Abstract：
OBJECTIVE: Quality of care in total knee arthroplasty (TKA) between implants was assessed using a novel composite outcome measure, early optimal recovery (EOR), to indicate ideal clinical outcomes and minimal healthcare resource utilization.
METHODS: Patients that underwent primary TKA in the study group (ATTUNE® Knee System) or control group (LCS® COMPLETE Knee System) were included in this retrospective, single-center study. EOR was defined as no complications, no readmissions, no extra outpatient visits, ≤ 48 h length of hospital stay (LOS), and restored range of motion and pain perception at 3-month follow-up. Multivariate logistic regression was used to compare EOR between the study and control groups. Results were adjusted for differences in baseline characteristics and are presented with 95% confidence intervals (CI). Data were collected from a specialized clinic for elective surgeries in the Netherlands, between January 2017 and December 2020.
RESULTS: A total of 566 patients (62.4% female, mean age 67 years) were included for analysis; 185 patients (32.7%) underwent TKA in the study group. Compared to the control group, patients in the study group had greater probability of achieving EOR (65.8% [95% CI: 55.1-75.2] vs. 38.9% [95% CI: 32.8-45.3]; p < 0.001), a LOS ≤ 48 h (77.2% [95% CI: 67.7-84.5] vs. 61.4% [95% CI: 54.7-67.7]; p < 0.05), and ideal pain perception at 3-month follow-up (93.3% [95% CI: 85.7-97.0] vs. 78.2% [95% CI: 71.0-83.9]; p < 0.05).
CONCLUSIONS: The study group was associated with a greater probability of achieving EOR versus the control group, suggesting improved quality of care.
METHODS: Patients that underwent primary TKA in the study group (ATTUNE® Knee System) or control group (LCS® COMPLETE Knee System) were included in this retrospective, single-center study. EOR was defined as no complications, no readmissions, no extra outpatient visits, ≤ 48 h length of hospital stay (LOS), and restored range of motion and pain perception at 3-month follow-up. Multivariate logistic regression was used to compare EOR between the study and control groups. Results were adjusted for differences in baseline characteristics and are presented with 95% confidence intervals (CI). Data were collected from a specialized clinic for elective surgeries in the Netherlands, between January 2017 and December 2020.
RESULTS: A total of 566 patients (62.4% female, mean age 67 years) were included for analysis; 185 patients (32.7%) underwent TKA in the study group. Compared to the control group, patients in the study group had greater probability of achieving EOR (65.8% [95% CI: 55.1-75.2] vs. 38.9% [95% CI: 32.8-45.3]; p < 0.001), a LOS ≤ 48 h (77.2% [95% CI: 67.7-84.5] vs. 61.4% [95% CI: 54.7-67.7]; p < 0.05), and ideal pain perception at 3-month follow-up (93.3% [95% CI: 85.7-97.0] vs. 78.2% [95% CI: 71.0-83.9]; p < 0.05).
CONCLUSIONS: The study group was associated with a greater probability of achieving EOR versus the control group, suggesting improved quality of care.
摘要：
目的：使用一种新的复合结局指标评估植入物之间的全膝关节置换术（TKA）的护理质量，早期最佳恢复(EOR)，以表明理想的临床结果和最低的医疗资源利用率。
方法：在研究组（ATTUNE®膝关节系统）或对照组（LCS®完全膝关节系统）中接受原发性TKA的患者被纳入本回顾性研究，单中心研究。EOR定义为无并发症,没有再入院，没有额外的门诊就诊，≤48小时的住院时间（LOS），并在3个月随访时恢复了运动范围和疼痛感知。采用多因素logistic回归分析比较研究组和对照组的EOR。根据基线特征的差异调整结果，并以95％置信区间（CI）表示。数据是从荷兰的选择性手术的专门诊所收集的，2017年1月至2020年12月。
结果：共有566例患者（62.4%为女性，平均年龄67岁)纳入分析;研究组185例患者(32.7%)接受了TKA.与对照组相比,研究组患者实现EOR的可能性更大(65.8%[95%CI：55.1-75.2]vs.38.9%[95%CI：32.8-45.3]；p<0.001)，aLOS≤48h(77.2%[95%CI：67.7-84.5]vs.61.4%[95%CI：54.7-67.7]；p<0.05），3个月随访时的理想疼痛感知（93.3％[95％CI：85.7-97.0]vs.78.2%[95%CI：71.0-83.9]；p<0.05）。
结论：与对照组相比，研究组实现EOR的可能性更大，建议提高护理质量。
方法：在研究组（ATTUNE®膝关节系统）或对照组（LCS®完全膝关节系统）中接受原发性TKA的患者被纳入本回顾性研究，单中心研究。EOR定义为无并发症,没有再入院，没有额外的门诊就诊，≤48小时的住院时间（LOS），并在3个月随访时恢复了运动范围和疼痛感知。采用多因素logistic回归分析比较研究组和对照组的EOR。根据基线特征的差异调整结果，并以95％置信区间（CI）表示。数据是从荷兰的选择性手术的专门诊所收集的，2017年1月至2020年12月。
结果：共有566例患者（62.4%为女性，平均年龄67岁)纳入分析;研究组185例患者(32.7%)接受了TKA.与对照组相比,研究组患者实现EOR的可能性更大(65.8%[95%CI：55.1-75.2]vs.38.9%[95%CI：32.8-45.3]；p<0.001)，aLOS≤48h(77.2%[95%CI：67.7-84.5]vs.61.4%[95%CI：54.7-67.7]；p<0.05），3个月随访时的理想疼痛感知（93.3％[95％CI：85.7-97.0]vs.78.2%[95%CI：71.0-83.9]；p<0.05）。
结论：与对照组相比，研究组实现EOR的可能性更大，建议提高护理质量。
