{"title":"确定影响膝关节周围截骨术术后效果的最佳中枢敏感性清单临界值。","authors":"Shoichi Hasegawa, Hideyuki Koga, Yusuke Nakagawa, Hao Ding, Aritoshi Yoshihara, Masaki Amemiya, Takashi Hoshino, Mai Katakura, Nobutake Ozeki, Tomomasa Nakamura, Hiroki Katagiri","doi":"10.1016/j.jos.2024.09.009","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Central sensitization has a significant effect on pain after osteotomy around the knee (OAK). The central sensitization inventory (CSI) score is considered disease specific, and the appropriate cut-off values for OAK are unclear. The purpose of this study was to establish the optimal CSI cut-off value affecting the postoperative outcomes of OAK based on the postoperative knee injury and osteoarthritis outcome score (KOOS).</p><p><strong>Methods: </strong>Patients who underwent OAK for medial compartment knee osteoarthritis were included. The postoperative KOOS symptoms, pain, and activities of daily living (ADL) were categorized into two groups (score ≥80 each for symptoms, pain, and ADL, and score <80 for any of the three) and were used as factors to calculate receiver operating characteristic curves and the area under the curve with the CSI score. Cut-off values were calculated using the Youden index and the threshold value closest to the upper left corner. Subsequently, logistic multivariate analysis was performed using the KOOS and the obtained CSI cut-off values and other variables.</p><p><strong>Results: </strong>A total of 173 patients were included in this study. The area under the curve of the model was 0.801 (95 % confidence interval, 0.74-0.87), and a CSI score of 12 was determined as the cut-off value. Logistic multivariate analysis based on the cut-off value showed that only the CSI score (odds ratio, 9.79; 95 % CI, 4.47-21.4; P < 0.01) was significant.</p><p><strong>Conclusions: </strong>The optimal CSI cut-off value affecting the postoperative outcomes of OAK calculated using the postoperative KOOS was 12, which was supported by multivariate analysis results. Central sensitization assessment with an appropriate cut-off value would allow a more personalized treatment approach and may contribute to a better postoperative outcome.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Establishing an optimal central sensitization inventory cut-off value affecting postoperative outcomes of osteotomy around the knee.\",\"authors\":\"Shoichi Hasegawa, Hideyuki Koga, Yusuke Nakagawa, Hao Ding, Aritoshi Yoshihara, Masaki Amemiya, Takashi Hoshino, Mai Katakura, Nobutake Ozeki, Tomomasa Nakamura, Hiroki Katagiri\",\"doi\":\"10.1016/j.jos.2024.09.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Central sensitization has a significant effect on pain after osteotomy around the knee (OAK). The central sensitization inventory (CSI) score is considered disease specific, and the appropriate cut-off values for OAK are unclear. The purpose of this study was to establish the optimal CSI cut-off value affecting the postoperative outcomes of OAK based on the postoperative knee injury and osteoarthritis outcome score (KOOS).</p><p><strong>Methods: </strong>Patients who underwent OAK for medial compartment knee osteoarthritis were included. The postoperative KOOS symptoms, pain, and activities of daily living (ADL) were categorized into two groups (score ≥80 each for symptoms, pain, and ADL, and score <80 for any of the three) and were used as factors to calculate receiver operating characteristic curves and the area under the curve with the CSI score. Cut-off values were calculated using the Youden index and the threshold value closest to the upper left corner. Subsequently, logistic multivariate analysis was performed using the KOOS and the obtained CSI cut-off values and other variables.</p><p><strong>Results: </strong>A total of 173 patients were included in this study. The area under the curve of the model was 0.801 (95 % confidence interval, 0.74-0.87), and a CSI score of 12 was determined as the cut-off value. Logistic multivariate analysis based on the cut-off value showed that only the CSI score (odds ratio, 9.79; 95 % CI, 4.47-21.4; P < 0.01) was significant.</p><p><strong>Conclusions: </strong>The optimal CSI cut-off value affecting the postoperative outcomes of OAK calculated using the postoperative KOOS was 12, which was supported by multivariate analysis results. Central sensitization assessment with an appropriate cut-off value would allow a more personalized treatment approach and may contribute to a better postoperative outcome.</p>\",\"PeriodicalId\":16939,\"journal\":{\"name\":\"Journal of Orthopaedic Science\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-10-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedic Science\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jos.2024.09.009\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jos.2024.09.009","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
背景:中枢敏感性对膝关节周围截骨术(OAK)后的疼痛有显著影响。中枢敏化量表(CSI)评分被认为具有疾病特异性,而 OAK 的适当临界值尚不明确。本研究的目的是根据术后膝关节损伤和骨关节炎结果评分(KOOS),确定影响OAK术后结果的最佳CSI临界值:方法:纳入因内侧室膝骨关节炎接受OAK手术的患者。将术后 KOOS 的症状、疼痛和日常生活活动能力(ADL)分为两组(症状、疼痛和 ADL 各得分≥80 分,以及得分结果:本研究共纳入 173 名患者。模型的曲线下面积为 0.801(95 % 置信区间,0.74-0.87),CSI 评分 12 分被确定为临界值。根据临界值进行的逻辑多变量分析表明,只有 CSI 评分(几率比 9.79;95 % CI,4.47-21.4;P 结论:CSI 临界值为 12 分:使用术后 KOOS 计算出的影响 OAK 术后结果的最佳 CSI 临界值为 12,多变量分析结果也支持这一观点。使用合适的临界值进行中枢敏感性评估,可使治疗方法更加个性化,并有助于获得更好的术后效果。
Establishing an optimal central sensitization inventory cut-off value affecting postoperative outcomes of osteotomy around the knee.
Background: Central sensitization has a significant effect on pain after osteotomy around the knee (OAK). The central sensitization inventory (CSI) score is considered disease specific, and the appropriate cut-off values for OAK are unclear. The purpose of this study was to establish the optimal CSI cut-off value affecting the postoperative outcomes of OAK based on the postoperative knee injury and osteoarthritis outcome score (KOOS).
Methods: Patients who underwent OAK for medial compartment knee osteoarthritis were included. The postoperative KOOS symptoms, pain, and activities of daily living (ADL) were categorized into two groups (score ≥80 each for symptoms, pain, and ADL, and score <80 for any of the three) and were used as factors to calculate receiver operating characteristic curves and the area under the curve with the CSI score. Cut-off values were calculated using the Youden index and the threshold value closest to the upper left corner. Subsequently, logistic multivariate analysis was performed using the KOOS and the obtained CSI cut-off values and other variables.
Results: A total of 173 patients were included in this study. The area under the curve of the model was 0.801 (95 % confidence interval, 0.74-0.87), and a CSI score of 12 was determined as the cut-off value. Logistic multivariate analysis based on the cut-off value showed that only the CSI score (odds ratio, 9.79; 95 % CI, 4.47-21.4; P < 0.01) was significant.
Conclusions: The optimal CSI cut-off value affecting the postoperative outcomes of OAK calculated using the postoperative KOOS was 12, which was supported by multivariate analysis results. Central sensitization assessment with an appropriate cut-off value would allow a more personalized treatment approach and may contribute to a better postoperative outcome.
期刊介绍:
The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.