Zhai Haohan, Geng Hongni, Bai Bo, Wang Yulong
Rehabilitation Medicine, Shenzhen Second People's Hospital, No. 3002 Sungang West Road, 518035, Shenzhen, People's Republic of China.
Orthopedics, First Affiliated Hospital of Guangzhou Medical University, 510120, Guangzhou, People's Republic of China.
Orthopade. 2019 Feb;48(2):136-143. doi: 10.1007/s00132-018-3636-2.
Patients who undergo primary total hip (THA) and knee (TKA) arthroplasty show better clinical outcomes, improved quality of life and increased participation in leisure activities; however, the differences between primary THA and TKA in older patients are unknown.
The aim of the study was to compare the Western Ontario and McMasters University osteoarthritis index (WOMAC) scores and changes in WOMAC scores, the Medical Outcomes study 12-item short-form version 2 (SF-12) mental and physical health scales, satisfaction and frequency of participation in leisure activities in older osteoarthritis patients with a mean age of 67.9 ± 10.6 years who underwent primary THA and TKA.
Data from 170 THA and 169 TKA patients were collected 1 week preoperatively through self-reporting of WOMAC scores and SF-12. These parameters, level of satisfaction and frequency of participation in leisure activities were collected 1 year postoperatively by self-reporting questionnaires.
The THA group of patients showed better WOMAC scores (P < 0.05), changes in WOMAC scores (P < 0.05), physical component summary (PCS) of SF-12 (P < 0.01) and changes in PCS scores (P < 0.01) compared with the TKA group. In addition, the THA patients showed higher overall satisfaction (91.90% vs. 83.60%), pain relief satisfaction (87.20% vs. 77.40%) and functional improvement satisfaction (90.10% vs. 83.08%) in comparison with the TKA patients. Furthermore, a higher frequency of participation in leisure activities was achieved in THA patients, except for intellectual leisure activities.
These findings suggest that primary THA provides superior clinical outcomes, quality of life, satisfaction, and participation in leisure activities compared with primary TKA in older patients.
接受初次全髋关节置换术(THA)和全膝关节置换术(TKA)的患者临床结局更佳,生活质量提高,参与休闲活动的机会增加;然而,老年患者中初次THA和TKA之间的差异尚不清楚。
本研究旨在比较平均年龄为67.9±10.6岁的老年骨关节炎患者在接受初次THA和TKA后,西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及WOMAC评分变化、医学结局研究简明健康调查量表(SF-12)的精神和身体健康量表、满意度以及参与休闲活动的频率。
通过患者自报WOMAC评分和SF-12,在术前1周收集170例THA患者和169例TKA患者的数据。术后1年通过自报问卷收集这些参数、满意度和参与休闲活动的频率。
与TKA组相比,THA组患者的WOMAC评分(P<0.05)、WOMAC评分变化(P<0.05)、SF-12的身体成分总结(PCS)(P<0.01)及PCS评分变化(P<0.01)更佳。此外,与TKA患者相比,THA患者的总体满意度更高(91.90%对83.60%)、疼痛缓解满意度更高(87.20%对77.40%)、功能改善满意度更高(90.10%对83.08%)。此外,除智力休闲活动外,THA患者参与休闲活动的频率更高。
这些研究结果表明,在老年患者中,与初次TKA相比,初次THA能提供更优的临床结局、生活质量、满意度及参与休闲活动的机会。