American Hip Institute, Westmont, IL, USA.
University of Illinois at Chicago, IL, USA.
Hip Int. 2021 May;31(3):362-368. doi: 10.1177/1120700019864015. Epub 2019 Jul 21.
Mental health and patient expectation have been identified as key predictors of recovery following THA; however, there is limited literature examining the effects of social support and marital status on patient-reported outcomes (PROs).
Data were prospectively collected and retrospectively reviewed for patients who underwent THA between July 2008 and January 2016. Patients were included if they underwent primary THA during this period and if they had documented preoperative marital status of married, divorced, or never married. Married patients were group matched to non-married patients (divorced or never married) with similar sex, age, body mass index (BMI), gender distribution, and frequency of surgical approach.
There were 414 married patients and 98 non-married patients who were eligible and had minimum 2-year follow-up. Mean PROs were significantly worse in the non-married group than the married group for the following measures: modified Harris Hip Score ( = 0.002), Harris Hip Score ( = 0.002), Forgotten Joint Score ( = 0.04), and the physical portions of the Veterans RAND ( = 0.025) and Short Form ( = 0.02) surveys.
Our study demonstrated inferior absolute PRO scores at latest follow-up for patients who were non-married compared to married following THA. These results show that while total hip replacement may still yield clinical benefit in all patients, non-married patients may ultimately achieve an inferior functional status, and expectations should be adjusted accordingly. Physicians should assess levels of psychosocial support in their patients prior to undergoing hip arthroplasty in order to optimise results.
心理健康和患者期望已被确定为 THA 后恢复的关键预测因素;然而,关于社会支持和婚姻状况对患者报告的结果(PROs)的影响的文献有限。
数据是前瞻性收集的,并对 2008 年 7 月至 2016 年 1 月期间接受 THA 的患者进行回顾性分析。如果患者在此期间接受了初次 THA,并且术前婚姻状况有记录为已婚、离婚或未婚,则将其纳入研究。已婚患者与非已婚患者(离婚或未婚)进行了性别匹配,具有相似的年龄、体重指数(BMI)、性别分布和手术入路频率。
有 414 名已婚患者和 98 名非已婚患者符合条件,并进行了至少 2 年的随访。在以下指标中,非已婚组的 PRO 明显差于已婚组:改良 Harris 髋关节评分( = 0.002)、Harris 髋关节评分( = 0.002)、遗忘关节评分( = 0.04),以及退伍军人 RAND( = 0.025)和简短表格( = 0.02)的物理部分。
我们的研究表明,与已婚患者相比,THA 后非已婚患者的最新随访时的绝对 PRO 评分更低。这些结果表明,虽然全髋关节置换术仍可能使所有患者受益,但非已婚患者最终可能会达到较差的功能状态,应相应调整预期。医生应在患者接受髋关节置换术前评估其社会心理支持水平,以优化结果。