MCID achievement in staged bilateral total knee arthroplasty: Are both joints created equal?

IF 1.6 4区医学 Q3 ORTHOPEDICS Knee Pub Date : 2024-07-31 DOI:10.1016/j.knee.2024.07.013

Amy Z. Blackburn , Akhil Katakam , Ikechukwu Amakiri , Ashish Mittal , Hany S. Bedair , Christopher M. Melnic

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Abstract

Background

A notable portion of unilateral total knee arthroplasty (TKA) patients undergo arthroplasty of the contralateral knee. The aims of this study were to describe the Minimal Clinically Important Difference for Improvement (MCID-I) and Worsening (MCID-W) in staged bilateral TKAs (BTKAs) and identify factors associated with these outcomes.

Methods

Patients with staged BTKA were retrospectively reviewed. Demographics, surgery details, and Patient-Reported Outcome Measurement Information System Physical Function Short Form 10a (PROMIS PF10a) were collected. MCID-I and MCID-W were defined for PROMIS PF10a. Patients were stratified into nine groups based on the MCID achievement of the first and second TKA: (A) MCID-I, MCID- I, (B) MCID-I, Neutral, (C) MCID-I, MCID-W, (D) Neutral, MCID-I, (E) Neutral, Neutral, (F) Neutral, MCID-W, (G) MCID- W, MCID-I, (H) MCID-W, Neutral, (I) MCID-W, MCID-W. Neutral patients did not achieve either MCID-I or MCID-W.

Results

The final cohort consisted of 59 staged BTKA patients. In patients who achieved MCID-I in the first TKA, 39.1% achieved MCID-I again in the second TKA (A), 39.1% were neutral (B), and 21.7% achieved MCID-W (C) in the second TKA. However, 77.8% of those who achieved MCID-W in the first joint (n = 9) went on to achieve MCID-I (G) in the second TKA. Those who achieved MCID-I after both TKAs (A) had a longer staged interval than those who achieved first MCID-I, then MCID-W (C) (15 months vs 8 months, P = 0.0113).

Conclusion

In staged BTKA, MCID achievement of the first TKA may not be associated with the outcome of the second TKA.

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分期双侧全膝关节置换术的 MCID 成效：两个关节都一样吗？

背景：相当一部分单侧全膝关节置换术（TKA）患者会接受对侧膝关节置换术。本研究的目的是描述分期双侧 TKA（BTKA）中改善（MCID-I）和恶化（MCID-W）的最小临床意义差异，并确定与这些结果相关的因素：对分期 BTKA 患者进行回顾性研究。方法：对分期 BTKA 患者进行了回顾性研究，收集了患者的人口统计学资料、手术细节和患者报告结果测量信息系统身体功能简表 10a（PROMIS PF10a）。对 PROMIS PF10a 的 MCID-I 和 MCID-W 进行了定义。根据第一次和第二次TKA的MCID结果将患者分为九组：（A）MCID-I、MCID-I；（B）MCID-I、中性；（C）MCID-I、MCID-W；（D）中性、MCID-I；（E）中性、中性；（F）中性、MCID-W；（G）MCID-W、MCID-I；（H）MCID-W、中性；（I）MCID-W、MCID-W。中性患者既未达到 MCID-I 也未达到 MCID-W：最终队列由 59 名分期 BTKA 患者组成。在第一次 TKA 中达到 MCID-I 的患者中，39.1% 在第二次 TKA 中再次达到 MCID-I（A），39.1% 为中性（B），21.7% 在第二次 TKA 中达到 MCID-W（C）。然而，在第一次关节置换中达到 MCID-W 的患者（9 人）中，77.8% 在第二次关节置换中达到 MCID-I (G)。与先达到 MCID-I 后达到 MCID-W（C）的患者（15 个月 vs 8 个月，P = 0.0113）相比，两次 TKA 都达到 MCID-I 的患者（A）的分期间隔时间更长：结论：在分期 BTKA 中，第一次 TKA 达到 MCID 可能与第二次 TKA 的结果无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.