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减重手术后膝关节骨关节炎疼痛和功能的改善:5 年随访结果。

Improvement in knee osteoarthritis pain and function following bariatric surgery: 5-year follow-up.

机构信息

Department of Orthopedics and Rehabilitation, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.

Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.

出版信息

Surg Obes Relat Dis. 2019 Jun;15(6):979-984. doi: 10.1016/j.soard.2019.04.005. Epub 2019 Apr 12.

Abstract

BACKGROUND

Weight loss through bariatric surgery improves short-term knee pain and symptoms in patients with osteoarthritis. There is little research regarding whether patients maintain symptomatic improvement in long-term follow-up after bariatric surgery.

OBJECTIVES

We hypothesized that bariatric surgery is a reliable method of maintaining weight loss in these patients with continued improvements in knee pain and symptoms at 5-year follow-up compared with baseline.

SETTING

University hospital.

METHODS

A 5-year prospective observational study was performed in patients with symptoms and radiographic evidence of knee osteoarthritis who were undergoing bariatric surgery. The Western Ontario and McMaster Universities Index of Osteoarthritis and Knee Osteoarthritis Outcome Score Surveys were administered at baseline, 6 months, 12 months, 2 years, and 5 years. Patients who met all inclusion criteria and followed up at baseline, 6 months, 1 year, and 5 years were included in the study (n = 13). Statistical analysis was performed using Student t and Wilcoxon signed rank tests.

RESULTS

Patients on average maintained a percent total weight loss of 22.3% at 5-year follow-up (P < .0001). There was a statistically significant improvement from baseline in all subscales-pain, stiffness, and physical function-as measured by Western Ontario and McMaster Universities at 6 months, 1 year, and 5 years. A statistically significant change in pain (P = .0005) and function/activities of daily living (P = .0088) was maintained at 5-year follow-up as measured by the Knee Osteoarthritis Outcome Score.

CONCLUSIONS

Bariatric surgery is a reliable method to maintain weight loss, reduce pain and stiffness, and improve function in patients with knee osteoarthritis at 5-year follow-up.

摘要

背景

减重手术可减轻肥胖症患者的短期膝关节疼痛和症状。但是,关于减重手术后长期随访患者症状是否持续改善的研究较少。

目的

我们假设与基线相比,减重手术是一种可靠的方法,可以使这些患者保持体重减轻,并且在 5 年随访时膝关节疼痛和症状持续改善。

设置

大学医院。

方法

对正在接受减重手术且有膝关节骨关节炎症状和影像学证据的患者进行了 5 年前瞻性观察性研究。在基线、6 个月、12 个月、2 年和 5 年时进行了西安大略和麦克马斯特大学骨关节炎指数和膝关节骨关节炎结局评分调查。符合所有纳入标准且在基线、6 个月、1 年和 5 年随访的患者纳入研究(n = 13)。使用学生 t 检验和 Wilcoxon 符号秩检验进行统计分析。

结果

患者在 5 年随访时平均维持 22.3%的总体重减轻率(P <.0001)。与基线相比,所有亚量表-疼痛、僵硬和身体功能,在 6 个月、1 年和 5 年均有统计学显著改善。在 5 年随访时,疼痛(P =.0005)和功能/日常生活活动(P =.0088)的变化仍具有统计学意义,这是通过膝关节骨关节炎结局评分来衡量的。

结论

减重手术是一种可靠的方法,可以在 5 年随访时保持体重减轻、减轻疼痛和僵硬以及改善膝关节骨关节炎患者的功能。

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