Schulze A, Fleskes K, Scharf H-P
Orthopädisch-Unfallchirurgisches Zentrum, Universitätsmedizin Mannheim.
Z Orthop Unfall. 2014 Oct;152(5):462-8. doi: 10.1055/s-0034-1383022. Epub 2014 Oct 14.
Only 84 % of patients are satisfied with the operative result after total knee arthroplasty. A relevant reason is non-fulfilled preoperative expectations. Non-fulfilled preoperative expectations cannot be influenced postoperatively. So a knowledge of preoperative expectations and their influential factors is essential. The following study analyses the expectations and influential factors in patients before total knee arthroplasty in Germany.
On the day before total knee replacement in 104 patients the following data were collected: school leaving level, comorbidities, articular knee function, psychological mood, health-related quality of life, and preoperative expectations. Statistical evaluation was done by factor analyses of expectations and independent variables, and correlation and regression analyses.
The following 4 factors of expectations resulted from the factor analyses: (i) relief of pain, (ii) increase of range of motion of the knee, (iii) better mobility, and (iv) better integration in social activities. In general patient expectations on the effects of a total knee replacement are high. Age and better integration in social activities correlate negatively, as also do age and better mobility. Body mass index and better integration in social activities correlate positively. The following formula analyses the expectations of better integration in social life: social expectations = 116-0.991 × age.
For the first time this study determines expectations and influential factors of patients who undergo a total knee replacement in Germany. By knowing the interaction of satisfaction and preoperative expectations, this knowledge is an essential condition to increase satisfaction after total knee replacement in the German population. Collecting the preoperative expectations of patients has to be an indispensable feature of the clinical practice in orthopaedic surgery.
全膝关节置换术后仅有84%的患者对手术效果满意。一个相关原因是术前期望未得到满足。术前期望未得到满足在术后无法得到改善。因此，了解术前期望及其影响因素至关重要。以下研究分析了德国全膝关节置换术前患者的期望及其影响因素。
在104例患者全膝关节置换术前一天收集以下数据：学历、合并症、膝关节功能、心理情绪、健康相关生活质量及术前期望。通过对期望和自变量进行因子分析以及相关性和回归分析进行统计学评估。
因子分析得出以下4个期望因子：（i）疼痛缓解，（ii）膝关节活动范围增加，（iii）更好的活动能力，（iv）更好地融入社交活动。总体而言，患者对全膝关节置换效果的期望较高。年龄与更好地融入社交活动呈负相关，年龄与更好的活动能力也呈负相关。体重指数与更好地融入社交活动呈正相关。以下公式分析了更好地融入社会生活的期望：社会期望=116 - 0.991×年龄。
本研究首次确定了德国全膝关节置换患者的期望及其影响因素。通过了解满意度与术前期望之间的相互作用，这一认识是提高德国人群全膝关节置换术后满意度的必要条件。收集患者的术前期望必须成为骨科临床实践中不可或缺的一部分。
