Lai Yen-Feng, Lin Pei-Chao, Chen Chung-Hwan, Chen Jyu-Lin, Hsu Hsin-Tien
Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, No.100, Tz-You 1st Road, Kaohsiung 807, Taiwan.
School of Nursing, College of Nursing, Kaohsiung Medical University; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.
J Clin Med. 2019 Feb 8;8(2):221. doi: 10.3390/jcm8020221.
Knee osteoarthritis (OA) is a very common disease in the elderly, and total knee replacement (TKR) surgery is currently considered the most effective treatment. A prospective, observational, repeated measures study was performed to explore the current status and changes in pain and activities of daily living (ADL) in 58 OA elderly patients undergoing unilateral TKR. The Wong⁻Baker Faces Pain Rating Scale (WBS) for pain and the self-reported Barthel Index for ADL were measured on the day before surgery, 48 hours after surgery, and the day before discharge. Moderate pain was reported before surgery. Pain significantly improved after surgery and before discharge. At all three time points, pain scores were significantly higher in patients who used assistive devices compared to those who did not. Partial independence in ADL was reported before surgery. The ADL scores reported were highest before surgery, and those reported after surgery were lowest. However, ADL scores gradually increased before discharge. ADL scores were higher in the subjects who lived in a detached, single-family homes compared to those who lived in bungalows at all three time points. The results could be used to screen for knee OA elderly patients at high-risk for pain or low ADL and to provide timely intervention strategies as soon as possible.
膝关节骨关节炎（OA）在老年人中是一种非常常见的疾病，全膝关节置换术（TKR）目前被认为是最有效的治疗方法。一项前瞻性、观察性、重复测量研究对58例接受单侧TKR的OA老年患者的疼痛及日常生活活动（ADL）的现状和变化进行了探索。在手术前一天、术后48小时及出院前一天，采用Wong⁻Baker面部表情疼痛评分量表（WBS）评估疼痛，采用自我报告的Barthel指数评估ADL。术前报告为中度疼痛。术后及出院前疼痛明显改善。在所有三个时间点，使用辅助装置的患者的疼痛评分均显著高于未使用辅助装置的患者。术前报告ADL部分独立。报告的ADL评分在术前最高，术后最低。然而，ADL评分在出院前逐渐升高。在所有三个时间点，居住在独立单户住宅中的受试者的ADL评分均高于居住在平房中的受试者。这些结果可用于筛查疼痛风险高或ADL低的膝关节OA老年患者，并尽快提供及时的干预策略。
