Sveikata Tomas, Porvaneckas Narunas, Kanopa Paulius, Molyte Alma, Klimas Dalius, Uvarovas Valentinas, Venalis Algirdas
The Clinic of Rheumatology, Traumatology Orthopaedics and Reconstructive Surgery, Faculty of Medicine of Vilnius University, Vilnius, Lithuania.
Geriatr Orthop Surg Rehabil. 2017 Jun;8(2):71-77. doi: 10.1177/2151458516687809. Epub 2017 Jan 1.
Total knee arthroplasty (TKA) is an effective treatment for knee osteoarthritis. Patient-reported outcome after TKA is influenced by multiple patient-related factors. The aim of this study was to prospectively evaluate preoperative patient-related factors and to compare the self-reported outcomes 1 year after TKA among groups differing by age, sex, body mass index (BMI), education, and social support level.
314 patients, who underwent TKA in Vilnius Republican University Hospital between the end of 2012 and the middle of 2014, were included in a study. The preoperative and 12-month follow-up measurements were obtained using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form-12 (SF-12). Differences between patient groups according to gender, age, BMI, level of education, and level of social support were analyzed.
At 12-month follow-up men demonstrated better results than women in WOMAC ( = .003) and SF-12 both domains ( < .05). Patients with a higher social support demonstrated higher scores in physical function according to SF-12 ( = .008). Better preoperative WOMAC and SF-12 scores were a predictor of better outcome 1 year after surgery. There was no difference in postoperative scores in different age, BMI, and education groups according to WOMAC and SF-12.
There is no difference in self-reported functional outcome between patient groups differing in age, BMI, and education. Men and socially supported patients demonstrate better postoperative functional results 12 months after TKA. Better preoperative knee function and overall physical and mental function are predictors of better outcome 1 year after TKA. Age and obesity should not be limiting factors when considering who should receive this surgery.
全膝关节置换术(TKA)是治疗膝关节骨关节炎的有效方法。TKA术后患者报告的结局受多种患者相关因素影响。本研究的目的是前瞻性评估术前患者相关因素,并比较在年龄、性别、体重指数(BMI)、教育程度和社会支持水平方面存在差异的各组患者TKA术后1年的自我报告结局。
纳入2012年底至2014年年中在维尔纽斯共和国大学医院接受TKA的314例患者。使用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)和简明健康调查量表(SF-12)进行术前和12个月随访测量。分析了根据性别、年龄、BMI、教育程度和社会支持水平划分的患者组之间的差异。
在12个月随访时,男性在WOMAC(P = 0.003)和SF-12两个领域的结果均优于女性(P < 0.05)。根据SF-12,社会支持较高的患者在身体功能方面得分更高(P = 0.008)。术前WOMAC和SF-12得分较高是术后1年结局较好的预测因素。根据WOMAC和SF-12,不同年龄、BMI和教育程度组的术后得分无差异。
在年龄、BMI和教育程度方面存在差异的患者组之间,自我报告的功能结局无差异。男性和获得社会支持的患者在TKA术后12个月的功能结果更好。术前更好的膝关节功能以及整体身体和心理功能是TKA术后1年结局较好的预测因素。在考虑哪些患者应接受该手术时,年龄和肥胖不应成为限制因素。