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患者对髋关节和膝关节置换术的期望得到满足了吗?一项针对130名患者的前瞻性研究。

Are patients' expectations of hip and knee arthroplasty fulfilled? A prospective study of 130 patients.

作者信息

Suda Arnold J, Seeger Joern B, Bitsch Rudi G, Krueger Marlis, Clarius Michael

机构信息

Department of Orthopedic Surgery, University of Heidelberg, Heidelberg, Germany.

出版信息

Orthopedics. 2010 Feb;33(2):76-80. doi: 10.3928/01477447-20100104-07.

DOI:10.3928/01477447-20100104-07
PMID:20192137
Abstract

Total hip arthroplasty (THA) is the most successful procedure in orthopedic and trauma surgery. Patients' expectations of joint replacement surgery prior to and after the procedure are often discounted. This study investigated the expectations of patients before and 3 years after THA or total knee arthroplasty (TKA). A total of 130 patients (70 hips, 60 knees) received a modified FFbH-OA survey with 6 additional questions concerning patients' expectations before and 3 years after joint replacement surgery. The overall response rate was 78.8% (101 patients). Patients who underwent THA had a mean age of 63.7 years, and those who underwent TKA had a mean age of 67.4 years.Sixty-three percent of all respondents reported that their expectations had been fulfilled or exceeded 3 years postoperatively (THA, 65%; TKA, 61%). A high negative correlation in the THA group could be seen between patients' expectations and clinical scores: the lower the clinical score, the less the patient's expectations had been fulfilled. A statistically significant increase of change in personal relationships was found, as well as a statistically significant decrease in worries and less complications than had been expected before joint replacement.Thirty-seven percent of all respondents felt that their expectations regarding joint replacement had not been fulfilled. Looking at the results of this study, the 37% of patients whose expectations had not been fulfilled did not exhibit a lower postoperative functioning than those who were satisfied.

摘要

全髋关节置换术(THA)是骨科和创伤外科中最成功的手术。患者在手术前后对关节置换手术的期望常常被忽视。本研究调查了全髋关节置换术(THA)或全膝关节置换术(TKA)患者术前及术后3年的期望。共有130例患者(70例髋关节,60例膝关节)接受了改良的FFbH-OA调查,该调查增加了6个关于患者关节置换手术前后期望的问题。总体回复率为78.8%(101例患者)。接受THA的患者平均年龄为63.7岁,接受TKA的患者平均年龄为67.4岁。63%的受访者表示,他们的期望在术后3年得到了满足或超出(THA为65%;TKA为61%)。在THA组中,患者的期望与临床评分之间存在高度负相关:临床评分越低,患者期望的满足程度越低。研究发现,人际关系变化有统计学意义的增加,担忧有统计学意义的减少,并发症也比关节置换术前预期的少。37%的受访者认为他们对关节置换的期望没有实现。从这项研究的结果来看,37%期望未实现的患者术后功能并不比满意的患者低。

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