Deehan David J, Murray James D, Birdsall Paul D, Pinder Ian M
Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.
Acta Orthop. 2006 Oct;77(5):761-6. doi: 10.1080/17453670610012953.
Radiographic and clinical survival analyses of revision total knee replacement (TKR) are considered acceptable outcome measures. However, the full influence of revision knee replacement on the overall health status of patients remains poorly defined.
We prospectively studied the health-related quality of life outcome in 94 patients who underwent revision knee replacement surgery over a 5-year period. Comparisons were drawn between the Nottingham health profile (NHP) scores and the Knee Society score pre-revision, and those obtained at 3 months, 1 year and 5 years after revision knee arthroplasty.
We found a significant improvement in Knee Society score and NHP pain scores 3 and 12 months after revision TKR (p < 0.05). No other modalities of the NHP showed a significant change. 5 years after surgery, pain was less than before revision (p = 0.2), but energy level was considered worse (p = 0.07). Knee Society scores were found to be higher pre- and postoperatively for patients undergoing revision for reasons other than sepsis than for patients with sepsis. Patients requiring implantation of a hinged prosthesis also had lower Knee Society scores than those patients receiving a non-hinged implant. Repeated revision was associated with a downward trend in Knee Society score with each surgical intervention.
翻修全膝关节置换术（TKR）的影像学和临床生存分析被认为是可接受的结局指标。然而，翻修膝关节置换术对患者整体健康状况的全面影响仍不明确。
我们前瞻性地研究了94例在5年期间接受翻修膝关节置换手术患者的健康相关生活质量结局。比较了翻修前、翻修膝关节置换术后3个月、1年和5年时的诺丁汉健康量表（NHP）评分和膝关节协会评分。
我们发现翻修TKR术后3个月和12个月时膝关节协会评分和NHP疼痛评分有显著改善（p < 0.05）。NHP的其他方面均未显示出显著变化。术后5年，疼痛程度低于翻修前（p = 0.2），但精力水平被认为更差（p = 0.07）。因败血症以外原因接受翻修的患者术前和术后的膝关节协会评分高于败血症患者。需要植入铰链式假体的患者的膝关节协会评分也低于接受非铰链式植入物的患者。每次手术干预后，反复翻修与膝关节协会评分呈下降趋势相关。
