Singh Jasvinder A, Gabriel Sherine, Lewallen David
Department of Health Sciences Research, Mayo Clinic School of Medicine, Rochester, MN, USA,
Clin Orthop Relat Res. 2008 Nov;466(11):2717-23. doi: 10.1007/s11999-008-0399-9. Epub 2008 Aug 5.
Do gender and age affect knee arthroplasty outcomes? In a cohort of patients who underwent primary or revision TKA between 1996 and 2004 and responded to a followup questionnaire 2 and 5 years after arthroplasty, we investigated the impact of gender and age on the prevalence of moderate or severe post-TKA knee pain (primary TKA: 2 years, 5290; 5 years, 2602; revision TKA: 2 years, 1109; 5 years, 505). Moderate-severe pain was higher in women than men after primary TKA at 2 and 5 years (9% versus 6.6% and 7.9% versus 6.5%) and post-revision TKA at 2 and 5 years (28.6% versus 22% and 28.9% versus 18.3%). More women compared to men and fewer patients between 61 and 70 years (versus patients <or= 60) had moderate-severe pain 2 years after primary TKA adjusting for gender, age, and preoperative pain severity. In the post-revision TKA group, the odds of moderate-severe pain were lower in patients older than 80 years (versus those <or= 60) at 2 years and higher in patients with moderate-severe preoperative pain at 2 and 5 years postoperatively, after adjustment for gender, age, and preoperative pain severity. We conclude female gender, younger age, and worse preoperative pain predict greater risk of moderate-severe pain postoperatively in patients with primary and revision TKA.
Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
性别和年龄会影响膝关节置换术的结果吗？在一组于1996年至2004年间接受初次或翻修全膝关节置换术（TKA）并在置换术后2年和5年回复随访问卷的患者中，我们研究了性别和年龄对TKA术后中度或重度膝关节疼痛患病率的影响（初次TKA：2年，5290例；5年，2602例；翻修TKA：2年，1109例；5年，505例）。初次TKA术后2年和5年，女性中度至重度疼痛的发生率高于男性（分别为9%对6.6%和7.9%对6.5%），翻修TKA术后2年和5年也是如此（分别为28.6%对22%和28.9%对18.3%）。在调整性别、年龄和术前疼痛严重程度后，初次TKA术后2年，与男性相比，更多女性以及61至70岁的患者（相对于≤60岁的患者）有中度至重度疼痛。在翻修TKA组中，调整性别、年龄和术前疼痛严重程度后，80岁以上患者（相对于≤60岁的患者）术后2年中度至重度疼痛的几率较低，而术后2年和5年有中度至重度术前疼痛的患者几率较高。我们得出结论，女性、年轻以及术前疼痛更严重预示着初次和翻修TKA患者术后发生中度至重度疼痛的风险更高。
II级，预后研究。有关证据水平的完整描述，请参阅作者指南。
