Varacallo Matthew, Chakravarty Rajit, Denehy Kevin, Star Andrew
Drexel University College of Medicine, Department of Orthopaedic Surgery, University Orthopaedic Institute, 245 N. 15th Street, MS 420, Philadelphia, PA 19102, United States.
Division of Orthopaedic Surgery, Rothman Institute at Abington-Jefferson Health, Willow Grove, PA, United States.
J Orthop. 2018 Mar 30;15(2):495-499. doi: 10.1016/j.jor.2018.03.018. eCollection 2018 Jun.
Total hip (THA) and knee arthroplasty (TKA) are two of the most successful procedures in orthopedics. Current evaluation trends focus on patient-reported outcomes. We sought to compare the changing WOMAC scores from various time points from pre-operative to 1-year follow-up between separate THA and TKA cohorts. In addition, we compared THA and TKA patients' joint perception, satisfaction, and function via a questionnaire.
One hundred elective THA (n = 50) and TKA (n = 50) patients at one institution were randomly selected and contacted between 2 and 4 years after the index surgery. A questionnaire assessed joint perception, satisfaction and function of their total joint. Clinical function scores utilizing the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) from the pre-operative, 3-month and 1-year post-arthroplasty visits were compared between groups.
78% of the THA group perceived their replaced joint as "native" vs 32% of TKA patients. 54% of THA patients (vs 16% of TKA patients) reported uninhibited function of their total joint. 24% of TKA patients noted to be least satisfied with their total joint compared to 2% in the THA group. Both groups demonstrated significant improvement in WOMAC scores after surgery, but the mean 3-month (12.4 (THA) vs 19.3 (TKA)) and 1-year (6.5 (THA) vs 14.1 (TKA)) follow-up WOMAC scores were significantly better in the THA group.
Evaluation of a patient's joint perception is a valuable tool that should be used to assess function in conjunction with validated clinical functional scores. Our data suggest further improvements in total knee implant design and implantation strategies are necessary.
全髋关节置换术（THA）和全膝关节置换术（TKA）是骨科最成功的两种手术。当前的评估趋势侧重于患者报告的结果。我们试图比较THA和TKA不同队列从术前到1年随访各时间点WOMAC评分的变化。此外，我们通过问卷调查比较了THA和TKA患者的关节感知、满意度及功能。
在一家机构随机选取100例行择期THA（n = 50）和TKA（n = 50）的患者，在初次手术后2至4年进行随访。通过问卷评估其对全关节的关节感知、满意度及功能。比较两组术前、置换术后3个月及1年随访时使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）的临床功能评分。
78%的THA组患者感觉其置换关节如同“原生”关节，而TKA组患者的这一比例为32%。54%的THA患者（相比之下TKA患者为16%）报告其全关节功能不受限。24%的TKA患者表示对其全关节最不满意，而THA组这一比例为2%。两组术后WOMAC评分均有显著改善，但THA组术后3个月（12.4（THA）对19.3（TKA））和1年（6.5（THA）对14.1（TKA））随访时的WOMAC评分明显更好。
评估患者的关节感知是一种有价值的工具，应与经过验证的临床功能评分一起用于评估功能。我们的数据表明，全膝关节植入物设计和植入策略有必要进一步改进。
