全膝关节置换术后帕金森病患者的生活质量评估。
Quality of life assessment after total knee arthroplasty in patients with Parkinson's disease.
机构信息
Department of Orthopedics, Bao Di Clinical College of Tianjin Medical University, Bao Di Hospital, 8 Guangchuan Road, Baodi District, Tianjin, 301800, Tianjin, China.
出版信息
BMC Musculoskelet Disord. 2022 Mar 9;23(1):230. doi: 10.1186/s12891-022-05176-1.
BACKGROUND
The number of Parkinson's patients (PD) undergoing total knee arthroplasty (TKA) is increasing. The purpose of the study was to characterize quality of life (QOL) outcomes for patients with coexisting PD and knee osteoarthritis (KOA) following TKA.
METHODS
Patients with coexisting PD and KOA undergoing TKA between June 2014 and June 2020 were included. These patients were matched to controls with KOA alone by age, gender, basic social background information and Knee society score (KSS). The primary measure was to assess the QOL by the absolute changes in the EuroQOL5-Dimensions (EQ-5D), Pain and Disability Questionnaire (PDQ), and Patient Health Questionnaire-9(PHQ-9) at the last follow-up (LFU). Secondary measures were changes in QOL that exceeded the minimum clinically important difference value (MCID). Data on the health status and QOL of all patients were collected. Simple and multivariate regression analysis was used to evaluate the impact of PD on their QOL.
RESULTS
Twelve KOA patients with PD were compared with 48 controls. Control patients experienced QOL improvement across all three measures:EQ-5D index (0.545-0.717, P < 0.01), PDQ (81.1-52.3, P < 0.01) and PHQ-9(8.22-5.91, P < 0.01) were significantly improved at the LFU; while in patients with PD, only PDQ (91.0-81.4, P = 0.03) slightly improved. There were significant differences in the improvement of QOL between PD patients and the control group through EQ-5D (0.531 vs.0.717, P < 0.01) and PDQ (81.4vs.52.3, P < 0.01) at the LFU.
CONCLUSION
TKA has no benefit of QOL beyond a slight improvement in pain-related disability in the KOA patients with PD.
背景
接受全膝关节置换术（TKA）的帕金森病（PD）患者数量正在增加。本研究的目的是描述同时患有 PD 和膝骨关节炎（KOA）的患者在 TKA 后的生活质量（QOL）结果。
方法
纳入 2014 年 6 月至 2020 年 6 月期间同时患有 PD 和 KOA 并接受 TKA 的患者。这些患者通过年龄、性别、基本社会背景信息和膝关节协会评分（KSS）与单纯 KOA 患者进行匹配。主要测量指标是通过在最后随访（LFU）时的欧洲五维健康量表（EQ-5D）、疼痛和残疾问卷（PDQ）和患者健康问卷-9（PHQ-9）的绝对变化来评估 QOL。次要测量指标是超过最小临床重要差异值（MCID）的 QOL 变化。收集所有患者的健康状况和 QOL 数据。采用简单和多变量回归分析评估 PD 对其 QOL 的影响。
结果
将 12 名 KOA 合并 PD 患者与 48 名对照患者进行比较。对照患者在所有三个测量指标上均表现出 QOL 改善：EQ-5D 指数（0.545-0.717，P<0.01）、PDQ（81.1-52.3，P<0.01）和 PHQ-9（8.22-5.91，P<0.01）在 LFU 时显著改善；而 PD 患者仅 PDQ（91.0-81.4，P=0.03）略有改善。PD 患者与对照组在 LFU 时通过 EQ-5D（0.531 比 0.717，P<0.01）和 PDQ（81.4 比 52.3，P<0.01）的 QOL 改善程度存在显著差异。
结论
TKA 对 PD 合并 KOA 患者的 QOL 没有获益，除了疼痛相关残疾的轻微改善。
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