Background

Osteochondral allograft (OCA) transplantation is an increasingly common treatment for patients with symptomatic focal chondral lesions of the knee. There has been increasing interest in determining predictive factors to maximize patient benefit after this operation. The aim of the present study is to evaluate the predictive association of the physical component (PCS) and mental component (MCS) scores of the Short Form 36 (SF-36) questionnaire for achievement of the minimal clinically important difference (MCID) after OCA transplantation.

Methods

This retrospective study of a longitudinally maintained institutional registry included 91 patients who had undergone OCA transplantation for symptomatic focal osteochondral lesions of the femoral condyle. Included patients were those with complete preoperative questionnaires for the SF-36 and IKDC and completed postoperative IKDC at 2-year follow-up. Multivariate analysis was performed evaluating predictive association of the preoperative MCS and PCS with achievement of the MCID for the IKDC questionnaire.

Results

Logistic multivariate modeling demonstrated a statistically significant association between lower preoperative PCS and achievement of the MCID (P = 0.022). A defect diameter >2 cm was also associated with achievement of MCID (P = 0.049). Preoperative MCS did not demonstrate a significant association (P = 0.09) with achievement of the MCID.

Conclusions

For this cohort of 91 patients, the preoperative SF-36 PCS and lesion size were predictive of achievement of the MCID at 2-year follow-up after femoral OCA transplantation. These findings support an important role of baseline physical health scores for predicting which patients will obtain a meaningful clinical benefit from this surgery.

中文翻译：

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SF-36 物理成分评分可预测股骨骨软骨同种异体移植后临床意义的改善。

背景

同种异体骨软骨移植 (OCA) 移植是治疗膝关节有症状的局灶性软骨损伤患者越来越常见的治疗方法。人们越来越关注确定预测因素以最大限度地提高手术后患者的利益。本研究的目的是评估 Short Form 36 (SF-36) 问卷的物理成分 (PCS) 和心理成分 (MCS) 评分对 OCA 后实现最小临床重要差异 (MCID) 的预测关联移植。

方法

这项纵向维护机构登记的回顾性研究包括 91 名因股骨髁有症状的局灶性骨软骨病变而接受 OCA 移植的患者。纳入的患者是那些完成了 SF-36 和 IKDC 的术前问卷调查并在 2 年随访时完成了术后 IKDC 的患者。进行了多变量分析，评估了术前 MCS 和 PCS 与 IKDC 问卷的 MCID 的预测关联。

结果

Logistic 多变量模型表明，较低的术前 PCS 与 MCID 的实现之间存在统计学显着关联（P = 0.022）。直径>2 cm 的缺陷也与获得 MCID 相关（P = 0.049）。术前 MCS与 MCID 的实现没有显着相关性（P = 0.09）。

结论

对于这 91 名患者的队列，术前 SF-36 PCS 和病变大小可预测股骨 OCA 移植后 2 年随访时 MCID 的实现。这些发现支持基线身体健康评分在预测哪些患者将从该手术中获得有意义的临床益处方面的重要作用。