Li Z C, Hou Y F, Zhou Z W, Jiang L, Zhang S, Lin J H
Institute of Arthritis, Peking University People's Hospital, Beijing 100044, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2022 Feb 18;54(1):170-176. doi: 10.19723/j.issn.1671-167X.2022.01.027.
To investigate the expectations of patients for total knee arthroplasty (TKA), and to analyze its influencing factors.
Experimental design: Single center, retrospective, multiple regression analysis. The data including the age, height, and weight of 108 patients undergoing unilateral TKA due to end-stage osteoarthritis were obtained. The patients' preoperative Hospital for Special Surgery (HSS) knee arthroplasty expectation score, the Western Ontario and McMaster Universities (WOMAC) score, Knee Society score (KSS), the MOS 36-item short-from health survey (SF-36) score, and visual analogue scale (VAS) were evaluated, and the 30-second chair-stand test (30-CST), 40-meter fast-paced walk test (40-FPWT), 12-level stair-climb test (12-SCT), 3-meter timed up-and-go test (TUG), 6-minute walk test (6-MWT), and recorded daily steps for 7 consecutive days were performed. The SPSS 22.0 software was used for statistical analysis. The observed values of various data were described. Pearson correlation analysis was used to evaluate the correlation between various parameters, and the multi-factor linear regression analysis was used to investigate the influencing factors of the patients preoperative expectation scores.
The average expectation score of this group of patients was 58.98±5.44. In the Pearson correlation analysis, the patient's preoperative expectation had a weak correlation to the result of the patient's 12-SCT, TUG, 6-MWT, KSS function score, and SF-36 mental component score (correlation coefficient 0.1-0.3). The patient's preoperative expectation had a moderate correlation to the patient's daily average steps, 30-CST, 40-FPWT, KSS, WOMAC and its pain, stiffness, function scores, SF-36 physical functioning, role-physical, bodily pain, vitality, and physical component score (correlation coefficient 0.3-0.6). In the multivariate linear regression analysis, only the results of 30-CST and the role-physical, bodily pain and vitality in the SF-36 scale were related to the patient's expectation score ( < 0.05).
The estimated expectation score of patients before TKA is not high. Patients with more severe preoperative pain, worse physical function, and lower overall health are more eager to improve after surgery. Thus surgeons must communicate fully with patients with unrealistic expectations before surgery in order to obtain more satisfactory results postoperatively.
探讨患者对全膝关节置换术（TKA）的期望，并分析其影响因素。
实验设计：单中心、回顾性、多元回归分析。获取108例因终末期骨关节炎接受单侧TKA患者的年龄、身高和体重数据。评估患者术前特种外科医院（HSS）膝关节置换术期望评分、西安大略和麦克马斯特大学（WOMAC）评分、膝关节协会评分（KSS）、医学结局研究简明健康调查（SF-36）评分及视觉模拟量表（VAS），并进行30秒坐立试验（30-CST）、40米快速步行试验（40-FPWT）、12级楼梯攀爬试验（12-SCT）、3米定时起立行走试验（TUG）、6分钟步行试验（6-MWT）以及连续7天记录每日步数。采用SPSS 22.0软件进行统计分析。描述各项数据的观测值。采用Pearson相关分析评估各参数间的相关性，采用多因素线性回归分析探究患者术前期望评分的影响因素。
该组患者的平均期望评分为58.98±5.44。在Pearson相关分析中，患者术前期望与12-SCT、TUG、6-MWT结果、KSS功能评分及SF-36心理成分评分呈弱相关（相关系数0.1 - 0.3）。患者术前期望与患者每日平均步数、30-CST、40-FPWT、KSS、WOMAC及其疼痛、僵硬、功能评分、SF-36身体功能、角色-身体、躯体疼痛、活力及身体成分评分呈中度相关（相关系数0.3 - 0.6）。在多因素线性回归分析中，仅30-CST结果及SF-36量表中的角色-身体、躯体疼痛和活力与患者的期望评分相关（<0.05）。
TKA术前患者的期望评分估计不高。术前疼痛更严重、身体功能更差及总体健康状况更低的患者术后更渴望改善。因此，外科医生在手术前必须与期望不切实际的患者充分沟通，以获得更满意的术后效果。
