Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
Value Health. 2011 Mar-Apr;14(2):322-8. doi: 10.1016/j.jval.2010.08.005.
To examine health-related quality of life (HRQoL) after total knee replacement (TKR) or unicompartmental knee arthroplasty (UKA).
Asian adult patients undergoing either TKR or UKA in a hospital in Singapore between 2001 and 2006 were interviewed before surgery and 6 and 24 months postoperatively to obtain demographic information and HRQoL scores using the Short Form-36 Health Survey (SF-36) and the Oxford Knee Score (OKS).
Data were collected from 2243, 1715, and 1113 patients at baseline and at 6 and 24 months, respectively. TKR patients had a lower preoperative OKS than UKA patients and lower preoperative scores on four subscales of the SF-36 (P < 0.01). Both TKR and UKA patients' OKS and SF-36 subscale scores improved 6 months postoperatively except in the general health domain. SF-36 role physical and bodily pain scores showed the most improvement (40.9 and 33.0 points in TKR and 36.9 and 31.4 points in UKA patients, respectively). Two years after surgery, TKR patients' SF-36 scores and OKSs were not significantly different from those of UKA patients except for physical functioning scores. Multiple regression analysis adjusting for demographics showed that baseline scores were a significant predictor of the postoperative OKSs and scores on all SF-36 subscales (P < 0.01), whereas the type of surgery was not associated with the postoperative scores.
Both TKR and UKA patients experienced significant improvements in HRQoL, particularly in the role physical and pain domains. After controlling for potential confounding variables, the type of surgery was not a significant predictor of patients' postoperative HRQoL scores.
评估全膝关节置换术(TKR)或单髁膝关节置换术(UKA)后与健康相关的生活质量(HRQoL)。
2001 年至 2006 年期间,在新加坡一家医院接受 TKR 或 UKA 的亚洲成年患者在手术前和术后 6 个月及 24 个月接受采访,以获取人口统计学信息和使用健康调查简表 36 项(SF-36)和牛津膝关节评分(OKS)的 HRQoL 评分。
分别在基线及术后 6 个月和 24 个月时,从 2243、1715 和 1113 例患者中收集了数据。TKR 患者的术前 OKS 低于 UKA 患者,且 SF-36 四个子量表的术前评分也较低(P<0.01)。TKR 和 UKA 患者的 OKS 和 SF-36 子量表评分在术后 6 个月均得到改善,除一般健康领域外。SF-36 躯体功能和躯体疼痛子量表的改善最大(TKR 患者为 40.9 分和 33.0 分,UKA 患者为 36.9 分和 31.4 分)。术后 2 年,TKR 患者的 SF-36 评分和 OKS 与 UKA 患者无显著差异,除躯体功能评分外。调整人口统计学因素的多元回归分析显示,基线评分是术后 OKS 和所有 SF-36 子量表评分的显著预测因素(P<0.01),而手术类型与术后评分无关。
TKR 和 UKA 患者的 HRQoL 均显著改善,特别是在躯体功能和疼痛领域。在控制潜在混杂变量后,手术类型不是患者术后 HRQoL 评分的显著预测因素。