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多韧带膝关节重建术后的生活质量和功能结果

Quality of Life and Functional Outcomes after Multiligament Knee Reconstruction.

作者信息

Hatch George F Rick, Villacis Diego, Damodar Dhanur, Dacey Michael, Yi Anthony

机构信息

Department of Orthopaedic Surgery, University of Southern California Keck School of Medicine, Los Angeles, California.

出版信息

J Knee Surg. 2018 Nov;31(10):970-978. doi: 10.1055/s-0038-1626737. Epub 2018 Feb 12.

Abstract

We aimed to determine factors that affect the quality of life of patients undergoing a standardized surgical and postoperative management protocol for knee dislocations. A total of 31 patients (33 knees) were included in this study. We contacted patients at a minimum of 12 months postoperatively (mean: 38 months; range, 12-111 months) and administered the previously validated Multiligament Quality of Life questionnaire (ML-QOL), 2000 International Knee Documentation Committee Subjective Knee Form (IKDC), and Lysholm Knee Scoring Scale. We performed independent two-sample -tests and age-adjusted multivariable linear regression analysis to examine the difference in these scores. Patients who underwent previous knee ligament surgery had significantly worse mean ML-QOL scores relative to patients who did not undergo previous knee ligament surgery (114.3 versus 80.4;  = 0.004) (higher score indicates worse quality of life). All other differences in the ML-QOL scores were not statistically significant. IKDC and Lysholm scores did not differ significantly with regards to the studied variables. Among patients with no previous knee ligament surgery, patients undergoing surgery within 3 weeks of injury had significantly worse mean ML-QOL scores relative to patients undergoing surgery greater than 3 weeks after their injury (98.7 versus 74.7;  = 0.042) and patients with Schenck classification of III or IV had significantly worse mean ML-QOL scores relative to patient with a Schenck classification of I or II (88.7 versus 62.9;  = 0.015). We found that patients with a previous history of knee ligament surgery had a significantly worse quality of life relative to those with no history of knee ligament surgery. This is a level III, retrospective cohort study.

摘要

我们旨在确定影响接受膝关节脱位标准化手术及术后管理方案患者生活质量的因素。本研究共纳入31例患者(33个膝关节)。我们在患者术后至少12个月(平均:38个月;范围12 - 111个月)时联系他们,并发放先前经验证的多韧带生活质量问卷(ML - QOL)、2000版国际膝关节文献委员会主观膝关节表(IKDC)以及Lysholm膝关节评分量表。我们进行了独立两样本t检验和年龄校正的多变量线性回归分析,以检验这些评分的差异。与未接受过膝关节韧带手术的患者相比,曾接受过膝关节韧带手术的患者平均ML - QOL评分显著更差(114.3对80.4;P = 0.004)(评分越高表明生活质量越差)。ML - QOL评分的所有其他差异均无统计学意义。IKDC和Lysholm评分在研究变量方面无显著差异。在未接受过膝关节韧带手术的患者中,受伤后3周内接受手术的患者平均ML - QOL评分显著差于受伤后3周以上接受手术的患者(98.7对74.7;P = 0.042),且Schenck分类为III或IV级的患者平均ML - QOL评分显著差于Schenck分类为I或II级的患者(88.7对62.9;P = 0.015)。我们发现,有膝关节韧带手术史的患者相对于无膝关节韧带手术史的患者生活质量显著更差。这是一项III级回顾性队列研究。

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