BACKGROUND A fracture of the acetabulum is an uncommon,but serious injury.Established outcome tools do not reflect the patient’s perspective after fracture of the hip joint.Originally designed for post-arthroplasty p...BACKGROUND A fracture of the acetabulum is an uncommon,but serious injury.Established outcome tools do not reflect the patient’s perspective after fracture of the hip joint.Originally designed for post-arthroplasty patients,the Forgotten Joint Score(FJS)is a patient-reported outcome measurement(PROM)tool evaluating the diseasespecific health-related quality of life(HR-QoL).AIM To validate the FJS in patients after acetabular fracture.METHODS In a prospective mono-centric cohort study,we evaluated 100 patients at mean 5.2±3.6 years after a fracture of the acetabulum.The validation study followed the complete COSMIN checklist protocol.For calculation of convergent validity,we used the Tegner-Activity Scale,the Western Ontario and McMaster Universities Osteoarthritis Index,the EuroQol-5D,and a subjective rating of change as an anchor variable.RESULTS We confirmed good internal consistency with a Cronbach‘s alpha of 0.95.With an intraclass correlation coefficient of 0.99(95%CI:0.97,0.99),test-retest reliability of the FJS was excellent.Correlation coefficients between the questionnaires were moderate to high ranging from|0.56|to|0.83|(absolute value).No relevant floor or ceiling effects occurred.Standard error of measurement was 3.2 and smallest detectable change(SDC)was 8.8.Thus,changes greater than 8.8 points between two assessments denote a real change in FJS.CONCLUSION The FJS is a valid and reliable tool for evaluation of patient-reported outcome in posttraumatic condition after acetabular fracture.The SDC indicating a real clinical improvement was 8.8 points in the FJS.We could confirm responsiveness of the FJS and found no relevant floor-or ceiling effects.展开更多
背景:国内外大多数文献报道了活动平台单髁置换的中远期疗效,而对于固定平台单髁置换的中远期临床效果报道较少,同时大部分研究未分析固定平台单髁置换后不同时间点膝关节功能恢复及下肢力线改变情况,也忽视了对单髁置换后患者自我感觉...背景:国内外大多数文献报道了活动平台单髁置换的中远期疗效,而对于固定平台单髁置换的中远期临床效果报道较少,同时大部分研究未分析固定平台单髁置换后不同时间点膝关节功能恢复及下肢力线改变情况,也忽视了对单髁置换后患者自我感觉情况的随访。目的:探讨膝关节固定平台单髁置换治疗膝关节内侧间室骨关节炎的中期临床效果,同时观察下肢力线改变情况。方法:回顾性分析2014年1月至2015年1月在佛山市中医院关节科诊断为膝关节内侧间室骨性关节炎患者的临床资料,按照纳入与排除标准,纳入行固定平台单髁置换66例患者,其中男18例,女48例,平均年龄(62.36±16.33)岁,分别在治疗前和治疗后1,3,5年采用美国膝关节协会评分(knee society knee score,KSS评分)、美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS评分)系统评估膝关节功能,采用目测类比评分评估膝关节疼痛严重程度,采用人工关节被遗忘指数评分评估单髁置换后假体自我主观感觉情况,治疗前和随访时拍摄双下肢负重全长X射线片测量髋-膝-踝角及胫股角评估下肢力线情况。结果与结论:①所有患者随访时间五六年,平均5.5年,切口均Ⅰ期愈合,无关节感染和下肢深静脉血栓形成等早期并发症发生,均无假体松动、脱位及对侧间室和髌股关节病变;②治疗后1,3,5年KSS临床评分、KSS功能评分、HSS评分、膝关节活动度、目测类比评分均低于治疗前(P<0.05),治疗后3,5年KSS临床评分、KSS功能评分、膝关节活动度、目测类比评分低于治疗后1年(P<0.05),治疗后3年与治疗后5年相比较,差异无显著性意义(P>0.05);③治疗后3,5年人工关节被遗忘指数评分高于治疗后1年(P<0.05),治疗后3年与治疗后5年相比较,差异无显著性意义(P>0.05);④所有患者治疗后髋-膝-踝角、胫股角较治疗前均有明显改善(P<0.05),治疗后1,3,5年时髋-膝-踝角、胫股角比较,差异无显著性意义(P>0.05);⑤结果表明,膝关节固定平台单髁假体置换中期临床疗效满意,假体自我化程度高,经治疗后下肢力线得到改善,治疗后5年随访时下肢力线无明显变化。展开更多
目的评估在加速康复外科理念(enhanced recovery after surgery,ERAS)下采用单髁置换术治疗膝关节前内侧间室骨关节炎(anterior medial osteoarthritis of the knee,AMOA)的疗效。方法选取2019年2月至2020年7月于我院住院,在ERAS模式下...目的评估在加速康复外科理念(enhanced recovery after surgery,ERAS)下采用单髁置换术治疗膝关节前内侧间室骨关节炎(anterior medial osteoarthritis of the knee,AMOA)的疗效。方法选取2019年2月至2020年7月于我院住院,在ERAS模式下进行单髁置换手术治疗的患者41例,其中男11例,女30例;年龄51~82岁,平均(68.20±7.23)岁。记录手术时间、术中出血量、术后并发症,比较手术前后疼痛视觉模拟评分(visual analogue scale,VAS),比较术前及末次随访时美国特种外科医院膝关节(hospital for special surgery,HSS)评分及术后6周、3个月、6个月的膝关节遗忘评分(forgotten joint score,FJS-12)。结果患者均获得随访,随访时间6~22个月,平均(15.07±4.38)个月,所有患者的影像学检查显示假体位置良好,无松动,无感染,无衬垫脱位。术后VAS评分(1.63±0.49)分,与术前(5.81±0.87)分相比较,差异有统计学意义(P<0.001)。末次随访时膝关节HSS评分(95.29±2.38)分,与术前(62.07±3.80)分相比较,差异有统计学意义(P<0.001)。术后6周FJS-12评分为(15.83±5.11)分,术后3个月为(8.07±3.05)分,二者比较差异有统计学意义(P<0.001),术后6个月为(6.39±2.88)分,与术后3个月相比较差异有统计学意义(P<0.001),但无实际临床意义。结论在加速康复外科理念下采用单髁置换术可以有效治疗膝关节前内侧骨关节炎,并在术后较早时间内达到较高的关节遗忘度。展开更多
AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who ...AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who had undergone unilateral TKA(UTKA) and 65 patients who had undergone simultaneous bilateral TKA(SBTKA) at our institution between 2010 and 2012. All TKAs were cemented and cruciate retaining. The mean follow-up period was 3.2(2 to 4) years. All the patients had symptomatic and debilitating unilateral or bilateral osteoarthritis for which all conservative and non-surgical treatments were failed, thus preoperatively the patients had poor functionality. All patients were asked to complete Forgotten Joint Score(FJS) and Oxford Knee Score(OKS) questionnaires. The patients were matched according to age, gender, year of surgery, Kellgren-Lawrence score and pre- andpostoperative overall knee alignment. The FJS and OKS questionnaire results of the two groups were then compared. RESULTS: A mixed-effects model was used to analyze differences between SBTKA and UTKA. OKS: The mean difference in the OKS between the patients who had undergone SBTKA and those who had undergone UTKA was 1.5, which was not statistically significant(CI =-0.9:4.0, P-value = 0.228). The mean OKS of the SBTKA patients was 37.6(SD = 9.0), and the mean OKS of the UTKA patients was 36.1(SD = 9.9). FJS: The mean difference in the FJS between the patients who had undergone SBTKA and those who had undergone UTKA was 2.3, which was not statistically significant(CI =-6.2:10.8, P-value = 0.593). The mean FJS of the SBTKA patients was 59.9(SD = 27.5), and the mean FJS of the UTKA patients was 57.5(SD = 28.8). CONCLUSION: SBTKA and UTKA patients exhibited similar joint functionality and knee awareness. Our results support the use of SBTKA in selected patients suffering from clinically symptomatic bilateral osteoarthritis.展开更多
文摘BACKGROUND A fracture of the acetabulum is an uncommon,but serious injury.Established outcome tools do not reflect the patient’s perspective after fracture of the hip joint.Originally designed for post-arthroplasty patients,the Forgotten Joint Score(FJS)is a patient-reported outcome measurement(PROM)tool evaluating the diseasespecific health-related quality of life(HR-QoL).AIM To validate the FJS in patients after acetabular fracture.METHODS In a prospective mono-centric cohort study,we evaluated 100 patients at mean 5.2±3.6 years after a fracture of the acetabulum.The validation study followed the complete COSMIN checklist protocol.For calculation of convergent validity,we used the Tegner-Activity Scale,the Western Ontario and McMaster Universities Osteoarthritis Index,the EuroQol-5D,and a subjective rating of change as an anchor variable.RESULTS We confirmed good internal consistency with a Cronbach‘s alpha of 0.95.With an intraclass correlation coefficient of 0.99(95%CI:0.97,0.99),test-retest reliability of the FJS was excellent.Correlation coefficients between the questionnaires were moderate to high ranging from|0.56|to|0.83|(absolute value).No relevant floor or ceiling effects occurred.Standard error of measurement was 3.2 and smallest detectable change(SDC)was 8.8.Thus,changes greater than 8.8 points between two assessments denote a real change in FJS.CONCLUSION The FJS is a valid and reliable tool for evaluation of patient-reported outcome in posttraumatic condition after acetabular fracture.The SDC indicating a real clinical improvement was 8.8 points in the FJS.We could confirm responsiveness of the FJS and found no relevant floor-or ceiling effects.
