Bachmeier C J, March L M, Cross M J, Lapsley H M, Tribe K L, Courtenay B G, Brooks P M
Departments of Medicine and Orthopaedics, St Vincent's Hospital, University of New South Wales, Australia.
Osteoarthritis Cartilage. 2001 Feb;9(2):137-46. doi: 10.1053/joca.2000.0369.
The aims of this study were to assess changes in physical function and quality of life with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the instrument of the Medical Outcomes Study SF-36 Health Survey (MOS SF-36), respectively, in patients undergoing hip anf knee joint replacement surgery and to compare the responsiveness of these two outcome measures 1 year after surgery.
One hundred and ninety-four patients with osteoarthritis (OA knee 108, OA hip 86) admitted to four hospitals in Sydney were followed over a period of 1 year at 3 monthly intervals.
WOMAC measures improved significantly after 1 year for OA hip and OA knee: there was reduction in pain of 71% and 53%, reduction of stiffness of 55% and 43% and improvement in physical function of 68% and 43%, respectively. MOS SF-36 measures in those having hip surgery improved significantly for pain (222%), physical function (247%), physical role functioning (402%), general health (110%), vitality (143%0, social functioning (169%) and mental health (114%). For those in the knee surgery group, significant improvement was seen for pain (175%), physical function (197%), physical role functioning (275%), vitality (125%) and social functioning (119%). The WOMAC was a more responsive measure than the MOS SF-36.
WOMAC and MOS SF-36 detect significant and clinically meaningful changes in outcome after hip and knee replacement. WOMAC requires a smaller sample size and is more responsive in the short term. For a follow-up longer than 6 months MOS SF-36 provides additional information. The improvement in outcomes following hip joint surgery were significantly greater than those following knee surgery.
本研究旨在分别使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及医学结局研究简明健康调查（MOS SF-36）工具，评估接受髋膝关节置换手术患者的身体功能变化和生活质量，并比较这两种结局指标在术后1年的反应性。
悉尼四家医院收治的194例骨关节炎患者（膝骨关节炎108例，髋骨关节炎86例），随访1年，每3个月进行一次评估。
1年后，髋骨关节炎和膝骨关节炎患者的WOMAC指标均有显著改善：疼痛分别减轻71%和53%，僵硬分别减轻55%和43%，身体功能分别改善68%和43%。接受髋关节手术患者的MOS SF-36指标在疼痛（222%）、身体功能（247%）、身体角色功能（402%）、总体健康（110%）、活力（143%）、社会功能（169%）和心理健康（114%）方面有显著改善。膝关节手术组患者在疼痛（175%）、身体功能（197%）、身体角色功能（275%）、活力（125%）和社会功能（119%）方面有显著改善。WOMAC比MOS SF-36更具反应性。
WOMAC和MOS SF-36能检测出髋膝关节置换术后结局的显著且具有临床意义的变化。WOMAC所需样本量较小，短期内反应性更强。对于超过6个月的随访，MOS SF-36能提供更多信息。髋关节手术的结局改善显著大于膝关节手术。
