Singh Jasvinder A, Lewallen David G
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.
J Arthroplasty. 2014 Jan;29(1):40-3. doi: 10.1016/j.arth.2013.04.003. Epub 2013 May 10.
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.
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。
