Kasmire Kathryn E, Rasouli Mohammad R, Mortazavi S M Javad, Sharkey Peter F, Parvizi Javad
Department of Orthopaedic Surgery, Rothman Institute of Orthopaedics at Thomas Jefferson University, Philadelphia, PA, USA.
Department of Orthopaedic Surgery, Rothman Institute of Orthopaedics at Thomas Jefferson University, Philadelphia, PA, USA.
Knee. 2014 Jan;21(1):264-7. doi: 10.1016/j.knee.2012.10.017. Epub 2012 Nov 14.
There are a limited number of studies related to quality of life and functional outcome after revision total knee arthroplasty (TKA). The present study aimed to identify predictors of functional outcome after revision TKA for aseptic failure.
One hundred seventy-five patients with mean age of 66.6 years (range, 35-88) who underwent revision TKA for aseptic failure at our institute from 2003 to 2007 were identified. Short-form 36 (SF-36), Western Ontario and McMaster Osteoarthritis Index (WOMAC) and Knee Society Scores (KSS) collected preoperatively and at 2 years follow up were evaluated. Univariate and multivariate analyses were performed to determine predictors of functional outcome in studied patients.
Both physical and mental dimensions of SF-36, pain, functional, and stiffness subscales of WOMAC and both functional and clinical scores of KSS improved significantly after revision TKA (p<0.001). In the multivariate analysis, male gender, a lower Charlson comorbidity index, and higher preoperative functional KSS were predictors of higher functional KSS at 2 years after revision. Lower preoperative pain and higher clinical KSS were predictors of better outcome as measured by pain scale of WOMAC. Body mass index (BMI) and preoperative clinical KSS were significant predictors of function and stiffness as measured by WOMAC.
BMI is a modifiable predictor of functional outcome after revision TKA. Moreover, patients with higher preoperative functional scores appear to have better postoperative function.
Level II.
关于翻修全膝关节置换术（TKA）后生活质量和功能结局的研究数量有限。本研究旨在确定无菌性失败的翻修TKA术后功能结局的预测因素。
确定了2003年至2007年在我院因无菌性失败接受翻修TKA的175例患者，平均年龄66.6岁（范围35 - 88岁）。评估术前及随访2年时收集的简明健康状况调查量表（SF - 36）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及膝关节协会评分（KSS）。进行单因素和多因素分析以确定研究患者功能结局的预测因素。
翻修TKA术后，SF - 36的生理和心理维度、WOMAC的疼痛、功能和僵硬子量表以及KSS的功能和临床评分均显著改善（p<0.001）。在多因素分析中，男性、较低的Charlson合并症指数以及较高的术前功能KSS是翻修术后2年较高功能KSS的预测因素。较低的术前疼痛和较高的临床KSS是以WOMAC疼痛量表衡量的更好结局的预测因素。体重指数（BMI）和术前临床KSS是WOMAC测量的功能和僵硬的重要预测因素。
BMI是翻修TKA术后功能结局的一个可改变的预测因素。此外，术前功能评分较高的患者术后功能似乎更好。
二级。