文摘背景:国内外大多数文献报道了活动平台单髁置换的中远期疗效,而对于固定平台单髁置换的中远期临床效果报道较少,同时大部分研究未分析固定平台单髁置换后不同时间点膝关节功能恢复及下肢力线改变情况,也忽视了对单髁置换后患者自我感觉情况的随访。目的:探讨膝关节固定平台单髁置换治疗膝关节内侧间室骨关节炎的中期临床效果,同时观察下肢力线改变情况。方法:回顾性分析2014年1月至2015年1月在佛山市中医院关节科诊断为膝关节内侧间室骨性关节炎患者的临床资料,按照纳入与排除标准,纳入行固定平台单髁置换66例患者,其中男18例,女48例,平均年龄(62.36±16.33)岁,分别在治疗前和治疗后1,3,5年采用美国膝关节协会评分(knee society knee score,KSS评分)、美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS评分)系统评估膝关节功能,采用目测类比评分评估膝关节疼痛严重程度,采用人工关节被遗忘指数评分评估单髁置换后假体自我主观感觉情况,治疗前和随访时拍摄双下肢负重全长X射线片测量髋-膝-踝角及胫股角评估下肢力线情况。结果与结论:①所有患者随访时间五六年,平均5.5年,切口均Ⅰ期愈合,无关节感染和下肢深静脉血栓形成等早期并发症发生,均无假体松动、脱位及对侧间室和髌股关节病变;②治疗后1,3,5年KSS临床评分、KSS功能评分、HSS评分、膝关节活动度、目测类比评分均低于治疗前(P<0.05),治疗后3,5年KSS临床评分、KSS功能评分、膝关节活动度、目测类比评分低于治疗后1年(P<0.05),治疗后3年与治疗后5年相比较,差异无显著性意义(P>0.05);③治疗后3,5年人工关节被遗忘指数评分高于治疗后1年(P<0.05),治疗后3年与治疗后5年相比较,差异无显著性意义(P>0.05);④所有患者治疗后髋-膝-踝角、胫股角较治疗前均有明显改善(P<0.05),治疗后1,3,5年时髋-膝-踝角、胫股角比较,差异无显著性意义(P>0.05);⑤结果表明,膝关节固定平台单髁假体置换中期临床疗效满意,假体自我化程度高,经治疗后下肢力线得到改善,治疗后5年随访时下肢力线无明显变化。
文摘目的对比分析单髁置换术(unicompartmental knee arthroplasty,UKA)与全膝关节置换术(total knee arthroplasty,TKA)治疗膝内侧间室骨关节炎(knee osteoarthritis,KOA)的疗效。方法回顾性分析2019年1月至2021年9月新乡医学院第一附属医院收治的78例膝关节内侧单间室骨关节炎患者,按手术方式分为UKA组和TKA组。UKA组39例患者,其中男7例,女32例;年龄45~74岁,平均(63.4±7.9)岁;身体质量指数(body mass index,BMI)为(25.92±2.70)kg/m~2。TKA组39例患者,其中男12例,女27例;年龄53~76岁,平均(65.8±6.3)岁;BMI为(26.61±4.07)kg/m~2。比较两组手术时间、术中出血量、总住院时长、术后引流量、疼痛视觉模拟评分(visual analogue scale,VAS)、膝关节活动度(range of motion,ROM)和纽约特种外科医院(the hospital for special surgery,HSS)膝关节评分及人工关节遗忘评分(forgotten joint scores,FJS)。结果78例患者均获得随访,随访时间12~16个月,平均随访(14.1±1.1)个月。UKA组手术时间、住院总时长、手术切口长度、术中出血量、术后引流量均少于TKA组,差异均有统计学意义(P<0.05)。两组患者术前VAS、ROM、HSS评分比较差异无统计学意义(P>0.05);术后3、6、12个月,UKA组患者VAS、HSS评分及ROM均优于TKA组,差异均有统计学意义(P<0.05)。术后3、6、12个月,UKA组患者FJS评分均高于TKA组,差异均有统计学意义(P<0.05)。结论UKA与TKA治疗内侧单间室KOA,均可明显缓解膝关节疼痛,改善膝关节功能;相较TKA,UKA具有创伤小、恢复快、患者关节忘却程度高等优势。
文摘目的评估在加速康复外科理念(enhanced recovery after surgery,ERAS)下采用单髁置换术治疗膝关节前内侧间室骨关节炎(anterior medial osteoarthritis of the knee,AMOA)的疗效。方法选取2019年2月至2020年7月于我院住院,在ERAS模式下进行单髁置换手术治疗的患者41例,其中男11例,女30例;年龄51~82岁,平均(68.20±7.23)岁。记录手术时间、术中出血量、术后并发症,比较手术前后疼痛视觉模拟评分(visual analogue scale,VAS),比较术前及末次随访时美国特种外科医院膝关节(hospital for special surgery,HSS)评分及术后6周、3个月、6个月的膝关节遗忘评分(forgotten joint score,FJS-12)。