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双动杯:全髋关节置换术后是否能提高患者满意度?一项前瞻性随机对照研究。

Dual Mobility Cup: Does It Improve Patient's Satisfaction After Total Hip Arthroplasty? A Prospective Comparative Randomized Study.

机构信息

From the Orthopedic Department, Tanta University, Tanta, Egypt.

出版信息

J Am Acad Orthop Surg. 2021 Nov 15;29(22):e1141-e1150. doi: 10.5435/JAAOS-D-20-00882.

Abstract

INTRODUCTION

Despite the great success of total hip arthroplasty (THA), many patients were fairly dissatisfied after surgery. Therefore, patient-reported outcome measures have become of an utmost importance in assessing the results after joint replacement. This study was conducted to compare the postoperative patient-reported satisfactions after implantation of two commonly used THA designs.

METHODS

Of 180 patients, who initially fulfilled the study selection criteria and received cementless THA, 165 patients were finally eligible and enrolled in this prospective comparative randomized study. All surgeries were carried out between 2010 and 2018. Two groups of homogenous demographic and clinical data were present. Group A patients (n = 80) were treated by large head THA, whereas group B (n = 85) received dual mobility cup designs. The Western Ontario McMaster Universities Osteoarthritis Index and visual analog scale were used for clinical evaluation. The degree of improvement that the patient expected and hoped before undergoing their surgeries was estimated using the score of the new knee society. The self-administered patient satisfaction scale was used to record the levels of patient satisfaction after surgery, and their values were statistically analyzed in relation to preoperative expectation scores (ie, score of the new knee society) and different clinical and sociodemographic variables.

RESULTS

After a mean follow-up of 79 ± 4.13 months (range 24 to 96 months), both groups recorded a significant improvement (P < 0.05) in Western Ontario McMaster Universities Osteoarthritis Index and visual analogue scale scores. Patients of group B were significantly more satisfied (P < 0.05) than those of group A up to the first postoperative year. Certain studied variables were linked to superior satisfaction results among group B at the last follow-up.

CONCLUSIONS

Dual mobility THA provides better patient satisfaction than their standard large head alternatives specifically among elderly patients, socially unsupported individuals, farmers, heavy manual workers, and those with high levels of expectations.

CLINICAL TRIAL REGISTRATION

Clinical Trials.gov identifier: NCT04333316.

摘要

简介

尽管全髋关节置换术(THA)取得了巨大成功,但许多患者术后仍相当不满意。因此,患者报告的结果测量在评估关节置换术后结果方面变得至关重要。本研究旨在比较两种常用 THA 设计植入后的术后患者报告满意度。

方法

在最初符合研究选择标准并接受非骨水泥 THA 的 180 名患者中,最终有 165 名符合条件并被纳入这项前瞻性、对照、随机研究。所有手术均在 2010 年至 2018 年期间进行。两组患者的人口统计学和临床数据均相似。A 组(n=80)患者接受大头 THA 治疗,B 组(n=85)患者接受双动杯设计。采用 Western Ontario McMaster Universities 骨关节炎指数和视觉模拟评分法进行临床评估。使用新膝关节协会评分估计患者在接受手术前预期和希望的改善程度。使用自我管理的患者满意度量表记录患者术后的满意度水平,并对其与术前预期评分(即新膝关节协会评分)和不同临床及社会人口统计学变量的关系进行统计学分析。

结果

平均随访 79 ± 4.13 个月(范围 24 至 96 个月)后,两组患者的 Western Ontario McMaster Universities 骨关节炎指数和视觉模拟评分均有显著改善(P<0.05)。B 组患者的满意度显著高于 A 组(P<0.05),尤其是在术后第一年。在最后一次随访时,某些研究变量与 B 组的满意度更高相关。

结论

双动 THA 比标准大头替代物能提供更好的患者满意度,特别是在老年患者、无社会支持的个体、农民、体力劳动者和期望较高的患者中。

临床试验注册

ClinicalTrials.gov 标识符:NCT04333316。

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