Lingard E A, Muthumayandi K, Holland J P
Department of Orthopaedics, Freeman Hospital, High Heaton, Newcastle upon Tyne, UK.
J Bone Joint Surg Br. 2009 Dec;91(12):1550-4. doi: 10.1302/0301-620X.91B12.22326.
This study compared the demographic, clinical and patient-reported outcomes after total hip replacement (THR) and Birmingham Hip Resurfacing (BHR) carried out by a single surgeon. Patients completed a questionnaire that included the WOMAC, SF-36 scores and comorbid medical conditions. Data were collected before operation and one year after. The outcome scores were adjusted for age, gender, comorbid conditions and, at one year, for the pre-operative scores. There were 214 patients with a THR and 132 with a BHR. Patients with a BHR were significantly younger (49 vs 67 years, p < 0.0001), more likely to be male (68% vs 42% of THR, p < 0.0001) and had fewer comorbid conditions (1.3 vs 2.0, p < 0.0001). Before operation there was no difference in WOMAC and SF-36 scores, except for function, in which patients awaiting THR were worse than those awaiting a BHR. At one year patients with a BHR reported significantly better WOMAC pain scores (p = 0.04) and in all SF-36 domains (p < 0.05). Patients undergoing BHR report a significantly greater improvement in general health compared with those with a THR.
本研究比较了由同一位外科医生实施全髋关节置换术（THR）和伯明翰髋关节表面置换术（BHR）后的人口统计学、临床及患者报告结局。患者完成了一份包含WOMAC、SF - 36评分及合并症的问卷。在手术前及术后一年收集数据。结局评分针对年龄、性别、合并症进行了校正，且在术后一年时针对术前评分进行了校正。接受THR的患者有214例，接受BHR的患者有132例。接受BHR的患者明显更年轻（49岁对67岁，p < 0.0001），男性比例更高（68%对THR的42%，p < 0.0001），且合并症更少（1.3对2.0，p < 0.0001）。手术前，除功能外，WOMAC和SF - 36评分无差异，在功能方面，等待THR的患者比等待BHR的患者情况更差。在术后一年，接受BHR的患者报告的WOMAC疼痛评分明显更好（p = 0.04），且在所有SF - 36领域均如此（p < 0.05）。与接受THR的患者相比，接受BHR的患者报告总体健康状况有显著更大改善。
