目的:本研究旨在回答接受全髋关节置换术(THA)的髋关节骨关节炎(OA)患者的以下问题:患者报告的结局指标(PROMs)是否受最大严重程度的位置影响疼痛的严重程度?;PROMs是否受非腹股沟疼痛的存在影响?;PROMs是否受疼痛的严重程度影响?以及PROMs是否受2016年12月使用THB/336治疗的患者
结果:在腹股沟和转子疼痛最严重的组之间,iHOT-12评分存在显着差异(p=0.039)。此外,更有利的mHHS评分与转子术前疼痛的存在有关(p=0.049),下背部(p=0.056),大腿外侧(p=0.034),和大腿后部(p=0.005)。最后,术前疼痛的最大严重程度和疼痛部位数量与PROM没有显著关系(最大严重程度:HHS:p=0.928,HOS:p=0.163,iHOT-12p=0.233;疼痛部位数量:HHS:p=0.211;HOS:p=0.801;iHOT-12:p=0.112).
结论:尽管在腹股沟或转子疼痛最严重的患者之间iHOT-12评分存在显著差异,以及转子上的疼痛,下背部,大腿外侧,或大腿后部与较高的mHHS评分有关,大多数术前疼痛特征对结局没有显著影响.因此,广泛的髋关节OA患者可能会期望类似的,尽管术前疼痛特征,但THA的有利结果。引用这篇文章:BoneJtOpen2022;3(4):332-339。
OBJECTIVE: This study aims to answer the following questions in patients with hip osteoarthritis (OA) who underwent total hip arthroplasty (THA): are patient-reported outcome measures (PROMs) affected by the location of the maximum severity of pain?; are PROMs affected by the presence of non-groin pain?; are PROMs affected by the severity of pain?; and are PROMs affected by the number of pain locations?
METHODS: We reviewed 336 hips (305 patients) treated with THA for hip OA from December 2016 to November 2019 using pain location/severity questionnaires, modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), international Hip Outcome Tool (iHOT-12) score, and radiological analysis. Descriptive statistics, analysis of covariance (ANCOVA), and Spearman partial correlation coefficients were used.
RESULTS: There was a significant difference in iHOT-12 scores between groups experiencing the most severe pain in the groin and the
trochanter (p = 0.039). Additionally, more favourable mHHS scores were related to the presence of preoperative pain in
trochanter (p = 0.049), lower back (p = 0.056), lateral thigh (p = 0.034), and posterior thigh (p = 0.005). Finally, the maximum severity of preoperative pain and number of pain locations had no significant relationship with PROMs (maximum severity: HHS: p = 0.928, HOS: p = 0.163, iHOT-12 p = 0.233; number of pain locations: HHS: p = 0.211; HOS: p = 0.801; iHOT-12: p = 0.112).
CONCLUSIONS: Although there was a significant difference in iHOT-12 scores between patients with the most severe pain in the groin or
trochanter, and the presence of pain in the
trochanter, lower back, lateral thigh, or posterior thigh was related to higher mHHS scores, the majority of preoperative pain characteristics did not have a significant impact on outcomes. Therefore, a broad array of patients with hip OA might expect similar, favourable outcomes from THA notwithstanding preoperative pain characteristics. Cite this article: Bone Jt Open 2022;3(4):332-339.