2026 · Journal of Bone and Joint Surgery American Volume
TKA 후 질환특이 PROM과 일반 건강 PROM은 15년 동안 어떻게 달라질까?
모든 PROMs는 6개월 안에 개선됐고 질환 특이 결과는 5년까지 대체로 안정적이었습니다.
대상과 방법
그림을 읽는 순서
주요 결과
진료·수술에서 읽을 지점
해석의 제한
짧게 정리하면
이 연구가 확인한 것은 무엇인가요?
모든 PROMs는 6개월 안에 개선됐고 질환 특이 결과는 5년까지 대체로 안정적이었습니다.
개별 환자의 치료 결정에 바로 적용할 수 있나요?
Therapeutic Level III. 생존·10년 평가 완료자라는 선택과 여성 편중이 있습니다. Implant나 정렬 전략을 직접 비교하지 않았습니다.
Keywords · 주제어
- Arthroplasty, Replacement, Knee
- Patient Reported Outcome Measures
- Osteoarthritis, Knee
- Retrospective Studies
- Longitudinal Studies
- Treatment Outcome
- Aged, 80 and over
- Time Factors
Abstract · 원문 초록
Byung Sun Choi, Du Hyun Ro, Hyuk-Soo Han. Long-Term Trajectories of Patient-Reported Outcomes Following Total Knee Arthroplasty: A Longitudinal Study of 1,264 Patients. The Journal of bone and joint surgery. American volume. 2026;108(5):355-362. doi:10.2106/JBJS.25.00770.
BACKGROUND
Although total knee arthroplasty (TKA) is known to improve patient-reported outcome measure (PROM) scores in the short term to midterm, the long-term trajectories of both disease-specific and generic PROM scores remain unclear.
METHODS
We retrospectively analyzed the prospectively collected registry data of 1,264 patients (mean age, 68.5 years; 93.7% female) who underwent primary TKA for osteoarthritis between 2005 and 2013 and completed PROM assessments at baseline and 10 years postoperatively. Disease-specific PROMs were assessed using the Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Generic PROMs were assessed using the Short Form-36 Health Survey (SF-36). Assessments were performed preoperatively and at 6 months and 1, 2, 5, 10, and 15 years postoperatively. Generalized linear models and linear mixed-effects models were used to evaluate temporal changes and subgroup differences by age and sex.
RESULTS
All PROM scores improved significantly within 6 months after TKA. Thereafter, disease-specific PROMs showed modest changes up to 1 year, with relative stability until 5 years, whereas generic PROMs demonstrated heterogeneous patterns across different domains. Between 5 and 10 years postoperatively, WOMAC pain and stiffness scores did not show significant changes, the KSKS decreased but not significantly so, and WOMAC physical function scores exhibited small but significant deterioration that was not clinically meaningful. SF-36 domains demonstrated varied trajectories: physical and mental component scores declined by more than the minimal clinically important difference after 5 years, whereas the social functioning score showed continuous improvement, although not all changes were significant. Octogenarians demonstrated lower physical functioning scores but higher social functioning scores in the long term compared with younger patients, and female patients demonstrated inferior functional and vitality scores compared with male patients.
CONCLUSIONS
Both disease-specific and generic PROM scores after TKA improved significantly and remained superior to baseline scores over a 15-year period, although physical function scores tended to decline in the long term. In this large, predominantly female Korean cohort, the distinct age- and sex-specific trajectories highlight the importance of implementing individualized, time-adapted long-term management strategies to optimize patient outcomes.
LEVEL OF EVIDENCE
Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
Copyright © 2025 The Author(s). Published by The Journal of Bone and Joint Surgery, Incorporated.
원래 논문
Long-Term Trajectories of Patient-Reported Outcomes Following Total Knee Arthroplasty: A Longitudinal Study of 1,264 Patients
Byung Sun Choi, Du Hyun Ro, Hyuk-Soo Han
Journal of Bone and Joint Surgery American Volume · 2026 · online 2025