结果患者均获得随访,随访时间6~22个月,平均(15.07±4.38)个月,所有患者的影像学检查显示假体位置良好,无松动,无感染,无衬垫脱位。术后VAS评分(1.63±0.49)分,与术前(5.81±0.87)分相比较,差异有统计学意义(P<0.001)。末次随访时膝关节HSS评分(95.29±2.38)分,与术前(62.07±3.80)分相比较,差异有统计学意义(P<0.001)。术后6周FJS-12评分为(15.83±5.11)分,术后3个月为(8.07±3.05)分,二者比较差异有统计学意义(P<0.001),术后6个月为(6.39±2.88)分,与术后3个月相比较差异有统计学意义(P<0.001),但无实际临床意义。结论在加速康复外科理念下采用单髁置换术可以有效治疗膝关节前内侧骨关节炎,并在术后较早时间内达到较高的关节遗忘度。
文摘AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who had undergone unilateral TKA(UTKA) and 65 patients who had undergone simultaneous bilateral TKA(SBTKA) at our institution between 2010 and 2012. All TKAs were cemented and cruciate retaining. The mean follow-up period was 3.2(2 to 4) years. All the patients had symptomatic and debilitating unilateral or bilateral osteoarthritis for which all conservative and non-surgical treatments were failed, thus preoperatively the patients had poor functionality. All patients were asked to complete Forgotten Joint Score(FJS) and Oxford Knee Score(OKS) questionnaires. The patients were matched according to age, gender, year of surgery, Kellgren-Lawrence score and pre- andpostoperative overall knee alignment. The FJS and OKS questionnaire results of the two groups were then compared. RESULTS: A mixed-effects model was used to analyze differences between SBTKA and UTKA. OKS: The mean difference in the OKS between the patients who had undergone SBTKA and those who had undergone UTKA was 1.5, which was not statistically significant(CI =-0.9:4.0, P-value = 0.228). The mean OKS of the SBTKA patients was 37.6(SD = 9.0), and the mean OKS of the UTKA patients was 36.1(SD = 9.9). FJS: The mean difference in the FJS between the patients who had undergone SBTKA and those who had undergone UTKA was 2.3, which was not statistically significant(CI =-6.2:10.8, P-value = 0.593). The mean FJS of the SBTKA patients was 59.9(SD = 27.5), and the mean FJS of the UTKA patients was 57.5(SD = 28.8). CONCLUSION: SBTKA and UTKA patients exhibited similar joint functionality and knee awareness. Our results support the use of SBTKA in selected patients suffering from clinically symptomatic bilateral osteoarthritis.
