术前对疾病特异性生活质量的主观评估极大地影响了复发性髌外侧不稳手术稳定后达到最小临床意义差异的可能性。

IF 3.3 2区 医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-01-01 Epub Date: 2024-06-21 DOI:10.1002/ksa.12319
Danko Dan Milinkovic, Sebastian Schmidt, Julian Fluegel, Sebastian Gebhardt, Felix Zimmermann, Peter Balcarek
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引用次数: 0

摘要

目的:评估对复发性髌骨外侧脱位(RLPD)接受定制手术治疗的患者中,哪些因素对未达到最小临床重要差异(MCID)具有预测价值:共纳入237名患者(男/女71/166;22.4 ± 6.8岁)。采用班夫髌股关节不稳定性量表2.0(BPII 2.0)以及膝关节功能和疼痛的主观评分(数字模拟量表[NAS];0-10)来评估患者从术前到术后的疗效。使用单变量逻辑回归分析评估了性别、手术时的年龄、体重指数(BMI)、尼古丁滥用、精神疾病、软骨状况和病理解剖学风险因素作为达到 MCID 的潜在预测因素:经计算,BPII 2.0 的 MCID 为 9.5 分。尽管从术前到术后,BPII 2.0 和 NAS 对膝关节功能和疼痛的影响均有显著改善(P 均为 62.5):结论:对于接受 RLPD 手术治疗的患者而言,术后达到 BPII 2.0 MCID 的概率仅取决于术前的 BPII 2.0 值和对膝关节功能的主观评价,以及手术时的年龄。在此,所提供的结果可帮助临床医生为患者提供建议,并介绍这种通常复杂的多因素病理治疗后的潜在结果:证据等级:三级。
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Preoperative subjective assessment of disease-specific quality of life significantly influenced the likelihood of achieving the minimal clinically important difference after surgical stabilization for recurrent lateral patellar instability.

Purpose: To evaluate which factors exert a predictive value for not reaching the minimal clinically important difference (MCID) in patients who underwent a tailored operative treatment for recurrent lateral patellar dislocation (RLPD).

Methods: A total of 237 patients (male/female 71/166; 22.4 ± 6.8 years) were included. The Banff Patellofemoral Instability Instrument 2.0 (BPII 2.0) and subjective rating of knee function and pain (numeric analogue scale [NAS]; 0-10) were used to evaluate patients' outcomes from pre- to postoperatively. Gender, age at the time of surgery, body mass index (BMI), nicotine abuse, psychiatric diseases, cartilage status and pathoanatomic risk factors were evaluated as potential predictors for achieving the MCID using univariate logistic regression analysis.

Results: The MCID for the BPII 2.0 was calculated at 9.5 points. Although the BPII 2.0 and NAS for knee function and pain improved significantly in the total cohort from pre- to postoperatively (all p < 0.001), 29 patients did not reach the MCID at the final follow-up. The analysis yielded that only the preoperative NAS for function and BPII 2.0 score values were significant predictors for reaching the MCID postoperatively. The optimal threshold was calculated at 7 (NAS function) and 65.2 points (BPII 2.0). Age at the time of surgery should be considered for patients with a preoperative BPII 2.0 score >62.5.

Conclusion: The probability of reaching BPII 2.0 MCID postoperatively depends only on the preoperative BPII 2.0 value and subjective rating of knee function, as well as age at the time of surgery for patients undergoing surgical treatment of RLPD. Here, presented results can assist clinicians in advising and presenting patients with potential outcomes following treatment for this often complex and multifactorial pathology.

Level of evidence: Level III.

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来源期刊
CiteScore
8.10
自引率
18.40%
发文量
418
审稿时长
2 months
期刊介绍: Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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