Nacca Daiane Cavenaghi, Amaro Joicemar Tarouco, Miyahira Mateus Kenji Christo, Novaretti João Victor, Astur Diego Costa, Cohen Moisés
Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.
Instituto Cohen de Ortopedia e Reabilitação e Medicina do Esporte, São Paulo, São Paulo, Brazil.
Rev Bras Ortop (Sao Paulo). 2021 Feb;56(1):53-60. doi: 10.1055/s-0040-1709989. Epub 2020 Jul 8.
To compare the function and quality of life of patients undergoing total knee arthroplasty (TKA) with fixed tibial platform and mobile tibial platform. We evaluated 240 patients with knee osteoarthritis, randomized into two groups - Group A consisted of 120 patients who underwent TKA with fixed tibial platform, and the B group, consisting of 120 patients who underwent mobile platform arthroplasty. Patients were accessed according to the function and quality of life by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Short Form Health Survey (SF-36), and pain scores by visual analog scale (VAS) of pain, preoperatively and at 6 months, 1 year, 2 years, 4 years and 8 years of surgery. Regarding the various domains of the SF-36, we observed that the average behavior of functional capacity scores, physical aspects, pain and emotional aspects in the patient groups were statistically different during follow-up. The other domains of quality of life showed no mean differences. Regarding the pain assessed by VAS and WOMAC pain scores, we can see that it showed a mean change in follow-up in both patient groups. However, at 2 years of follow-up, they were statistically worse in group A, equaling group B in the other moments. After 2 years of follow-up, we observed that pain scores and VAS were lower in the fixed platform group. However, these differences did not remain in the mid-term, suggesting that the mobile tibial platform arthroplasty has a short-term advantage, and may help in the rehabilitation process.
比较接受固定胫骨平台和活动胫骨平台全膝关节置换术(TKA)患者的功能和生活质量。
我们评估了240例膝骨关节炎患者,随机分为两组——A组由120例行固定胫骨平台TKA的患者组成,B组由120例行活动平台置换术的患者组成。术前以及术后6个月、1年、2年、4年和8年,采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)和健康调查简表(SF-36)评估患者的功能和生活质量,并通过视觉模拟疼痛量表(VAS)评估疼痛评分。
关于SF-36的各个领域,我们观察到,在随访期间,两组患者的功能能力评分、身体方面、疼痛和情感方面的平均表现存在统计学差异。生活质量的其他领域没有显著差异。关于通过VAS评估的疼痛和WOMAC疼痛评分,我们可以看到两组患者在随访中均有平均变化。然而,在随访2年时,A组在统计学上更差,在其他时间点与B组相当。
随访2年后,我们观察到固定平台组的疼痛评分和VAS较低。然而,这些差异在中期并未持续存在,这表明活动胫骨平台置换术具有短期优势,可能有助于康复过程。