AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint condition...AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.展开更多
目的:探究膝关节镜下引导小切口与传统切开内固定治疗胫骨平台骨折(fracture of tibial plateau,FTP)的效果及对膝关节功能的影响。方法:回顾性分析2022年6月—2023年3月厦门市第五医院收治的60例FTP患者,按照膝关节镜下引导小切口和传...目的:探究膝关节镜下引导小切口与传统切开内固定治疗胫骨平台骨折(fracture of tibial plateau,FTP)的效果及对膝关节功能的影响。方法:回顾性分析2022年6月—2023年3月厦门市第五医院收治的60例FTP患者,按照膝关节镜下引导小切口和传统切开内固定手术方式差异分为研究组(28例)和传统组(32例)。两组患者均于术后随访3个月,观察两组围手术期指标(手术时间、术中出血量、下床活动时间、骨折愈合时间、住院时间),统计两组随访期间并发症发生率,比较两组术前、术后48 h炎症应激指标[白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、皮质醇(cortisol,Cor)]及术前、术后3个月膝关节功能评分[采用美国特种外科医院膝关节评分(Hospital for Special Surgery knee score,HSS)、膝关节活动度(range of motion,ROM)]。结果:研究组手术时间显著长于传统组,术中出血量显著少于传统组,下床活动时间显著早于传统组,差异有统计学意义(P<0.05);两组骨折愈合时间、住院时间比较,差异无统计学意义(P>0.05);研究组并发症总发生率低于传统组,差异有统计学意义(P<0.05);术后48 h,两组IL-6、TNF-α、Cor水平均较术前显著升高,但研究组术后48 h的IL-6、TNF-α、Cor水平显著低于传统组,差异有统计学意义(P<0.05);术后3个月,两组HSS评分、ROM中伸膝和屈膝角度均较术前显著升高,且研究组HSS评分、ROM伸膝和屈膝角度高于传统组,差异有统计学意义(P<0.05)。结论:膝关节镜下引导小切口与传统切开内固定手术治疗FTP均能取得较好临床效果,但膝关节镜下引导小切口式更具微创优势,可减少术中出血量、缩短下床活动时间,且并发症发生率低,术后炎症及应激反应轻,膝关节活动功能恢复好,有利于患者康复。展开更多
目的观察浮针疗法治疗早中期膝骨关节炎对关节软骨厚度的影响。方法将60例早中期膝骨关节炎患者随机分为治疗组和对照组,每组30例。治疗组采用浮针治疗,对照组采用电针治疗。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS...目的观察浮针疗法治疗早中期膝骨关节炎对关节软骨厚度的影响。方法将60例早中期膝骨关节炎患者随机分为治疗组和对照组,每组30例。治疗组采用浮针治疗,对照组采用电针治疗。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、疼痛开始缓解时间、Lysholm膝关节功能评分、平衡功能及股骨内侧和外侧髁软骨厚度的变化。结果治疗组疼痛开始缓解时间短于对照组(P<0.05)。治疗后,两组VAS评分以及平衡功能的横向标准差和前后标准差均较治疗前降低(P<0.05),Lysholm膝关节功能评分、平衡功能的稳定极限均较治疗前升高(P<0.05)。治疗后3个月,两组VAS评分较治疗前降低(P<0.05),Lysholm膝关节功能评分较治疗前升高(P<0.05),膝关节内外侧髁软骨厚度均较治疗前增加(P<0.05)。治疗后和治疗后3个月,治疗组VAS评分均低于对照组(P<0.05),Lysholm膝关节功能评分均高于对照组(P<0.05)。治疗后,治疗组横向标准差低于对照组(P<0.05),稳定极限高于对照组(P<0.05)。结论浮针治疗早中期膝骨关节炎起效速度优于电针治疗,能有效缓解疼痛症状及提高膝关节功能,可改善软骨损伤。展开更多
基金National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health,No.U01AR067138.
文摘AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.
文摘目的:探究膝关节镜下引导小切口与传统切开内固定治疗胫骨平台骨折(fracture of tibial plateau,FTP)的效果及对膝关节功能的影响。方法:回顾性分析2022年6月—2023年3月厦门市第五医院收治的60例FTP患者,按照膝关节镜下引导小切口和传统切开内固定手术方式差异分为研究组(28例)和传统组(32例)。两组患者均于术后随访3个月,观察两组围手术期指标(手术时间、术中出血量、下床活动时间、骨折愈合时间、住院时间),统计两组随访期间并发症发生率,比较两组术前、术后48 h炎症应激指标[白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、皮质醇(cortisol,Cor)]及术前、术后3个月膝关节功能评分[采用美国特种外科医院膝关节评分(Hospital for Special Surgery knee score,HSS)、膝关节活动度(range of motion,ROM)]。结果:研究组手术时间显著长于传统组,术中出血量显著少于传统组,下床活动时间显著早于传统组,差异有统计学意义(P<0.05);两组骨折愈合时间、住院时间比较,差异无统计学意义(P>0.05);研究组并发症总发生率低于传统组,差异有统计学意义(P<0.05);术后48 h,两组IL-6、TNF-α、Cor水平均较术前显著升高,但研究组术后48 h的IL-6、TNF-α、Cor水平显著低于传统组,差异有统计学意义(P<0.05);术后3个月,两组HSS评分、ROM中伸膝和屈膝角度均较术前显著升高,且研究组HSS评分、ROM伸膝和屈膝角度高于传统组,差异有统计学意义(P<0.05)。结论:膝关节镜下引导小切口与传统切开内固定手术治疗FTP均能取得较好临床效果,但膝关节镜下引导小切口式更具微创优势,可减少术中出血量、缩短下床活动时间,且并发症发生率低,术后炎症及应激反应轻,膝关节活动功能恢复好,有利于患者康复。
文摘目的观察浮针疗法治疗早中期膝骨关节炎对关节软骨厚度的影响。方法将60例早中期膝骨关节炎患者随机分为治疗组和对照组,每组30例。治疗组采用浮针治疗,对照组采用电针治疗。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、疼痛开始缓解时间、Lysholm膝关节功能评分、平衡功能及股骨内侧和外侧髁软骨厚度的变化。结果治疗组疼痛开始缓解时间短于对照组(P<0.05)。治疗后,两组VAS评分以及平衡功能的横向标准差和前后标准差均较治疗前降低(P<0.05),Lysholm膝关节功能评分、平衡功能的稳定极限均较治疗前升高(P<0.05)。治疗后3个月,两组VAS评分较治疗前降低(P<0.05),Lysholm膝关节功能评分较治疗前升高(P<0.05),膝关节内外侧髁软骨厚度均较治疗前增加(P<0.05)。治疗后和治疗后3个月,治疗组VAS评分均低于对照组(P<0.05),Lysholm膝关节功能评分均高于对照组(P<0.05)。治疗后,治疗组横向标准差低于对照组(P<0.05),稳定极限高于对照组(P<0.05)。结论浮针治疗早中期膝骨关节炎起效速度优于电针治疗,能有效缓解疼痛症状及提高膝关节功能,可改善软骨损伤。
