新南威尔士州两家医院门诊物理治疗诊所成年患者髋膝关节骨关节炎的临床病程:骨关节炎慢性护理项目(OACCP)评估
The Clinical Course of Hip and Knee Osteoarthritis in Adults Attending Two Hospital Outpatient Physiotherapy Clinics in NSW: An Evaluation of the Osteoarthritis Chronic Care Program (OACCP).
作者信息
Melman Alla, Menz Fred, Needs Chris, de Campos Tarcisio F, Marabani Mona, Bostock Kimberley, Dick Rhiannon, Hayes Stuart, Zadro Joshua R, Machado Gustavo C, Maher Chris G
机构信息
Sydney Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia.
Osteoarthritis Chronic Care Program, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia.
出版信息
Musculoskeletal Care. 2025 Sep;23(3):e70174. doi: 10.1002/msc.70174.
BACKGROUND
Osteoarthritis (OA) affects over 700,000 individuals in NSW, with projections estimating an increase to 1 million by 2030. This has led to a significant rise in joint replacement surgeries and associated healthcare costs. Despite guidelines recommending non-surgical care as first line treatment, many patients remain on surgical waiting lists without accessing these treatments.
AIM
The aims of this study were to describe the characteristics and clinical outcomes of people with hip and knee OA attending two Sydney Local Health District (SLHD) Osteoarthritis Chronic Care Program (OACCP) clinics, and to identify whether baseline measures are associated with achieving Minimal Clinically Important (MCI) difference in outcomes.
METHODS
This retrospective study (n = 1402) evaluated the OACCP's implementation within two SLHD hospitals between Oct 2018 and Sept 2023, describing patient characteristics, patient reported outcomes, physical performance measures, and allied health access. Changes in clinical outcomes in the short-term (3 months) and long-term (12 months) assessment as well as associations of patient's baseline measures with MCI improvements in clinical outcomes were analysed.
RESULTS
Most self-reported outcomes and physical performance measures improved at both 3 and 12 months. 38.6% of patients reached the MCI threshold for KOOS total score at 3 months, which rose to 52.1% at 12 months. None of the baseline characteristics predicted outcomes.
CONCLUSION
Following multidisciplinary non-surgical care, people with hip and/or knee OA experience improved quality of life and function that is sustained for up to 12 months. However, analysis was limited by low long-term follow-up rates and no control group.
背景
骨关节炎(OA)影响着新南威尔士州超过70万人,预计到2030年将增至100万。这导致关节置换手术及相关医疗费用大幅上升。尽管指南推荐非手术治疗作为一线治疗方法,但许多患者仍在手术等候名单上,无法获得这些治疗。
目的
本研究的目的是描述在悉尼两个地方卫生区(SLHD)骨关节炎慢性护理项目(OACCP)诊所就诊的髋部和膝部骨关节炎患者的特征和临床结果,并确定基线测量指标是否与实现最小临床重要差异(MCI)相关。
方法
这项回顾性研究(n = 1402)评估了2018年10月至2023年9月期间OACCP在两家SLHD医院的实施情况,描述了患者特征、患者报告的结果、身体性能指标和联合健康服务的使用情况。分析了短期(3个月)和长期(12个月)评估中临床结果的变化,以及患者基线测量指标与临床结果MCI改善之间的关联。
结果
大多数自我报告的结果和身体性能指标在3个月和12个月时均有所改善。38.6%的患者在3个月时达到了膝关节骨关节炎结局评分(KOOS)总分的MCI阈值,12个月时升至52.1%。没有任何基线特征能够预测结果。
结论
接受多学科非手术治疗后,髋部和/或膝部骨关节炎患者的生活质量和功能得到改善,且可持续长达12个月。然而,分析受到长期随访率低和缺乏对照组的限制。