Meessen Jennifer M T A, Fiocco Marta, Tordoir Rutger L, Sjer Arnout, Verdegaal Suzan H M, Slagboom P Eline, Vliet Vlieland Thea P M, Nelissen Rob G H H
Department of Orthopedics, LUMC, Albinusdreef 2, J-11, 2333 ZA, Leiden, The Netherlands.
Department of Biomedical Data Sciences, LUMC, Leiden, The Netherlands.
Rheumatol Int. 2020 Apr;40(4):565-571. doi: 10.1007/s00296-020-04532-5. Epub 2020 Feb 18.
About 33% patients with osteoarthritis undergoing total hip/knee arthroplasty are not satisfied with the outcome, warranting the need to improve patient selection. Handgrip strength (HGS) has been suggested as a proxy for overall muscle strength and may be associated with post-arthroplasty function. This study aims to assess the association of pre-operative HGS with change in hip/knee function and quality of life in patients with arthroplasty. 226 hip (THA) and 246 knee (TKA) arthroplasty patients were included in this prospective cohort study. Pre-operative HGS was assessed by means of a dynamometer and the HOOS/KOOS and SF-36 questionnaires were collected before arthroplasty and 1 year thereafter. The association of HGS with score change on each sub-domain of the included questionnaires was assessed by linear regression models, adjusting for sex, body mass index and baseline score. Mean pre-operative HGS was 26 kg for patients undergoing THA and 24 kg for those undergoing TKA. HGS was positively associated with an increased improvement score on "function in sport and recreation"-domain in hip (β = 0.68, P = 0.005) and knee (β = 0.52, P = 0.049) and "symptoms"-domain in hip (β = 0.56, P = 0.001). For patients with THA, HGS was associated with the "quality of life" domain (β = 0.33, P = 0.033). In patients with TKA, HGS was associated with the physical component score (β = 0.31, P = 0.001). All statistically significant effects were positive, indicating that with greater pre-operative HGS, an increased gain in 1-year post-surgery score was observed. HGS can be used as a tool to inform patients with OA who are future candidates for a prosthesis about the possible improvements of certain aspects of life after arthroplasty.
接受全髋关节/膝关节置换术的骨关节炎患者中,约33%对手术结果不满意,因此有必要改进患者选择标准。握力(HGS)被认为是整体肌肉力量的代表,可能与置换术后功能有关。本研究旨在评估术前握力与置换术患者髋关节/膝关节功能变化及生活质量之间的关联。这项前瞻性队列研究纳入了226例髋关节置换术(THA)患者和246例膝关节置换术(TKA)患者。术前通过测力计评估握力,并在置换术前及术后1年收集HOOS/KOOS和SF - 36问卷。通过线性回归模型评估握力与所纳入问卷各子领域得分变化的关联,并对性别、体重指数和基线得分进行校正。接受THA的患者术前平均握力为26千克,接受TKA的患者为24千克。握力与髋关节“运动和娱乐功能”领域(β = 0.68,P = 0.005)和膝关节(β = 0.52,P = 0.049)以及髋关节“症状”领域(β = 0.56,P = 0.001)的改善得分增加呈正相关。对于THA患者,握力与“生活质量”领域相关(β = 0.33,P = 0.033)。在TKA患者中,握力与身体成分得分相关(β = 0.31,P = 0.001)。所有具有统计学意义的影响均为正向,表明术前握力越大,术后1年得分的增加幅度越大。握力可作为一种工具,让未来可能接受假体置换的骨关节炎患者了解置换术后生活某些方面可能得到的改善。