Merle-Vincent Florence, Couris Chantal M, Schott Anne-Marie, Perier Marie, Conrozier Sylvie, Conrozier Thierry, Piperno Muriel, Mathieu Pierre, Vignon Eric
Rheumatology Department, Pavilion 2B, Lyon-South Hospital Center, 69495 Pierre Bénite, France.
Joint Bone Spine. 2007 Dec;74(6):612-6. doi: 10.1016/j.jbspin.2007.01.038. Epub 2007 Aug 13.
To evaluate pain and disability at the time of knee replacement surgery for osteoarthritis.
In this multicenter cross-sectional study, 299 patients at 12 orthopedic surgery centers in Lyon, France were evaluated on the day before knee replacement surgery. Pain severity was assessed on a visual analog scale (VAS) and function using the Lequesne index and the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC).
There were 207 women and 92 men with a mean age of 73 years. Mean (+/-SD) VAS pain score upon walking was 55.8+/-24mm. Compared to patients with very severe disability (Lequesne index>12), those with mild-to-severe disability (Lequesne index<or=12) were more likely to be older than 70 years (odds ratio [OR], 2.85; 95% confidence interval [95%CI], 1.25-5) and male (OR, 2.5; 95%CI, 1.3-5); they were less likely to have a body mass index>27kg/m(2) (OR, 2.2; 95%CI, 1.3-3.3) and to engage in sporting activities (OR, 3.3; 95%CI, 1.4-10).
Patients about to undergo knee replacement surgery had high levels of pain and disability, with little variation across centers. Nevertheless, the severity of pain and disability may depend in part on age, gender, body mass index, and sporting activities, which probably influence the decision to perform knee replacement surgery.
评估骨关节炎患者膝关节置换手术时的疼痛及功能障碍情况。
在这项多中心横断面研究中，对法国里昂12个骨科手术中心的299例患者在膝关节置换手术前一天进行评估。采用视觉模拟评分法（VAS）评估疼痛严重程度，并使用Lequesne指数和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评估功能。
共有207例女性和92例男性，平均年龄73岁。行走时VAS疼痛评分均值（±标准差）为55.8±24mm。与残疾程度非常严重（Lequesne指数>12）的患者相比，残疾程度为轻度至重度（Lequesne指数≤12）的患者年龄超过70岁的可能性更大（比值比[OR]，2.85；95%置信区间[95%CI]，1.25 - 5）且为男性的可能性更大（OR，2.5；95%CI，1.3 - 5）；他们体重指数>27kg/m²的可能性较小（OR，2.2；95%CI，1.3 - 3.3），参与体育活动的可能性较小（OR，3.3；95%CI，1.4 - 10）。
即将接受膝关节置换手术的患者疼痛和功能障碍程度较高，各中心之间差异不大。然而，疼痛和功能障碍的严重程度可能部分取决于年龄、性别、体重指数和体育活动，这些因素可能会影响膝关节置换手术的决策。
