Thomsen Morten G, Husted Henrik, Otte Kristian S, Orsnes Thue, Troelsen Anders
Ortopædkirurgisk Afdeling, Hvidovre Hospital, 2650 Hvidovre, Denmark.
Dan Med J. 2012 Aug;59(8):A4492.
Between 2004 and 2009, the incidence of primary total knee arthroplasty (TKA) in Denmark has almost doubled. It has been speculated that this increase may be a result of patients being operated on weaker indications. The purpose of this study was to compare preoperative degrees of osteoarthritis and health-related quality of life (QoL) in patients receiving primary TKA in 2004 and 2009.
We identified 154 and 369 primary TKAs inserted at our institution in 2004 and 2009, respectively. Patients had been invited to complete the Short Form (SF)-36 questionnaire preoperatively. Two groups of patients that were representative with regard to age and gender were randomly sampled and compared (n = 44 in 2004 versus n = 106 in 2009). The Kellgren-Lawrence (K-L) grade of osteoarthritis was assessed on preoperative radiographs in all patients.
We found no statistically significant differences in gender distribution or mean age at surgery. We reached K-L grades of 3-4 in 52.4% and 49.6% in 2004 and 2009, respectively (p = 0.57). The preoperative mean SF-36 physical component scores were 32.6 and 33.7, respectively (p = 0.44). The preoperative mean SF-36 mental component scores were 43.0 in 2004 and 49.3 (i.e. 6.3 points higher) in 2009 (p = 0.003).
Preoperative degrees of osteoarthritis and physical health-related QoL did not change from 2004 to 2009. Thus, it seems that these components of operative indications have not weakened. The increased preoperative SF-36 mental component score of these patients may have had a positive effect on postoperative outcomes.
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2004年至2009年间，丹麦初次全膝关节置换术（TKA）的发生率几乎翻了一番。据推测，这种增长可能是由于患者在手术指征较弱的情况下接受了手术。本研究的目的是比较2004年和2009年接受初次TKA患者术前骨关节炎程度和健康相关生活质量（QoL）。
我们分别确定了2004年和2009年在我们机构进行的154例和369例初次TKA。患者被邀请在术前完成简短形式（SF）-36问卷。随机抽取两组在年龄和性别方面具有代表性的患者进行比较（2004年n = 44，2009年n = 106）。对所有患者术前X线片评估骨关节炎的Kellgren-Lawrence（K-L）分级。
我们发现性别分布或手术时的平均年龄无统计学显著差异。2004年和2009年分别有52.4%和49.6%的患者达到K-L 3-4级（p = 0.57）。术前平均SF-36身体成分得分分别为32.6和33.7（p = 0.44）。2004年术前平均SF-36精神成分得分为43.0，2009年为49.3（即高6.3分）（p = 0.003）。
从2004年到2009年，术前骨关节炎程度和与身体健康相关的生活质量没有变化。因此，手术指征的这些方面似乎并未变弱。这些患者术前SF-36精神成分得分的增加可能对术后结果产生了积极影响。
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