The objective indicators which reflect the past results of end-stage knee osteoarthritis (OA) patients who have already received total knee arthroplasty (TKA) could be helpful for physicians to discuss with patients who are considering TKA. The aim of this prospective cohort study was to examine whether we could predict the knee OA patients who would receive TKA in advance based on baseline data, and to set cut-off points for receiving TKA. The two-hundred and forty end-stage medial-type knee OA patients were enrolled and followed up for 6 months while performing therapeutic exercises. Radiographic findings, visual analog scale for pain and a patient-oriented outcome measure, the Japanese Knee Osteoarthritis Measure (JKOM), were recorded at baseline. Relative risks (RRs) using the area under the curve (AUC) for a receiver operating characteristic (ROC) curve were calculated to evaluate several scores for receiving TKA. While 119 patients (55.3 %) did not undergo TKA, the remaining 96 patients (44.7 %) underwent TKA during this period. The AUCs of the ROC curve for the JKOM total score [0.71 (95 % CI 0.64-0.79)] were higher than those for radiographic parameters. Among the JKOM subcategories, JKOM category III, which indicates the condition in daily life, showed the highest AUC of 0.72 (0.65-0.80). The JKOM total score (65/100) and JKOM category III score (17/40) showed RRs of 2.20 (1.33-3.63) and 1.95 (1.18-3.22) for receiving TKA, respectively. The presence of disability in daily living was found to be an important factor determining whether the patient should undergo TKA.

译文

:客观的指标反映了已经接受全膝关节置换术(TKA)的晚期膝关节骨关节炎(OA)患者的过去结果,可能有助于医生与正在考虑进行TKA的患者进行讨论。这项前瞻性队列研究的目的是检查我们是否可以根据基线数据预测可以提前接受TKA的膝骨OA患者,并设定接受TKA的临界点。入选了240例中晚期膝关节OA患者,并进行了6个月的随访,同时进行了治疗性锻炼。在基线记录影像学发现,疼痛的视觉模拟量表和以患者为导向的结果指标,即日本膝骨关节炎指标(JKOM)。使用接收者操作特征(ROC)曲线的曲线下面积(AUC)计算相对风险(RRs),以评估接收TKA的几个分数。虽然有119名患者(55.3%)没有接受过TKA,但其余96名患者(44.7%)在此期间接受了TKA。 JKOM总分[0.71(95%CI 0.64-0.79)]的ROC曲线的AUC高于射线照相参数的AUC。在JKOM子类别中,指示日常生活状况的JKOM第三类显示最高的AUC为0.72(0.65-0.80)。 JKOM总评分(65/100)和JKOM III类评分(17/40)分别显示接受TKA的RR为2.20(1.33-3.63)和1.95(1.18-3.22)。发现日常生活中是否存在残疾是决定患者是否应该接受TKA的重要因素。

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