背景:关于全髋关节置换术(THA)方法之间的结果仍存在争议。这项研究旨在比较髋关节残疾和骨关节炎结果评分-身体功能简表(HOOS-PS)和患者报告结果测量信息系统(PROMIS)达到最小临床重要差异(MCID)的时间。在原发性THA中接受前后手术入路手术的患者的物理。
方法:将2018年至2021年接受术前和术后HOOS-PS或PROMISGlobal-Physical问卷的患者按方法分组。比较了人口统计和MCID成就率,并且使用有和没有间隔审查的生存曲线来评估通过方法实现MCID的时间。对数秩和加权对数秩检验用于比较组,进行了Weibull回归分析以评估潜在的协变量。
结果:共分析了2,725例患者(前1,054例,后1,671例)。HOOS-PS的MCID成绩中位数均无显着差异(前:5.9个月,95%置信区间(CI):4.6至6.4;后:4.4个月,95%CI:4.1至5.1,P=0.65)或PROMISGlobal-Physical(前:4.2个月,95%CI:3.5至5.3;后部:3.5个月,95%CI:3.4至3.8,P=0.08)。间隔审查显示,HOOS-PS均获得MCID的时间较早(前:1.509至1.511个月;后:1.7至2.3个月,P=0.87)和PROMISGlobal-Physical(前:3.0至3.1周;后:2.7至3.3周,两种手术方法的P=0.18)。
结论:获得MCID的时间因手术方式而异。大多数患者将比以前认为的更早地实现身体功能的临床上有意义的改善。
BACKGROUND: Controversy remains over outcomes between total hip arthroplasty approaches. This study aimed to compare the time to achieve the minimal clinically important difference (MCID) for the Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form (HOOS-PS) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Global-Physical for patients who underwent anterior and posterior surgical approaches in primary total hip arthroplasty.
METHODS: Patients from 2018 to 2021 with preoperative and postoperative HOOS-PS or PROMIS Global-Physical questionnaires were grouped by approach. Demographic and MCID achievement rates were compared, and survival curves with and without interval-censoring were used to assess the time to achieve the MCID by approach. Log-rank and weighted log-rank tests were used to compare groups, and Weibull regression analyses were performed to assess potential covariates.
RESULTS: A total of 2,725 patients (1,054
anterior and 1,671 posterior) were analyzed. There were no significant differences in median MCID achievement times for either the HOOS-PS (
anterior: 5.9 months, 95% confidence interval [CI]: 4.6 to 6.4; posterior: 4.4 months, 95% CI: 4.1 to 5.1, P = .65) or the PROMIS Global-Physical (
anterior: 4.2 months, 95% CI: 3.5 to 5.3; posterior: 3.5 months, 95% CI: 3.4 to 3.8, P = .08) between approaches. Interval-censoring revealed earlier times of achieving the MCID for both the HOOS-PS (
anterior: 1.509 to 1.511 months; posterior: 1.7 to 2.3 months, P = .87) and the PROMIS Global-Physical (
anterior: 3.0 to 3.1 weeks; posterior: 2.7 to 3.3 weeks, P = .18) for both surgical approaches.
CONCLUSIONS: The time to achieve the MCID did not differ by surgical approach. Most patients will achieve clinically meaningful improvements in physical function much earlier than previously believed.
METHODS: Level III, Retrospective Comparative Study.