Arslan Aydın, Çuglan Bilal, Özkurt Bülent, Utkan Ali, Korkmaz Mehmet Fatih, Koca Tuba Tülay, Sevimli Resit
Department of Orthopaedics and Traumatology, Elite İstanbul Medical Center,Istanbul Gelisim University,Istanbul,Turkey.
Department of Cardiology, Silivri Medical Park Hospital,Bahcesehir University,Istanbul,Turkey.
Open Orthop J. 2018 Jul 19;12:261-268. doi: 10.2174/1874325001812010261. eCollection 2018.
Patients suffering from knee osteoarthritis lead a less active life than their healthy peers. It is well known that insufficient physical activity is the most common cause of chronic diseases. However, there is not enough research to enlighten the effect of increased functional capacity on cardiac functions after Total Knee Arthroplasty (TKA). This study aimed to investigate whether the orthopedic surgeons can predict that the patients will be healthier after TKA in terms of cardiac functions or not?
109 patients who underwent TKA were prospectively followed for one year. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and short form 36 (SF-36) surveys, BMI measures, average step count per day, the six-minute walking test (6MWT), the Five-Times-Sit-to-Stand Test (FTSST) and Doppler echocardiography were performed both in the preoperative and postoperative period.
After TKA, there was a substantial improvement in terms of WOMAC and SF36 survey scores. The average step count increased from 2199.6±690.8 steps/day to 4124.3±1638.8 steps/day. 6MWT and FTSST improved significantly as well. The average brisk walking time was 174.23±95.11 minutes/week. The means of early and late mitral inflow velocity ratios (E/A and Em/Am ratios) increased from 0.71±0.12 to 0.77±0.13 and from 0.66±0.13 to 0.76± 0.15 at the first year follow-up visit, respectively (p<0.001).
In the first year, objective physical capacity measures increased together with the expected improvements in disease-specific and generic measures. After TKA, left ventricular diastolic functions may be considered to have recovered in the light of the healing signs echocardiography.
膝关节骨关节炎患者的生活活跃度低于健康同龄人。众所周知，身体活动不足是慢性病最常见的病因。然而，关于全膝关节置换术（TKA）后功能能力增强对心脏功能的影响，目前尚无足够研究予以阐明。本研究旨在调查骨科医生能否预测患者在TKA后心脏功能方面是否会更健康？
对109例行TKA的患者进行了为期一年的前瞻性随访。在术前和术后均进行了西安大略和麦克马斯特大学骨关节炎指数（WOMAC）和简明健康状况调查问卷（SF-36）、体重指数测量、每日平均步数、六分钟步行试验（6MWT）、五次坐立试验（FTSST）以及多普勒超声心动图检查。
TKA后，WOMAC和SF36调查评分有显著改善。平均步数从每日2199.6±690.8步增加至4124.3±1638.8步。6MWT和FTSST也有显著改善。平均快走时间为每周174.23±95.11分钟。在第一年随访时，早期和晚期二尖瓣流入速度比值（E/A和Em/Am比值）的平均值分别从0.71±0.12增加至0.77±0.13，从0.66±0.13增加至0.76±0.15（p<0.001）。
在第一年，客观身体能力指标与疾病特异性和一般性指标的预期改善同时增加。TKA后，根据超声心动图的愈合迹象，可认为左心室舒张功能已恢复。
