Similar short-term KOOS between open-wedge high tibial osteotomy and total knee arthroplasty in patients over age 60: A propensity score matched cohort study
Similar short-term KOOS between open-wedge high tibial osteotomy and total knee arthroplasty in patients over age 60: A propensity score matched cohort study
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60 岁以上患者的开放楔形高位胫骨截骨术和全膝关节置换术之间的类似短期 KOOS：倾向评分匹配队列研究
DOI：
10.1093/mr/roac052
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发表时间：
2022
影响因子：
2.2
通讯作者：
Nakashima Yasuharu
中科院分区：
文献类型：
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作者：
Sakai Mamiko;Akasaki Yukio;Akiyama Takenori;Horikawa Tomohiro;Okazaki Ken;Hamai Satoshi;Tsushima Hidetoshi;Kawahara Shinya;Kurakazu Ichiro;Kubota Kenji;Mizu-uchi Hideki;Nakashima Yasuharu
目的本研究的目的是评价60岁以上的队列中，胫骨高位楔形截骨术（HTO）与全膝关节置换术（TKA）相比，膝关节损伤和骨关节炎结局评分（KOOS）的改善，这些队列的术前年龄、性别、体重指数（BMI）、髋-膝-踝角（HKAA）、KOOS分项评分、方法对162例HTO患者和134例TKA患者进行倾向评分匹配。当通过多变量逻辑回归分析计算倾向评分时，纳入了以下术前混杂因素：年龄、性别、BMI、HKAA、KOOS子评分和OA分级。因此，每组共纳入55例患者。Student'st检验被用来分析组间术后KOOS分项评分的差异。ResultsAfter倾向评分匹配，所有匹配的术前贵重物品是相同的，HTO和TKA组之间没有显着差异。术后1年时，HTO组和TKA组的术后KOOS分项评分均无显著差异。两组表现出显着的和可比的术后改善，在每个KOOS子score.ConclusionsIn年龄超过60岁的患者，有没有显着差异，短期疼痛缓解和改善活动和生活质量之间的HTO和TKA后，倾向评分匹配，包括术前年龄，KOOS子分数，OA等级。HTO是一种关节保留手术，即使在60岁以上的患者中也适用于膝关节OA。
ObjectivesThe purpose of the present study was to evaluate improvement in the Knee Injury and Osteoarthritis Outcome Score (KOOS) after open-wedge high tibial osteotomy (HTO) in comparison with total knee arthroplasty (TKA) in cohorts over age 60 matched by pre-operative age, gender, body mass index (BMI), hip-knee-ankle angle (HKAA), KOOS sub-scores, and osteoarthritis (OA) grade.MethodsPropensity score matching was performed between 162 HTO patients and 134 TKA patients. When calculating the propensity score by multivariate logistic regression analysis, the following pre-operative confounders were included: age, gender, BMI, HKAA, KOOS sub-scores, and OA grade. Consequently, a total of 55 patients were included in each group. The Student’st-test was used to analyse differences in the post-operative KOOS sub-scores between groups.ResultsAfter propensity score matching, all matched pre-operative valuables were identical, with no significant differences between the HTO and TKA groups. None of the post-operative KOOS sub-scores at 1 year after surgery showed a significant difference between the HTO and TKA groups. Both groups demonstrated significant and comparable post-operative improvement in every KOOS sub-score.ConclusionsIn patients over age 60, there was no significant difference in short-term pain relief and improvements in activity and quality of life between HTO and TKA after propensity score matching including pre-operative age, KOOS sub-scores, and OA grade. HTO is a joint preservation procedure that is valid for knee OA even in individuals over age 60.