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快速通道膝关节置换术后的患者报告结局。

Patient-reported outcome after fast-track knee arthroplasty.

机构信息

The Orthopaedic Research Unit, Department of Orthopedics, Holstebro Regional Hospital, Hospital Unit West, Holstebro, Denmark.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2012 Jun;20(6):1128-35. doi: 10.1007/s00167-012-1919-4. Epub 2012 Feb 17.

Abstract

PURPOSE

The purpose of this study was to describe patient-related functional outcomes after fast-track total knee arthroplasty and unicompartmental knee arthroplasty. Furthermore, we wanted to assess physical areas where an additional need for rehabilitation could be identified, and finally, we wanted to describe the association between physical function, health-related quality-of-life (HRQOL) and patient satisfaction.

METHODS

The study consisted of 211 consecutive fast-track patients of which none received additional rehabilitation beyond an instructional exercise plan at discharge, which was adjusted at one outpatient visit. The patients filled in 3 questionnaires (EQ-5D, SF36 and a disease-specific questionnaire) at 2 time points before the operation and 2 time points after the operation. The observed results were compared to normative population data for EQ-5D and SF36.

RESULTS

Four months after the operation, the patients had reached a HRQOL level of 0.82 (SD 0.15), which was lower than the background population norm of 0.85 (n.s.), whereas it equaled the population norm at 12 months (n.s.). For SF36, physical function was 62.8 (SD 23.0) at 4 months and 66.2 (SD 24.1) at 12 months, which was lower than the background population norm of 75.0 (P < 0.01). No or mild pain and good function ability were associated with high HRQOL and patient satisfaction at follow-up.

CONCLUSIONS

There seems to be an additional need for postoperative rehabilitation after fast-track total knee arthroplasty and unicompartmental knee arthroplasty regarding early functional outcome. No or mild pain and good functional abilities at 4 months are associated with high HRQOL and patient satisfaction at 4- and 12-month follow-up.

LEVEL OF EVIDENCE

II.

摘要

目的

本研究旨在描述快速康复全膝关节置换术和单髁膝关节置换术后与患者相关的功能结果。此外,我们希望评估可以确定额外康复需求的身体区域,最后,我们还希望描述身体功能、健康相关生活质量(HRQOL)和患者满意度之间的关联。

方法

本研究纳入了 211 例连续快速康复患者,这些患者在出院时除了出院指导锻炼计划外,没有接受额外的康复治疗,该计划在一次门诊就诊时进行了调整。患者在手术前和手术后的 2 个时间点填写了 3 份问卷(EQ-5D、SF36 和特定疾病问卷)。观察结果与 EQ-5D 和 SF36 的背景人群正常值进行了比较。

结果

术后 4 个月,患者的 HRQOL 达到 0.82(SD 0.15),低于背景人群正常值 0.85(无统计学意义),而 12 个月时则与背景人群正常值相等(无统计学意义)。SF36 的身体功能在 4 个月时为 62.8(SD 23.0),12 个月时为 66.2(SD 24.1),低于背景人群正常值 75.0(P < 0.01)。术后 4 个月时无或轻度疼痛和良好的功能能力与随访时的 HRQOL 和患者满意度较高相关。

结论

快速康复全膝关节置换术和单髁膝关节置换术后似乎需要额外的术后康复,以改善早期功能结果。术后 4 个月时无或轻度疼痛和良好的功能能力与术后 4 个月和 12 个月时的 HRQOL 和患者满意度较高相关。

证据等级

II 级。

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