Departments of Physical Therapy and Orthopaedic Surgery and Rheumatology, Virginia Commonwealth University, Richmond, VA.
Arch Phys Med Rehabil. 2018 May;99(5):887-892. doi: 10.1016/j.apmr.2017.12.010. Epub 2018 Jan 9.
To determine the prevalence of a 1- to 2-year postsurgical pain-free state and pain plus symptom-free state as well as functional restoration after knee arthroplasty (KA) and to identify predictors of these outcomes.
Cohort study.
Communities of 4 sites.
Consecutive participants (N=383) who underwent KA on at least 1 knee during the first 8 years of the study (mean age, 67.95±8.5y; 61.4% women; n=235).
Not applicable.
A composite pain score included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain scale and 2 generic pain rating scales. Composite pain plus other symptoms scores included 3 pain scales, a stiffness scale, and, in addition, the Knee injury and Osteoarthritis Outcome Score Symptoms scale. The WOMAC Function scale was used to quantify functional status. Prevalence estimates and predictors of a pain-free state, symptom-free state, and a fully functioning state were determined.
A sample of 383 participants with KA was studied, and of these, 34.1% (95% confidence interval [CI], 29.3%-39.2%; n=131) had a composite score of 0 for pain. A total of 14.1% (95% CI, 10.8%-18.1%; n=54) had a composite score of 0, indicating a symptom-free state, whereas 29.0% (95% CI, 24.4%-34.0%; n=111) achieved a score of 0 on the WOMAC Function scale.
The prevalence of complete pain relief was 34%, the prevalence of complete pain and symptom relief was 14%, and the prevalence of complete functional restoration was 29% after KA. Participants who are older and with lower (better) WOMAC Pain scores were more likely to be pain-free after surgery. These data collected from a community-based sample have the potential to inform clinicians screening patients for KA consultation in a shared decision-making discussion to better align patient expectations with the most likely outcome.
确定膝关节置换术后 1 至 2 年无痛状态和疼痛加症状无状态以及功能恢复的患病率，并确定这些结果的预测因素。
队列研究。
4 个社区。
连续参与者（N=383），在研究的前 8 年中至少有 1 条膝关节接受了膝关节置换术（平均年龄 67.95±8.5 岁；61.4%女性；n=235）。
不适用。
综合疼痛评分包括西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）疼痛量表和 2 个通用疼痛评分量表。综合疼痛加其他症状评分包括 3 个疼痛量表、僵硬量表，此外还有膝关节损伤和骨关节炎结局评分症状量表。WOMAC 功能量表用于量化功能状态。确定无痛状态、无症状状态和完全功能状态的患病率估计和预测因素。
研究了 383 名接受膝关节置换术的参与者样本，其中 34.1%（95%置信区间[CI]，29.3%-39.2%；n=131）的综合疼痛评分为 0。共有 14.1%（95%CI，10.8%-18.1%；n=54）的综合评分为 0，表明无症状状态，而 29.0%（95%CI，24.4%-34.0%；n=111）的 WOMAC 功能评分为 0。
膝关节置换术后完全缓解疼痛的患病率为 34%，完全缓解疼痛和症状的患病率为 14%，完全恢复功能的患病率为 29%。年龄较大且 WOMAC 疼痛评分较低（较好）的患者术后更有可能无痛。这些从社区样本中收集的数据有可能为临床医生在共同决策讨论中筛选接受膝关节置换术咨询的患者提供信息，以便更好地将患者的期望与最有可能的结果相匹配。
