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诺丁汉健康概况——髋关节翻修置换术后的体验

The Nottingham health profile-experiences after hip revision arthroplasty.

作者信息

Ernstberger T, Köster G, Walde T, Schultz W

机构信息

Department of Orthopaedic, University of Gottingen, Robert-Koch-Str. 40, 37075 Gottingen, Germany.

出版信息

Arch Orthop Trauma Surg. 2005 Oct;125(8):521-5. doi: 10.1007/s00402-005-0030-4. Epub 2005 Oct 22.

Abstract

INTRODUCTION

Considering patients after hip revision arthroplasty postoperative quality controls allows an evaluation of the individual implant situation as well as the achieved postoperative quality of life. With regard to a possible loss of data reliable statements about the used implant system with special consideration to the implant survival rate could not be received. In this connection standardized self-assessment questionnaires like the Nottingham Health Profile (NHP) are in the centre of interest. The main focus of this study was to demonstrate a correlation between the Nottingham Health Profile and the Merle d'Aubigne (MDA) Score.

PATIENTS AND METHODS

Fifty-one patients after femoral stem revision were re-examined. All patients received a written appointment for an ambulatory re-examination together with the NHP 4 weeks before. The clinical evaluation was carried out by using the MDA Score. Correlations between the NHP and the MDA were calculated.

RESULTS

Overall the data of 39 patients could be evaluated completely. Three patients (5.9%) did not appear to the ambulatory re-examination, four patients (7.8%) deceased in the meantime. With further five patients (9.8%) the NHP questionnaire could not be rated due to an incorrect treatment. The mean follow-up after revision was 5.8 years. Correlations between the category 'Pain' NHP/MDA as well as to the combination of the NHP-categories 'Pain' + 'Physical Mobility' and the total MDA-Score could be demonstrated.

CONCLUSION

Out of our personal experiences the use of the NHP makes an individual follow-up evaluation after revision hip arthroplasty possible. Patient-referred changes can lead to direct re-examinations. Correlation coherences between the NHP and the MDA could be demonstrated equivalent to already published results. In what way a survival rate analysis of an implant by using the NHP is possible could not be answered clearly. It has to be included that wrong answered questionnaires lead to an additional drop-out rate beneath the lost to follow-up rate.

摘要

引言

对髋关节翻修置换术后患者进行质量控制,有助于评估个体植入物情况以及术后生活质量。然而,由于可能存在数据丢失的情况,无法获得关于所用植入系统的可靠陈述,尤其是植入物生存率方面。在这方面,标准化的自我评估问卷,如诺丁汉健康量表(NHP),成为关注的焦点。本研究的主要重点是证明诺丁汉健康量表与默尔·德奥宾涅(MDA)评分之间的相关性。

患者与方法

对51例股骨柄翻修术后的患者进行复查。所有患者在4周前都收到了一份书面预约,要求进行门诊复查并填写NHP问卷。通过使用MDA评分进行临床评估。计算NHP与MDA之间的相关性。

结果

总体而言,39例患者的数据可得到完整评估。3例患者(5.9%)未前来门诊复查,4例患者(7.8%)在此期间死亡。另有5例患者(9.8%)因治疗不当无法对NHP问卷进行评分。翻修术后的平均随访时间为5.8年。可以证明NHP/ MDA的“疼痛”类别以及NHP“疼痛”+“身体活动能力”类别与MDA总分之间的相关性。

结论

根据我们的个人经验,使用NHP可对髋关节翻修置换术后进行个体随访评估。患者报告的变化可导致直接复查。NHP与MDA之间的相关性与已发表的结果相当。使用NHP对植入物生存率进行分析的具体方式尚无法明确回答。必须指出的是,问卷回答错误会导致额外的失访率,使其低于随访丢失率。

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