Comparison of Self-Reported Knee Injury and Osteoarthritis Outcome Score to Performance Measures in Patients After Total Knee Arthroplasty-猫眼课题宝

DOI：

10.1016/j.pmrj.2011.03.002

发表时间：

2011-06-01

期刊：

PM&R

影响因子：

2.1

通讯作者：

中科院分区：

医学4区

文献类型：

作者：

Stevens-Lapsley, Jennifer E.;Schenkman, Margaret L.;Dayton, Michael R.

目的：通过(1)检查全膝关节置换术(TKA)后前6个月的自我报告指标(膝关节损伤和骨关节炎结果评分[KOS])和功能指标的变化，(2)评估MoOS自报告功能(日常生活能力[ADO子量表])和功能表现(6分钟步行[6 MW])之间的变化，以及(3)探索疼痛变化与MOOS ADL和6 MW结果的相关性。设计：回溯性队列评估。设置：临床研究实验室。患者(或参与者)：39名单侧患者。方法：对终末期单侧膝骨性关节炎患者于术前2周、术后1、3、6个月进行全膝关节置换术。主要观察指标：运动功能、6 mW、起跳计时(TUG)、爬楼梯试验(SCT)、股四头肌力量。结果：术后1个月5个KoOS量表中有3个明显改善。术后3个月和6个月时，所有5个Koos分量表均有明显改善。相反，性能指标(6 mW、TUG、SCT和股四头肌力量)在TKA术后1个月时均较术前显著下降，而在TKA后3个月和6个月时较术前值显著改善；然而，较术前值的改善并不具有临床意义。术后1、3、6个月Koos ADL子量表的变化与6 mW之间的Pearson相关性无统计学意义。此外，MoOS疼痛与MOOS AD L评分始终呈正相关，而MoOS疼痛与6 mW距离无相关性。结论：患者使用MOOS评分不能反映术后，尤其是术后1个月的操作缺陷程度。自我报告的MOOS结果与术后疼痛缓解密切相关，而绩效评估与疼痛无关。这些结果强调了在跟踪TKA后恢复情况时纳入绩效衡量标准的重要性，而不是仅仅依靠自我报告的衡量标准。PM R 2011；3：541-549

Objective: To characterize patient outcomes after total knee arthroplasty (TKA) by (1) examining changes in self-report measures (Knee Injury and Osteoarthritis Outcome Score [KOOS]) and performance measures over the first 6 months after TKA, (2) evaluating correlations between changes in MOOS self-report function (activities of daily living [ADO subscale) and functional performance (6-minute walk [6MW]), and (3) exploring how changes in pain correlate with MOOS ADL and 6MW outcomes.Design: Retrospective cohort evaluation.Setting: Clinical research laboratory.Patients (or Participants): Thirty-nine patients scheduled for a unilateral, primary TKA for end-stage unilateral knee osteoarthritis.Methods: Patients were evaluated 2 weeks before surgery and 1, 3, and 6 months after surgery.Main Outcome Measurements: MOOS, 6MW, timed-up-and-go (TUG), and stair climbing tests (SCT), quadriceps strength.Results: Three of 5 KOOS subscales significantly improved by 1 month after TKA. All 5 KOOS subscales significantly improved by 3 and 6 months after TKA. In contrast, performance measures (6MW, TUG, SCT, and quadriceps strength) all significantly declined from preoperative values by 1 month after TKA and significantly improved from preoperative values by 3 and 6 months after TKA; yet, improvements from preoperative values were not clinically meaningful. Pearson correlations between changes in the KOOS ADL subscale and 6MW from before surgery were not statistically significant at 1, 3, or 6 months after TKA. In addition, MOOS Pain was strongly correlated with MOOS AD L scores at all times, but MOOS Pain was not correlated with 6MW distance at any time.Conclusions: Patient self-report by using the MOOS did not reflect the magnitude of performance deficits present after surgery, especially 1 month after TKA. Self-report MOOS outcomes closely paralleled pain relief after surgery, whereas performance measures were not correlated with pain. These results emphasize the importance of including performance measures when tracking recovery after TKA as opposed to solely relying on self-reported measures. PM R 2011;3:541-549

Comparison of Self-Reported Knee Injury and Osteoarthritis Outcome Score to Performance Measures in Patients After Total Knee Arthroplasty

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