Clement Nick D, Leitch Gillian, Scott Chloe E H
Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
Musculoskeletal Care. 2025 Mar;23(1):e70064. doi: 10.1002/msc.70064.
The aim was to identify independent variables associated with chronic knee pain (CKP) 6 months after knee arthroplasty (KA) and to determine whether CKP influenced improvement in patient reported outcomes measures (PROMs).
A retrospective study was conducted over an 8-year period and included 3310 patients with completed PROMs at 6 months postoperatively; with a mean age of 69.9 (standard deviation 9.3) and 1823 (55.1%) were females. The Oxford knee score (OKS) pain component score was used to define patients with CKP (≤ 14 points) at 6 months.
There were 551 (16.6%) patients with CKP. Gender (p < 0.001), BMI (p = 0.025), preoperative EQ-5D (p = 0.010) and pain VAS (p < 0.001) as well as questions 2: washing (p = 0.006), 8: night pain (p = 0.001), 10: stability (p = 0.008) and 11: shopping (p = 0.047) of the OKS were independently associated CKP. The pre-operative OKS total score (p = 0.542) was not independently associated with CKP. The risk of CKP was shown to vary from 3.0% to 30.5% when discriminatory threshold values were used in the pre-operative responses to questions 2, 8, 10 and 11 of the OKS. Patients with CKP had significantly (p < 0.001) worse 6-month OKS, EQ-5D, EQ-VAS, and pain VAS scores and improvements in scores relative to preoperative baseline that were potentially not clinically meaningful (OKS mean difference 2.6, 95% CI 2.1-3.2). Those with CKP were significantly less likely to be satisfied with their KA (odds ratio 0.076, p < 0.001): only 231 (42.9%) patients with CKP were satisfied.
Approximately one-in-six (16.6%) patients had CKP at 6 months following KA, which was associated with significantly worse PROMs and lower satisfaction. Preoperative responses to four (2, 8, 10 and 11) of the pre-operative OKS questions were independently associated with CKP. These questions could be used to inform patients of their risk of CKP (3.0%-30.5%) following KA and potentially with expectation modification this may improve their PROMs.
Retrospective study, Level III.
旨在确定与膝关节置换术（KA）后6个月慢性膝关节疼痛（CKP）相关的独立变量，并确定CKP是否会影响患者报告结局指标（PROMs）的改善情况。
进行了一项为期8年的回顾性研究，纳入了3310例术后6个月完成PROMs的患者；平均年龄为69.9岁（标准差9.3），其中1823例（55.1%）为女性。采用牛津膝关节评分（OKS）疼痛分量表评分来定义术后6个月时患有CKP（≤14分）的患者。
有551例（16.6%）患者患有CKP。性别（p<0.001）、体重指数（BMI）（p=0.025）、术前EQ-5D（p=0.010）和疼痛视觉模拟评分（VAS）（p<0.001）以及OKS中的问题2：洗漱（p=0.006）、问题8：夜间疼痛（p=0.001）、问题10：稳定性（p=0.008）和问题11：购物（p=0.047）与CKP独立相关。术前OKS总分（p=0.542）与CKP无独立相关性。当在术前对OKS的问题2、8、10和11的回答中使用判别阈值时，CKP的风险显示为3.0%至30.5%。患有CKP的患者6个月时的OKS、EQ-5D、EQ-VAS和疼痛VAS评分显著更差（p<0.001），且相对于术前基线的评分改善可能无临床意义（OKS平均差异2.6，95%CI 2.1-3.2）。患有CKP的患者对其KA满意的可能性显著更低（优势比0.076，p<0.001）：只有231例（42.9%）患有CKP的患者表示满意。
在KA后6个月，约六分之一（16.6%）的患者患有CKP，这与显著更差的PROMs和更低的满意度相关。术前对术前OKS四个问题（2、8、10和11）的回答与CKP独立相关。这些问题可用于告知患者KA后发生CKP的风险（3.0%-30.5%），通过潜在地调整期望，这可能会改善他们的PROMs。
回顾性研究，III级。
