Studies On Incorporating Patient Reported Outcome Measures Into The Evaluation Of Conservative Treatment Procedures For Osteonecrosis Of The Femeral Head

Studies On Incorporating Patient Reported Outcome Measures Into The Evaluation Of Conservative Treatment Procedures For Osteonecrosis of the Femeral HeadObjective1 To assess the relationship between self-reported measures (Western Ontario and McMaster University Osteoarthritis Index (WOMAC),EQ-5D) and doctor report outcome;2 To put forward evaluation protocols concerning PROMs applying in ONFH conservative treatment3 To explore Health Related Quality of Life before and after ONFH conservative treatment.MethodScreen the cases of ONFH for conservative treatment in Wangjing hospital of China Acadamy of Chinese Medicine Science from October 2010 to January 2011, for demographic data and outcome scores at baseline and 3-month follow-up. Then establish a database,and analyse statistically by appropriate means.Results1 General informationScreen 65 cases of femoral head necrosis (ONFH) receiveing conservative treatment in Wangjing hospital of China Acadamy of Chinese Medicine Science from October 2010to January 2011.61 cases of patients met the follow-up,up to 93.84%.38 Cases were male,27 cases female.The age range was 21-55 years old, mean 41.15±9.85; Mean BMI is 24.63±3.27.2 Harris score before and after conservative treatmentAverage Harris score before conservative treatment is 81.56±13.18,after treatment 85.12±12.54,indicateing change has significant difference statistically (P=0.026<0.05) 3 WOMAC score before and after conservative treatmentAverage WOMAC score before conservative treatment is 27.98±13.74, after treatment 23.74±11.92,indicateing change has significant difference statistically (P=0.033<0.05)4 EQ-5D score before and after conservative treatmentAverage EQ-5D score before conservative treatment is 0.56±0.17,after treatment 0.62±0.20,indicateing change has significant difference statistically (P=0.019<0.05)5 Relationship between WOMAC,EQ-5D and Harris scoreThe correlation betweenEQ-5D and Harris score (r=0.616),WOMAC and Harris score (r=-0.663) is high before conservative treatment. The correlation betweenEQ-5D and Harris score(r=0.586),WOMAC and Harris score (r=-0.683) is high after conservative treatment.6 Comorbidity of patient suffererd from ONFHThere is 96 Comorbidity among 61 patients,includeing rheumatism, rheumatoid, kidney disease which need Taking hormone.only 8 patients have no Comorbidity.Survey reveals that 52.31% has psychological problems, such as depression or anxiety,21.54% patients feel the circulation in both legs is poor, which doctor ignore.7 Post treatment complication8.57% patients receiveing interventional operation complain subcutaneous congestion.16.67%patients receiveing core decompression assisted with grafts complain oozing of the blood from wound,which needs dressing change.8 Patient satisfaction questionnairesPatient satisfaction questionnaires show patients with medium satisfaction,very satisfaction are in majority,with patients with medium satisfaction 32.79%,very satisfaction 50.82%.9 Interview survey outcome92.31% patients fill out interview survey seriously,and 7.69% patients were not glad to fill out interview survey.56.92% patients consider that questionnaire is a slightly complex,suggesting downsizing it.Conclusion1 The correlation betweenEQ-5D,WOMAC and Harris score is high before and after conservative treatment;2 Proposed evaluation scheme has certain value of clinical applications from the results of the study;3 We can obtain more comprehensive medical information about diagnosis and treatment through the proposed evaluation scheme;4 The level of patient satisfaction is high after conservative treatment for hip characteristic of Chinese medicine.