全膝关节置换术可改善中期随访时的运动活动和患者报告的功能结果。

Total knee arthroplasty improves sports activity and the patient-reported functional outcome at mid-term follow-up.

机构信息

Gelenkpunkt - Sports and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria.

Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI), Private University for Health Sciences, Medical Informatics and Technology, Innsbruck, Austria.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2023 Mar;31(3):905-913. doi: 10.1007/s00167-022-07025-z. Epub 2022 Jun 11.

DOI:10.1007/s00167-022-07025-z

PMID:35689683

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9957844/

Abstract

PURPOSE

The purpose of this study was to assess (1) sports participation and preference for the type of sports activity after TKA, (2) mid-term functional outcome and activity level, (3) correlation of different age groups with activity level and functional outcomes, and (4) mid-term survivorship of the prosthesis.

METHODS

A retrospective review of prospectively collected data was performed. 182 patients were included who underwent primary TKA between January 2010 and December 2016. Inclusion criteria were symptomatic knee osteoarthritis, age 50-90 years, and with a minimum of 5-year follow-up after TKA. Patients with rheumatoid arthritis and revision TKA were excluded. Sports participation and sports preference, Oxford Knee Score (OKS), Tegner Activity Level, and Visual Analogue Scale (VAS) for pain were recorded pre- and postoperatively at 6 months, 1 year, 2 years, and 5 years. The patient cohort was subdivided according to age groups; activity levels, patient-reported outcomes, and improvement in knee pain were correlated with these age groups. Kaplan-Meier curves were used to investigate survivorship at a minimum of 5 years.

RESULTS

The mean age of the cohort was 75.6 ± 7.2 years (range 52-89). Significant improvement was noted in sports participation (p < 0.003). After TKA, there was no change in the preference for sports and none of the patients had to discontinue their sporting activity. OKS improved significantly at all follow-up time points compared to the preoperative score (p < .0001). Patients' sports and physical activity improved significantly at 1 year compared to the preoperative activity level (p < 0.001). Although the Tegner activity level improved over time, this improvement was not significant (NS), while it was significantly higher in males than in females (p < 0.004). Significant improvement was found in the VAS for pain at all follow-up time points compared to the preoperative score (p < .0001). Survivorship was found to be 100% at a 5-year follow-up.

CONCLUSION

After TKA, patients can be able to return to sporting activity or even perform better than before surgery. Maximum improvement was noted in the first post-operative year. The male and younger groups perform better than the female and older groups. Sports and physical activity do not negatively impact survivorship of the knee prosthesis at mid-term follow-up and all patients are encouraged to take up sports participation after their TKA.

LEVEL OF EVIDENCE

Level 3.

摘要

目的

本研究旨在评估：（1）TKA 后患者参与运动的情况和对运动类型的偏好；（2）中期的功能结果和活动水平；（3）不同年龄组与活动水平和功能结果的相关性；（4）假体的中期生存率。

方法

对前瞻性收集的数据进行回顾性分析。纳入了 2010 年 1 月至 2016 年 12 月期间接受初次 TKA 的 182 例患者。纳入标准为症状性膝骨关节炎、50-90 岁、TKA 后至少 5 年随访。排除类风湿关节炎和翻修 TKA 的患者。记录术前、术后 6 个月、1 年、2 年和 5 年时的运动参与情况和运动偏好、牛津膝关节评分（OKS）、Tegner 活动水平和视觉模拟量表（VAS）的疼痛评分。根据年龄组对患者队列进行分组；将活动水平、患者报告的结果与这些年龄组进行相关性分析。使用 Kaplan-Meier 曲线在至少 5 年的时间内评估假体的生存率。

结果

该队列的平均年龄为 75.6±7.2 岁（范围 52-89 岁）。运动参与率显著提高（p<0.003）。TKA 后，患者对运动的偏好没有改变，也没有患者不得不停止运动。与术前评分相比，OKS 在所有随访时间点均显著改善（p<0.0001）。与术前活动水平相比，患者的运动和身体活动在 1 年时显著改善（p<0.001）。虽然 Tegner 活动水平随时间推移而提高，但这一提高无统计学意义（NS），而男性明显高于女性（p<0.004）。与术前评分相比，VAS 疼痛评分在所有随访时间点均显著改善（p<0.0001）。5 年随访时假体生存率为 100%。