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[全膝关节置换术后膝关节功能的恢复:骨关节炎和类风湿关节炎患者的不同结果]

[Recovery of knee function after total knee arthroplasty: different outcomes in patients with osteoarthritis and rheumatoid arthritis].

作者信息

Reiss L, Stolle J, Carl H-D, Swoboda B

机构信息

Abteilung für Orthopädische Rheumatologie, FAU Erlangen-Nürnberg im Waldkrankenhaus St. Marien, Rathsberger Str. 57, 91054, Erlangen, Deutschland.

出版信息

Z Rheumatol. 2014 Aug;73(6):559-64. doi: 10.1007/s00393-013-1291-x.

Abstract

INTRODUCTION

Following total knee arthroplasty (TKA), no investigations have been published to assess possible differences between rheumatoid arthritic (RA) and osteoarthritic (OA) patients with respect to patient-reported outcome measures of knee function.

PATIENTS AND METHODS

A cohort of 128 consecutively operated patients (OA: n = 92, RA: n = 36) treated with bicondylar TKA was included in this prospective, clinical study. Knee function was assessed preoperatively and at 6 and 12 months after TKA, using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Oxford Knee Score (OKS).

RESULTS

Both OKS and KOOS revealed a statistically significant improvement for OA and RA patients at 6 and 12 months after surgery, as compared to the preoperative status. The results of the OKS at 6 and 12 months did not show a further improvement for either group. The KOOS, however, revealed an additional improvement between 6 and 12 months for the osteoarthritis group, regarding the total score and all subscores, but not for the RA subgroup.

CONCLUSION

Functional recovery after TKA improves in the second 6 months after surgery in OA patients, but not in RA patients, when knee function is exclusively assessed with patient-reported outcome measures.

摘要

引言

全膝关节置换术(TKA)后,尚无研究发表以评估类风湿性关节炎(RA)患者和骨关节炎(OA)患者在膝关节功能的患者报告结局指标方面可能存在的差异。

患者与方法

本前瞻性临床研究纳入了一组128例接受双髁TKA治疗的连续手术患者(OA:n = 92,RA:n = 36)。术前以及TKA术后6个月和12个月,使用膝关节损伤和骨关节炎结局评分(KOOS)和牛津膝关节评分(OKS)评估膝关节功能。

结果

与术前状态相比,OKS和KOOS均显示OA和RA患者在术后6个月和12个月时在统计学上有显著改善。两组在术后6个月和12个月时的OKS结果均未显示进一步改善。然而,KOOS显示,骨关节炎组在术后6至12个月期间,总分和所有子评分均有额外改善,但RA亚组未出现这种情况。

结论

当仅通过患者报告结局指标评估膝关节功能时,OA患者在TKA术后的第二个6个月功能恢复有所改善,而RA患者则没有。

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