,132 (91%) had improved KOOS-PS, but among those with worsened anchor only 74 (52%) had worsened KOOS-PS. Pain at 1-year follow-up was lower in the groups reporting improved anchor.
The KOOS-PS can be replaced with an anchor question to assess change in function until 1 year. However, the KOOS-PS might be a valuable supplement in patients reporting worsened anchor as only half of those had worsened KOOS-PS.
全膝关节置换术(TKA)后,身体功能和疼痛是最重要的结果。这些可以通过患者报告的结果测量(PROM)或锚定问题来评估。该研究的主要目的是通过分析两种方法之间的一致性来评估简单的锚定问题是否可以替代 KOOS-PS 来评估术后膝关节功能,直到 1 年随访,使用诊断比值比(DOR)进行评估。次要目标是休息时和活动时的疼痛(NRS)。
这是一项诊断准确性研究,主要 TKA 于 2010 年至 2022 年进行。手术根据与自我感知的身体功能变化相关的二分法锚定问题以及直到 1 年随访的 KOOS-PS 的二分法变化进行分类为改善(I)或恶化(W)。这导致了 4 个组:(II、IW、WI 和 WW)。
发现一致性的 DOR 为 11.3(CI 7.9-16.2)。2335 名(94%)报告在锚定问题上功能改善,143 名(6%)功能恶化。在那些具有改善的锚定的人中,有 2132 名(91%)具有改善的 KOOS-PS,但在那些具有恶化的锚定的人中,只有 74 名(52%)具有恶化的 KOOS-PS。在报告改善的锚定的组中,1 年随访时的疼痛较低。
KOOS-PS 可以用锚定问题来替代评估功能的变化,直到 1 年。然而,在报告锚定恶化的患者中,KOOS-PS 可能是有价值的补充,因为只有一半的患者的 KOOS-PS 恶化。