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手术前患者报告的结果预测了门诊全膝关节整形术的候选人

Bhavana Gunda¹, Sara Strecker, Robert James Magaldi

¹From the Department of Orthopedics, University of Connecticut Medical School, Farmington, CT (Dr. Gunda); the Bone and Joint Institute Hartford Hospital, Hartford, CT (Dr. Strecker, Dr. Allen, and Dr. Witmer); the Division of Orthopaedic Surgery, Jefferson Health, Stratford, NJ (Dr. Magaldi); and the Orthopedic Associates of Hartford, Hartford, CT (Dr. Allen and Dr. Witmer).

Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews

|August 19, 2025

概括

通过简要弹性量表 (BRS) 测量的低手术前弹性,预测了熟练护理机构出院的更高率和全膝关节整形术 (TKA) 后延长停留时间. 这凸显了患者选择对于门诊TKA成功的重要性.

科学领域:

整形外科手术整形外科手术
患者研究成果研究结果
医疗保健服务研究医疗服务研究

背景情况:

对于末期关节炎的全膝关节整形术 (TKA) 越来越常见.
越来越多的门诊TKA趋势需要精细的患者选择.
术前评估工具对于优化 ambulatory TKA 的结果至关重要.

研究的目的:

评估手术前患者报告的结果测量 (PROMs) 对门诊TKA成功的预测价值.
确定简要弹性度量 (BRS) 是否可以识别患有不良结果风险的患者.
评估PROMs在指导患者选择门诊TKA时的有用性.

主要方法:

对2,167名接受选择性初级单边TKA.患者的回顾性分析.
收集手术前的PROMs:BRS,KOOS,JR,PROMIS-10,RAPT. 这就是为什么.
根据BRS得分,将患者分为低,平均和高弹性群体.
使用后勤回归和ROC曲线,分析住院时间 (LOS),出院安排和并发症.

主要成果:

耐药性较低的患者 (BRS < 3) 显示出出院到熟练护理机构 (SNF) 的比例显著更高,并延长了LOS.
BRS,RAPT和PROMIS-10分数是延长LOS和SNF释放的重要预测指标.
一个组合模型准确地预测了82.4%的灵敏度和79.9%的特异性扩展的LOS和SNF排放.

结论:

术前PROMs,特别是BRS,对于预测门诊环境中的全膝关节关节整形术 (TKA) 失败非常有价值.
将PROM整合到手术前决策中,可以改善患者对门诊手术的选择.
需要进一步的前性研究来验证这些发现,并探索弹性修改策略.

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