双侧膝关节骨关节炎患者单侧全膝关节置换术后健康相关生活质量的改善。

Improvement in health-related quality of life after unilateral total knee arthroplasty in patients with bilateral knee osteoarthritis.

作者信息

Thiam Desmond, Teh Daniel Jing Wen, Bin Abd Razak Hamid Rahmatullah, Tan Andrew Hwee Chye

机构信息

Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.

出版信息

J Orthop Surg (Hong Kong). 2016 Dec;24(3):294-297. doi: 10.1177/1602400304.

DOI:10.1177/1602400304

PMID:28031493

Abstract

PURPOSE

To review the outcome of unilateral total knee arthroplasty (TKA) in patients with bilateral knee osteoarthritis (OA) to determine whether unilateral TKA can achieve good health-related quality of life (HRQoL).

METHODS

Records of 68 women and 25 men with severe bilateral knee OA who underwent unilateral TKA on the more symptomatic knee by a single surgeon and did not return for the second TKA within 2 years were reviewed. Outcome at 6 months and 2 years was assessed using the mental and physical component summary (MCS and PCS) of the Short-Form 36 (SF-36) for HRQoL as well as the Oxford Knee Score (OKS) and Knee Society Score (KSS) for knee-specific outcome.

RESULTS

The SF-36, OKS, and KSS improved significantly after unilateral TKA. Respectively for MCS and PCS of SF-36, OKS, and KSS knee and function scores, 65%, 89%, 98%, 98%, and 98% of patients reported absolute improvement at 2 years. Respectively for PCS, OKS, and KSS function score that a minimal clinically important difference (MCID) was established, 77%, 96%, and 80% of patients achieved MCID at 2 years.

CONCLUSION

Unilateral TKA achieves good outcome in HRQoL at 2 years in patients with bilateral knee OA.

摘要

目的

回顾双侧膝关节骨关节炎（OA）患者单侧全膝关节置换术（TKA）的结果，以确定单侧TKA是否能实现良好的健康相关生活质量（HRQoL）。

方法

回顾了68名女性和25名男性重度双侧膝关节OA患者的记录，这些患者由同一位外科医生对症状更严重的膝关节进行了单侧TKA，且在2年内未进行第二次TKA。使用简明健康状况调查量表（SF-36）的心理和生理健康总结量表（MCS和PCS）评估HRQoL，以及使用牛津膝关节评分（OKS）和膝关节协会评分（KSS）评估膝关节特定结局，分别在6个月和2年时进行评估。

结果

单侧TKA后，SF-36、OKS和KSS均有显著改善。在SF-36的MCS和PCS、OKS以及KSS膝关节和功能评分方面，分别有65%、89%、98%、98%和98%的患者在2年时报告有绝对改善。在已确定最小临床重要差异（MCID）的PCS、OKS和KSS功能评分方面，分别有77%、96%和80%的患者在2年时达到MCID。