Niu Nina N, Collins Jamie E, Thornhill Thomas S, Alcantara Abreu Luis, Ghazinouri Roya, Okike Kanu, Katz Jeffrey N
Orthopedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, USA.
Open Orthop J. 2011;5:307-14. doi: 10.2174/1874325001105010307. Epub 2011 Aug 10.
An increasing number of medical relief organizations have launched programs to perform total joint replacements in the developing world. There is a paucity of data on the clinical outcomes of these procedures. We documented pre- and post-operative pain and functional status in a group of low income Dominicans who underwent total hip or knee replacement performed by an American relief organization.
In March 2009 and 2010, we surveyed patients participating in Operation Walk Boston, a medical relief organization that provides total joint replacements to patients in the Dominican Republic. Questionnaires included the Western Ontario and McMaster University Osteoarthritis (WOMAC) Index scales and the Short-Form 36 (SF-36) scales for physical activity and mental health. Scores were transformed to a 0 - 100 point scale (100 is best).
81 individuals (mean age 61 years, 60% female) completed the pre-operative questionnaires. Twenty eight of the 35 who completed preoperative forms in 2009 also completed follow up forms in 2010 (follow-up rate 80%). Patients reported poor pre-operative WOMAC function (mean = 33.6, sd = 22.0) and WOMAC pain (mean = 38.4, sd = 22.9) scores preoperatively. Mean post-operative WOMAC pain and function scores were 86.4 (sd = 13.1) and 88.1 (sd = 11.4) respectively. Improvement in pain and function was similar for patients undergoing hip (n=11) and knee (n=17) replacements.
Total joint replacement was effective in relieving pain and restoring function in this program. These results are useful for comparison to outcomes in developed countries and for establishing benchmarks for future programs.
越来越多的医疗救助组织在发展中国家开展全关节置换项目。关于这些手术临床结果的数据匮乏。我们记录了一组接受美国救助组织进行全髋关节或膝关节置换的低收入多米尼加人的术前和术后疼痛及功能状况。
2009年3月和2010年，我们对参与波士顿行走行动（一个为多米尼加共和国患者提供全关节置换的医疗救助组织）的患者进行了调查。问卷包括西安大略和麦克马斯特大学骨关节炎（WOMAC）指数量表以及用于身体活动和心理健康的简短健康调查问卷（SF - 36）量表。分数转换为0至100分制（100分为最佳）。
81人（平均年龄61岁，60%为女性）完成了术前问卷。2009年完成术前表格的35人中，有28人在2010年也完成了随访表格（随访率80%）。患者术前WOMAC功能评分较差（平均 = 33.6，标准差 = 22.0），术前WOMAC疼痛评分（平均 = 38.4，标准差 = 22.9）。术后WOMAC疼痛和功能评分的平均值分别为86.4（标准差 = 13.1）和88.1（标准差 = 11.4）。接受髋关节置换（n = 11）和膝关节置换（n = 17）的患者在疼痛和功能改善方面相似。
在该项目中，全关节置换在缓解疼痛和恢复功能方面是有效的。这些结果有助于与发达国家的结果进行比较，并为未来项目建立基准。
