The Journal of the American Academy of Orthopaedic Surgeons. 2025 May 20. doi: 10.5435/JAAOS-D-24-01493 Q12.82025
Time to Minimal Clinically Important Difference in Patients Undergoing Conversion Total Hip Arthroplasty After Femoral Neck Fracture: A Propensity Score Matched Study
髋部骨折后股骨头置换再转行全髋关节置换术患者最小临床意义差异时间点：倾向性匹配研究 翻译改进
Jacob S Borgida 1, Perry Lim, Lara L Cohen, Nicholas Sauder, Thuan V Ly, Hany S Bedair, Christopher M Melnic
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DOI: 10.5435/JAAOS-D-24-01493 PMID: 40424395
摘要 中英对照阅读
背景： 置换全髋关节成形术（cTHA）常用于治疗持续性骨关节炎或股骨颈骨折（FNF）后固定失败的患者。关于接受FNF术后cTHA和初次全髋关节置换术（pTHA）患者的报告结果数据有限。本研究旨在比较髋关节功能与骨关节炎结局评分-物理功能简表（HOOS-PF）、患者报告结果测量信息系统（PROMIS）整体身体状况、以及PROMIS身体功能短表10a（PF-10a）在达到最小临床重要差异（MCID）所需时间。
方法： 从2016年至2022年间接受FNF术后cTHA的患者从机构数据库中识别，并通过年龄、性别、体重指数和Charlson合并症指数进行倾向评分匹配，以1:4的比例与初次全髋关节置换术（pTHA）患者相配。比较了人口统计学特征及MCID达成率。为了评估达到MCID的时间，使用了有无区间审查的生存曲线。
结果： 共分析258例全髋关节置换术（其中FNF cTHA 52例，pTHA 206例）。所有FNF均接受了手术治疗。三份PROMs中，FNF cTHA和pTHA患者在达成MCID的速率相似。对于PROMIS PF-10a评分，FNF cTHA组达到MCID的中位时间明显长于pTHA组（9.8个月 vs 4.2个月），分别为95%置信区间[6.5至12.1]和[3.3至6.0]（P
结论： FNF cTHA患者达成MCID所需时间明显长于初次全髋关节置换术的患者。这种延迟应纳入共同决策讨论中，以提高术前预期管理及病人教育效果。未来研究需要确定可调整的因素来改善FNF cTHA患者的康复结果。
版权所有 © 2025 美国骨科医师学会。
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期刊名：Journal of the american academy of orthopaedic surgeons
缩写：J AM ACAD ORTHOP SUR
ISSN：1067-151X
e-ISSN：1940-5480
IF/分区：2.8/Q1
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Time to Minimal Clinically Important Difference in Patients Undergoing Conversion Total Hip Arthroplasty After Femoral Neck Fracture: A Propensity Score Matched Study