2026 · Journal of Bone and Joint Surgery American Volume
TKA後の疾患特異的PROMと一般健康PROMは、15年間でどう変化するか？
すべてのPROMが6か月以内に改善し、疾患特異的な結果は概ね5年まで安定していました。
対象と方法
絵を読んだ順序です
主な結果
手術に関する読書のポイント
解釈の限界
簡単に説明しましょう
この研究で何が確認されましたか?
すべてのPROMが6か月以内に改善し、疾患特異的な結果は概ね5年まで安定していました。
治療決定に直接適用できるか?
治療エビデンスレベルIII。生存し10年評価を完了した患者という選択と、女性への偏りがあります。インプラントやアライメント戦略を直接比較していません。
Keywords・キーワード
- Arthroplasty, Replacement, Knee
- Patient Reported Outcome Measures
- Osteoarthritis, Knee
- Retrospective Studies
- Longitudinal Studies
- Treatment Outcome
- Aged, 80 and over
- Time Factors
Abstract・原文の抄録
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.
オリジナル紙だ
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