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脑血管疾病与全膝关节置换术后的预后相关:一项美国全关节注册研究。

Cerebrovascular disease is associated with outcomes after total knee arthroplasty: a US total joint registry study.

作者信息

Singh Jasvinder A, Lewallen David G

机构信息

Medicine Service and Center for Surgical Medical Acute Care Research and Transitions, VA Medical Center, Birmingham, Alabama; Department of Medicine at School of Medicine, and Division of Epidemiology at School of Public Health, University of Alabama, Birmingham, Alabama; Department of Orthopedic, Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota.

出版信息

J Arthroplasty. 2014 Jan;29(1):40-3. doi: 10.1016/j.arth.2013.04.003. Epub 2013 May 10.

Abstract

We assessed the association of cerebrovascular disease preoperatively with patient-reported outcomes (PROs) of moderate-severe activity limitation and moderate-severe pain at 2- and 5-years after primary total knee arthroplasty (TKA) using multivariable-adjusted logistic regression; 7139 primary and 4234 revision TKAs were included. Compared to the patients without cerebrovascular disease, those with cerebrovascular disease had a higher odds ratio (OR) of moderate-severe limitation at 2 years and 5 years, 1.32 (95% confidence interval [CI]: 1.02, 1.72; P = .04) and 1.83 (95% CI: 1.32, 2.55; P < .001), respectively. No significant associations were noted with moderate-severe pain at 2 years or 5 years. In conclusion, we found that cerebrovascular disease is independently associated with pain and function outcomes after primary TKA. This should be taken into consideration when discussing expected outcomes of TKA with patients.

摘要

我们采用多变量调整逻辑回归分析,评估了初次全膝关节置换术(TKA)术前脑血管疾病与患者报告的2年和5年后中重度活动受限及中重度疼痛结局(PROs)之间的关联;纳入了7139例初次TKA和4234例翻修TKA。与无脑血管疾病的患者相比,有脑血管疾病的患者在2年和5年时出现中重度活动受限的比值比(OR)更高,分别为1.32(95%置信区间[CI]:1.02, 1.72;P = .04)和1.83(95% CI:1.32, 2.55;P < .001)。在2年或5年时,未发现与中重度疼痛有显著关联。总之,我们发现脑血管疾病与初次TKA后的疼痛和功能结局独立相关。在与患者讨论TKA的预期结局时应考虑到这一点。

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