Risager Stefan Kastalag, Viberg Bjarke, Abrahamsen Charlotte Skov, Arndt Kristine Bollerup, Odgaard Anders, Lindberg-Larsen Martin
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Department of Orthopedic Surgery and Traumatology, Hospital Lillebaelt, University Hospital of Southern Denmark, Kolding; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Acta Orthop. 2025 Feb 27;96:209-216. doi: 10.2340/17453674.2025.43083.
Periprosthetic knee fractures (PPKFs) can be a serious complication after total knee arthroplasty (TKA). We aimed to compare patient-reported outcome (PRO) scores reported between 1 and 4 years after PPKF with a matched uncomplicated TKA control group.
This nationwide cross-sectional matched cohort study included 372 TKA patients with a PPKF occurring from 2019 to 2022 and a control group of 878 uncomplicated TKA patients matched by age, time since TKA, and sex. The study population was derived from the Danish National Patient Register. The patients received questionnaires regarding knee function, quality of life, pain and satisfaction in 2023. The questionnaires included Oxford Knee Score (OKS), the Forgotten Joint Score (FJS), and the EQ-5D-5L Index.
The response rate was 48%. Mean OKS was 7 (confidence interval [CI] 5-9) points lower after a PPKF with a score of 30 (standard deviation [SD] 11) in the PPKF group vs 37 (SD 11) in the control group. The FJS was 13 (CI 7-19) points lower after a PPKF with a score of 50 (SD 30) in the PPKF group vs 63 (SD 30) in the control group. Mean EQ-5D-5L Index scores were 0.17 (CI 0.12-0.22) lower after a PPKF with a score of 0.68 (SD 0.25) in the PPKF group vs 0.85 (SD 0.25) in the control group. Additional analysis of patients who completed PROMs 1-2 years compared with 3-4 years after PPKF showed better PRO scores after 3-4 years with an OKS of 32 (SD 12) vs 27 (SD 12), FJS 55 (SD 32) vs 43 (SD 32), and EQ-5D-5L Index of 0.74 (SD 0.34) vs 0.60 (SD 0.34).
Following PPKF, patients reported worse knee function, more pain, lower satisfaction, and poorer quality of life than those with uncomplicated TKAs.
人工膝关节周围骨折（PPKF）是全膝关节置换术（TKA）后可能出现的严重并发症。我们旨在比较PPKF后1至4年患者报告的结局（PRO）评分与匹配的无并发症TKA对照组。
这项全国性横断面匹配队列研究纳入了372例2019年至2022年发生PPKF的TKA患者以及878例按年龄、TKA术后时间和性别匹配的无并发症TKA患者作为对照组。研究人群来自丹麦国家患者登记处。2023年，患者收到了关于膝关节功能、生活质量、疼痛和满意度的问卷。问卷包括牛津膝关节评分（OKS）、遗忘关节评分（FJS）和EQ-5D-5L指数。
应答率为48%。PPKF后平均OKS比对照组低7（置信区间[CI]5 - 9）分，PPKF组评分为30（标准差[SD]11），而对照组为37（SD 11）。PPKF后FJS比对照组低13（CI 7 - 19）分，PPKF组评分为50（SD 30），而对照组为63（SD 30）。PPKF后平均EQ-5D-5L指数评分比对照组低0.17（CI 0.12 - 0.22），PPKF组评分为0.68（SD 0.25），而对照组为0.85（SD 0.25）。对PPKF后1 - 2年与3 - 4年完成患者报告结局测量（PROMs）的患者进行的额外分析显示，3 - 4年后PRO评分更好，OKS为32（SD 12）对比27（SD 12），FJS为55（SD 32）对比43（SD 32），EQ-5D-5L指数为0.74（SD 0.34）对比0.60（SD 0.34）。
与无并发症的TKA患者相比，PPKF患者报告的膝关节功能更差、疼痛更多、满意度更低且生活质量更差。
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