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骨关节炎放射学严重程度和症状持续时间对全髋关节置换术后结局的影响:一项前瞻性队列研究。

The Influence of Radiological Severity and Symptom Duration of Osteoarthritis on Postoperative Outcome After Total Hip Arthroplasty: A Prospective Cohort Study.

机构信息

Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.

Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.

出版信息

J Arthroplasty. 2018 Feb;33(2):436-440. doi: 10.1016/j.arth.2017.09.051. Epub 2017 Oct 5.

Abstract

BACKGROUND

We aimed to investigate the influence of preoperative radiological severity and symptom duration of hip osteoarthritis (OA) on the postoperative functional outcome, quality of life, as well as abductor muscle strength after total hip arthroplasty (THA).

METHODS

In this prospective cohort study, we studied 250 patients. Preoperatively, we evaluated the function with the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and quality of life with euroqol-5D (EQ-5D). At 1 year after THA, the same scores and also hip abductor muscle strength were measured in 222 patients. We divided the cohort twice, first according to the radiological OA severity [Kellgren-Lawrence classification (KL)] and then according to the OA symptom duration. We investigated whether the preoperative KL class and symptom duration influenced the 1-year WOMAC (primary outcome measure) or EQ-5D and abductor muscle strength (secondary outcome measures).

RESULTS

The crude results showed that KL class and symptom duration had no influence (P = .90 and P = .20, respectively) on the 1-year WOMAC. Younger age, male gender, and lower body mass index were associated with a better function. Regarding 1-year EQ-5D, the crude results showed that body mass index and KL class had no influence (P = .83 and P = .39, respectively). The adjusted results showed that only age and gender influenced the postoperative EQ-5D. No influence of the tested factors was found on the 1-year abductor muscle strength.

CONCLUSION

Preoperative radiological OA severity and symptom duration had no influence on the outcome of THA and should probably not affect the decision about timing the operative intervention.

摘要

背景

我们旨在研究髋关节骨关节炎(OA)术前放射学严重程度和症状持续时间对全髋关节置换术后功能结局、生活质量以及外展肌力量的影响。

方法

在这项前瞻性队列研究中,我们研究了 250 名患者。术前,我们使用西部安大略省和麦克马斯特大学骨关节炎(WOMAC)指数评估功能,使用欧洲五维健康量表(EQ-5D)评估生活质量。在 THA 后 1 年,222 名患者测量了相同的评分和髋关节外展肌力量。我们将队列分为两次,首先根据放射学 OA 严重程度[Kellgren-Lawrence 分级(KL)],然后根据 OA 症状持续时间。我们调查了术前 KL 分级和症状持续时间是否影响 1 年 WOMAC(主要观察指标)或 EQ-5D 和外展肌力量(次要观察指标)。

结果

初步结果显示,KL 分级和症状持续时间对 1 年 WOMAC 无影响(P =.90 和 P =.20)。年龄较小、男性和较低的体重指数与更好的功能相关。关于 1 年 EQ-5D,初步结果显示体重指数和 KL 分级无影响(P =.83 和 P =.39)。调整结果显示,只有年龄和性别影响术后 EQ-5D。测试因素对外展肌力量 1 年无影响。

结论

术前放射学 OA 严重程度和症状持续时间对 THA 结果没有影响,因此可能不应影响手术干预时机的决策。

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