Previous cartilage surgery is associated with inferior patient‐reported outcomes after knee arthroplasty

医学 关节置换术 骨关节炎 软骨 队列 优势比 置信区间 外科 队列研究 内科学 病理 解剖 替代医学
作者
Thomas Birkenes,Ove Furnes,Stein Håkon Låstad Lygre,Eirik Solheim,Asbjorn Aaroen,Gunnar Knutsen,Jon Olav Drogset,Stig Heir,Lars Engebretsen,Sverre Løken,Håvard Visnes
出处
期刊:Knee Surgery, Sports Traumatology, Arthroscopy [Springer Science+Business Media]
卷期号:32 (2): 361-370 被引量:1
标识
DOI:10.1002/ksa.12050
摘要

Abstract Purpose The hypothesis of the present study assumed that a history of focal cartilage lesions would not affect Knee Injury and Osteoarthritis Outcome scores (KOOSs) following knee arthroplasty compared to a matched national cohort of knee arthroplasty patients. Methods Fifty‐eight knee arthroplasty patients with previous surgery for focal cartilage lesions (cartilage cohort) were compared to a matched cohort of 116 knee arthroplasty patients from the Norwegian Arthroplasty Register (control group). Age, sex, primary or revision arthroplasty, type of arthroplasty (total, unicondylar or patellofemoral), year of arthroplasty surgery and arthroplasty brand were used as matching criteria. Demographic data and KOOS were obtained through questionnaires. Regression models were employed to adjust for confounding factors. Results Mean follow‐up post knee arthroplasty surgery was 7.6 years (range 1.2–20.3) in the cartilage cohort and 8.1 (range 1.0–20.9) in the control group. The responding patients were at the time of surgery 54.3 versus 59.0 years in the cartilage and control group, respectively. At follow‐up the control group demonstrated higher adjusted Knee Injury and Osteoarthritis Outcome subscores than the previous focal cartilage patients with a mean adjusted difference (95% confidence interval in parentheses): Symptoms 8.4 (0.3, 16.4), Pain 11.8 (2.2, 21.4), Activities of daily living (ADL) 9.3 (−1.2, 18.6), Sport and recreation 8.9 (−1.6, 19.4) and Quality of Life (QoL) 10.6 (0.2, 21.1). The control group also demonstrated higher odds of reaching the patient‐acceptable symptom state threshold for the Knee Injury and Osteoarthritis Outcome subscores with odds ratio: Symptoms 2.7 (1.2, 6.4), Pain 3.0 (1.3, 7.0), ADL 2.1 (0.9, 4.6) and QoL 2.4 (1.0, 5.5). Conclusion Previous cartilage surgery was associated with inferior patient‐reported outcomes after knee arthroplasty. These patients also exhibited significantly lower odds of reaching the patient‐acceptable symptom state threshold for the Knee Injury and Osteoarthritis Outcome subscores. Level of Evidence Level III.
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