Patient-reported outcomes of 7133 distal femoral, patellar, and proximal tibial fracture patients: A national cross-sectional study with one-, three-, and five-year follow-up

Knee. 2020 Oct;27(5):1310-1324. doi: 10.1016/j.knee.2020.06.006. Epub 2020 Jul 27.

Abstract

Background: Few studies have described patient-reported outcome measures (PROMs) in knee fracture patients. We reported knee-specific and generic median PROM scores after knee fracture and identified risk factors for poor outcome defined by low median PROM scores.

Methods: In a Danish cross-sectional study of 7133 distal femoral, patellar, and proximal tibial fracture patients during 2011-2017, OKS, FJS-12, EQ5D-5L Index, and EQ5D-5L Visual Analogue Scale (VAS), were collected electronically (response rate 53%; median age 60; 63% female). Poor outcome was defined as score lower than median PROM score. Poor outcome risk factors were estimated as odds ratios from binary logistic regression models.

Results: At 0 to one year after knee fracture, median PROM scores were 31 (OKS), 27 (FJS-12), 0.50 (EQ5D-5L Index), and 74 (EQ5D-5L VAS). At >5 years after knee fracture, median OKS score was 40, median FJS-12 score was 54, median EQ5D-5L Index was 0.76, and median EQ5D-5L VAS score was 80. Age > 40 years had higher odds for poor OKS and FJS-12 scores at short- and long-term follow-up after knee fracture. Comorbidity burden, distal femoral fracture, and treatment with external fixation and knee arthroplasty were risk factors for poor outcome at long-term follow-up, for all four PROMs.

Conclusions: Although knee fracture patients have relatively high knee function and quality of life, their ability to forget about the knee joint after knee fracture is compromised. We identified several important risk factors for poor outcome measured by PROMs at different follow-up periods following knee fracture, which will help direct future quality-improvement initiatives.

Keywords: Distal femoral fracture; EQ5D-5L; Forgotten Joint Score-12; Oxford Knee Score; Patellar fracture; Proximal tibial fracture.

MeSH terms

  • Adult
  • Age Factors
  • Arthroplasty, Replacement, Knee / adverse effects
  • Comorbidity
  • Cross-Sectional Studies
  • External Fixators / adverse effects
  • Female
  • Femoral Fractures / surgery*
  • Follow-Up Studies
  • Fractures, Bone / surgery*
  • Humans
  • Male
  • Middle Aged
  • Patella / injuries
  • Patella / surgery*
  • Patient Reported Outcome Measures*
  • Risk Factors
  • Tibial Fractures / surgery*
  • Visual Analog Scale