全膝关节置换术后患者的不满：文献系统评价。
Patient Dissatisfaction Following Total Knee Arthroplasty: A Systematic Review of the Literature.
机构信息
Physics Department, Curtin University, Bentley, Western Australia, Australia; Australian Institute of Robotic Orthopaedics, Subiaco, Western Australia, Australia.
Physics Department, Curtin University, Bentley, Western Australia, Australia; Australian Institute of Robotic Orthopaedics, Subiaco, Western Australia, Australia; The Joint Studio, Hollywood Medical Centre, Nedlands, Western Australia, Australia; The Virtual Centre for Advanced Orthopaedics, Denton, Texas; Physics Department, University of North Texas, Denton, Texas.
出版信息
J Arthroplasty. 2017 Dec;32(12):3854-3860. doi: 10.1016/j.arth.2017.07.021. Epub 2017 Jul 21.
BACKGROUND
Dissatisfaction following total knee arthroplasty (TKA) is common. Approximately 20% of patients report dissatisfaction following primary TKA. This systematic literature review explores key factors affecting patient dissatisfaction following TKA.
METHODS
Six literature databases published between 2005 and 1 January 2016 were searched using 3 key search phrases. Papers were included if the study investigated patient dissatisfaction in primary unilateral or bilateral TKA. Information from each article was categorized to the domains of socioeconomic, preoperative, intraoperative, and postoperative factors affecting patient dissatisfaction.
RESULTS
This review found that patient dissatisfaction pertains to several key factors. Patient expectations prior to surgery, the degree of improvement in knee function, and pain relief following surgery were commonly cited in the literature. Fewer associations were found in the socioeconomic and surgical domains.
CONCLUSION
Identifying who may be dissatisfied after their TKA is mystifying; however, we note several strategies that target factors whereby an association exists. Further research is needed to better quantify dissatisfaction, so that the causal links underpinning dissatisfaction can be more fully appreciated and strategies employed to target them.
背景
全膝关节置换术后（TKA）的不满意率很常见。约 20%的患者在初次 TKA 后报告不满意。本系统文献回顾探讨了影响 TKA 后患者不满意的关键因素。
方法
使用 3 个关键搜索短语，检索了 2005 年至 2016 年 1 月 1 日期间发表的 6 个文献数据库。如果研究调查了初次单侧或双侧 TKA 患者的不满意情况，则纳入论文。从每个文章中提取信息，并将其归类到影响患者不满的社会经济、术前、术中以及术后因素的各个领域。
结果
本综述发现，患者的不满与几个关键因素有关。术前的患者预期、膝关节功能的改善程度以及术后的疼痛缓解，在文献中经常被提及。在社会经济和手术领域，关联较少。
结论
确定谁可能在 TKA 后不满意是令人困惑的；然而，我们注意到了一些针对存在关联的因素的策略。需要进一步的研究来更好地量化不满，以便更全面地了解其背后的因果关系，并采取措施加以应对。
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