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术前认知障碍会影响膝关节置换手术的结果吗?

[Does pre-surgical cognitive impairment affect knee replacement results?].

作者信息

Jiménez M, Zorrilla P, López-Alonso A, León A, Salido J A

机构信息

Departamento de Cirugía Ortopédica y Traumatología, Hospital General Universitario de Ciudad Real, Ciudad Real, España.

Departamento de Cirugía Ortopédica y Traumatología, Hospital General Universitario de Ciudad Real, Ciudad Real, España.

出版信息

Rev Esp Cir Ortop Traumatol. 2014 Nov-Dec;58(6):364-9. doi: 10.1016/j.recot.2014.04.008. Epub 2014 Jun 23.

Abstract

OBJECTIVE

To determine the influence of the pre-operative cognitive impairment on results of the total knee arthroplasty according to a doctor and patient perspective.

MATERIAL AND METHOD

A prospective study was conducted on patient from the surgical waiting list who had undergone a primary total knee arthroplasty. The sample initially included 265 patients, but 50 were subsequently excluded. Cognitive impairment was assessed pre-operatively by the Mini Cognitive Examination (MEC-35). The Visual Analog Scale (VAS), the Knee Society Score (KSS), the Western Ontario and McMaster Osteoarthritis Index (WOMAC), and the Hospital Anxiety and Depression Scale (HADS), were used pre-operatively and one year later post-operatively.

RESULTS

A total of 215 patients were assessed (57 men and 158 women). Cognitive impairment had no influence on the results of total knee arthroplasty. In fact, there was no statistical significance in any of the scales analyzed. Preoperatively, and one year later, the patients with cognitive impairment showed higher levels of anxiety and depression, with these differences being statistically significant.

DISCUSSION

All of the patients experienced an improvement in the specific outcomes and quality of life after the total knee arthroplasty procedure, regardless of the presence of preoperative cognitive impairment.

摘要

目的

从医生和患者的角度确定术前认知障碍对全膝关节置换术结果的影响。

材料与方法

对手术等待名单上接受初次全膝关节置换术的患者进行前瞻性研究。样本最初包括265名患者,但随后排除了50名。术前通过简易认知检查(MEC-35)评估认知障碍。术前及术后一年使用视觉模拟量表(VAS)、膝关节协会评分(KSS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)以及医院焦虑抑郁量表(HADS)。

结果

共评估了215名患者(57名男性和158名女性)。认知障碍对全膝关节置换术的结果没有影响。事实上,在所分析的任何量表中均无统计学意义。术前及术后一年,认知障碍患者的焦虑和抑郁水平较高,这些差异具有统计学意义。

讨论

无论术前是否存在认知障碍,所有患者在全膝关节置换术后的特定结局和生活质量均有所改善。

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