BACKGROUND Uncomplicated joint replacement improves pain and other patient-reported outcome measures (PROMs) such as joint function scores and quality-of-life measures. However, the overall impact of periprosthetic joint infection (PJI) and its successful treatment on PROMs is poorly defined. In this study, we describe quality-of-life scores using the 12-item Short Form survey, version 2 (SF-12v2), collected as part of a large, prospective, observational study of PJI. QUESTIONS/PURPOSES (1) Do patients with newly diagnosed PJI have lower quality-of-life scores than the general age-matched population? (2) Are lower quality-of-life scores for patients with PJI sustained for ≥ 12 months? (3) What factors are associated with a good functional outcome at 12 months, defined by achieving a physical component summary (PCS) score of > 50 on the SF-12v2 (that is, above the age-adjusted population mean) or an increase of > 8.9 or more from baseline? METHODS The PIANO (Prosthetic joint Infection in Australia and New Zealand, Observational study) cohort was a prospective, longitudinal, multicenter cohort study of 783 patients with newly diagnosed PJI recruited across 27 centers between July 2014 and December 2017. All participants were followed for 2 years. SF-12v2 scores were collected at diagnosis (baseline) and 3, 12, and 24 months after diagnosis. Treatment success was defined as being alive with no clinical or microbiological evidence of infection and no ongoing use of antibiotics for the index joint. RESULTS After exclusion of 6.6% (52) who had died, 4.2% (33) with PJI of joints other than hips and knees, and those with incomplete data sets (200 [25.5%]), 498 patients had complete SF-12v2 data sets available. At baseline, the median (IQR) PCS score was 37 (30 to 46), which increased to 41 (34 to 49; p < 0.001) at 12 months. Both measures were lower than those for the general age-matched population norm. There was no further improvement in PCS scores between 12 and 24 months. By contrast, the median (IQR) mental component summary score of the SF-12v2 was similar to age-adjusted population norms (48 [37 to 57]) at baseline. Only 40% of patients with PJI achieved a good functional outcome at 12 months. After adjustment for other factors, treatment success of PJI increased the odds of a good functional outcome by 67% (95% CI 11% to 154%; p = 0.02). CONCLUSION PJIs have a large effect on the PCS score of the SF-12v2 quality-of-life measure at baseline, which is sustained for at least 2 years. Successful treatment of PJI increases the likelihood of a good functional outcome. These data can be used to set expectations for patients presenting with PJI and can be used to inform future clinical studies in which quality-of-life measures are incorporated into clinical endpoints. LEVEL OF EVIDENCE Level II, therapeutic study.

中文翻译：

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人工关节感染及其成功治疗对患者报告的生活质量有多大影响？


背景 无并发症的关节置换术可改善疼痛和其他患者报告的结果测量 （PROM），例如关节功能评分和生活质量测量。然而，假体周围关节感染 （PJI） 及其成功治疗对 PROM 的总体影响尚不清楚。在这项研究中，我们使用 12 项简式调查第 2 版 （SF-12v2） 来描述生活质量评分，该调查是作为 PJI 的大型前瞻性观察研究的一部分收集的。问题/目的 （1） 新诊断的 PJI 患者的生活质量评分是否低于一般年龄匹配的人群？（2） PJI 患者较低的生活质量评分是否持续≥ 12 个月？（3） 哪些因素与 12 个月时的良好功能结果相关，定义为在 SF-12v2 上达到 > 50 的物理成分汇总 （PCS） 评分（即高于年龄调整后的人群平均值）或比基线增加 > 8.9 或更多？方法 PIANO （澳大利亚和新西兰人工关节感染，观察性研究） 队列是一项前瞻性、纵向、多中心队列研究，对 2014 年 7 月至 2017 年 12 月期间在 27 个中心招募的 783 名新诊断的 PJI 患者进行研究。所有参与者均被随访 2 年。在诊断 （基线） 和诊断后 3 、 12 和 24 个月收集 SF-12v2 评分。治疗成功定义为存活，没有感染的临床或微生物学证据，并且指数关节没有持续使用抗生素。结果 在排除 6.6% （52） 的死亡患者、4.2% （33） 的髋关节和膝关节以外的关节 PJI 患者以及数据集不完整的患者 （200 [25.5%]） 后，498 名患者有完整的 SF-12v2 数据集可用。 基线时，中位 （IQR） PCS 评分为 37 （30 至 46），12 个月时增加到 41 （34 至 49;p < 0.001）。这两项指标均低于一般年龄匹配的人口标准。PCS 评分在 12 至 24 个月之间没有进一步改善。相比之下，SF-12v2 的中位 （IQR） 心理成分总分与基线时年龄调整后的人群标准 （48 [37， 57]）相似。只有 40% 的 PJI 患者在 12 个月时取得了良好的功能结局。在调整其他因素后，PJI 的治疗成功使良好功能结局的几率增加了 67% （95% CI [11%， 154%];p = 0.02）。结论 PJI 对基线时 SF-12v2 生活质量测量的 PCS 评分有很大影响，该评分持续至少 2 年。PJI 的成功治疗增加了获得良好功能结果的可能性。这些数据可用于为患有 PJI 的患者设定期望，并可用于为未来的临床研究提供信息，在这些研究中，生活质量指标被纳入临床终点。证据级别 II 级，治疗研究。