{"title":"全膝关节置换术后慢性膝关节疼痛的术前预测因素及对患者报告的6个月预后的影响","authors":"Nick D Clement, Gillian Leitch, Chloe E H Scott","doi":"10.1002/msc.70064","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Level of evidence: </strong>Retrospective study, Level III.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 1","pages":"e70064"},"PeriodicalIF":1.5000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Preoperative Predictors Associated With Postoperative Chronic Knee Pain Following Total Knee Arthroplasty and the Effect on Patient Reported Outcomes at 6-Months.\",\"authors\":\"Nick D Clement, Gillian Leitch, Chloe E H Scott\",\"doi\":\"10.1002/msc.70064\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Level of evidence: </strong>Retrospective study, Level III.</p>\",\"PeriodicalId\":46945,\"journal\":{\"name\":\"Musculoskeletal Care\",\"volume\":\"23 1\",\"pages\":\"e70064\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Musculoskeletal Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/msc.70064\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Musculoskeletal Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/msc.70064","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
Preoperative Predictors Associated With Postoperative Chronic Knee Pain Following Total Knee Arthroplasty and the Effect on Patient Reported Outcomes at 6-Months.
Aim: 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).
Methods: 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.
Results: 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.
Conclusions: 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.
Level of evidence: Retrospective study, Level III.
期刊介绍：
Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
