Torres-Claramunt Raúl, Hinarejos Pedro, Amestoy Jorge, Leal Joan, Sánchez-Soler Juan, Puig-Verdié Lluís, Monllau Joan C
Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, PasseigMarítim 25-29, 08003, Barcelona, Spain.
IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Knee Surg Sports Traumatol Arthrosc. 2017 Nov;25(11):3411-3416. doi: 10.1007/s00167-016-4418-1. Epub 2017 Jan 3.
The hypothesis of this study was that depressive patients feel more pain in the immediate TKA postoperative period in comparison with non-depressed patients.
The diagnosis of depression was made with the Geriatric Depression Scale Short Form. The Visual Analogic Score (VAS) was registered each 8 h during the first 3 days. The mean and maximum VAS and the number of analgesic rescues required in this period were calculated in 803 consecutive TKAs. The Knee Society Score (KSS), the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form-36 (SF-36) scores were obtained preoperatively and at the 1-year follow-up.
Forty-eight (6%) of these patients were considered depressed. The results obtained in the depressed patients and non-depressed were, respectively, mean VAS (2.0 vs 1.0, p = 0.00), maximum VAS (5.3 vs 1.6, p = 0.00), and number of rescues needed (4.4 vs 1.8, p = 0.00). Although depressed patients scored worse in the functional and quality of life scores in the preoperative period, the improvement obtained (1-year outcomes minus preoperative outcomes) in the different scores was similar in both groups with the exception of the mental domain of the SF-36, which improved further in depressed patients (p = 0.00).
Depressed patients feel more pain in the immediate postoperative period. However, the improvement obtained in functional and referred quality of life scores is similar to non-depressed patients.
II.
本研究的假设是，与非抑郁患者相比，抑郁患者在全膝关节置换术（TKA）术后即刻会感到更多疼痛。
采用老年抑郁量表简表进行抑郁诊断。在术后前3天，每8小时记录一次视觉模拟评分（VAS）。计算803例连续TKA患者在此期间的平均VAS、最大VAS以及所需的镇痛补救次数。术前及1年随访时获取膝关节协会评分（KSS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及简明健康状况调查量表（SF - 36）评分。
这些患者中有48例（6%）被认为患有抑郁症。抑郁患者和非抑郁患者的结果分别为：平均VAS（2.0对1.0，p = 0.00）、最大VAS（5.3对1.6，p = 0.00）以及所需补救次数（4.4对1.8，p = 0.00）。尽管抑郁患者在术前功能和生活质量评分方面较差，但除SF - 36的心理领域外，两组在不同评分中获得的改善（1年结果减去术前结果）相似，抑郁患者在该心理领域改善更明显（p = 0.00）。
抑郁患者在术后即刻感到更多疼痛。然而，在功能和生活质量评分方面获得的改善与非抑郁患者相似。
II级。
