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在全髋关节置换术治疗骨关节炎方面,纤维肌痛以外的中枢敏感综合征患者与无中枢敏感综合征患者的结局存在差异。

Differences in outcomes after total hip arthroplasty for osteoarthritis between patients with and without central sensitivity syndromes other than fibromyalgia.

机构信息

Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.

Department of Patient Safety and Healthcare Administration, Kitasato University School of Medicine, 1-15-1 Minami-ku, Kitasato, Sagamihara, Kanagawa, 252-0374, Japan.

出版信息

Sci Rep. 2022 Sep 12;12(1):15327. doi: 10.1038/s41598-022-19369-0.

DOI:10.1038/s41598-022-19369-0
PMID:36096936
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9468138/
Abstract

We investigated the differences in outcomes after total hip arthroplasty (THA) for hip osteoarthritis (HOA) between patients with and without central sensitivity syndromes (CSSs) other than fibromyalgia (FM). After excluding two patients with FM, we compared the clinical data of 41 patients with CSSs and 132 patients without CSSs. Clinical data included scores on the central sensitization inventory, visual analog scale for pain (VAS pain), and Japanese Orthopedic Association Hip Disease Evaluation Questionnaire (JHEQ). VAS pain was significantly higher at 3 and 6 months after THA in patients with CSSs than in those without CSSs (3 and 6 months, P < 0.001). Satisfaction, pain, and mental JHEQ scores were lower in patients with CSSs than in those without CSSs (satisfaction, P < 0.001; pain, P = 0.011; mental, P = 0.032). Multiple regression analyses indicated that one and ≥ 2 CSS diagnoses significantly impacted the satisfaction score (one CSS, β = - 0.181, P = 0.019; ≥ 2 CSSs, β = - 0.175, P = 0.023). Two or more CSSs were the only factor influencing the pain score (β = - 0.175, P = 0.027). Pain in patients with CSSs reflects central sensitization, which may adversely affect post-operative outcomes. Surgeons should pay attention to patients with a history of CSSs diagnoses who undergo THA for HOA.

摘要

我们研究了髋骨关节炎(HOA)患者全髋关节置换术(THA)后合并纤维肌痛症(FM)以外的中枢敏感综合征(CSSs)与不合并 CSSs 的患者之间结局的差异。排除两名 FM 患者后,我们比较了 41 名 CSSs 患者和 132 名不合并 CSSs 患者的临床资料。临床资料包括中枢敏感量表评分、疼痛视觉模拟评分(VAS 疼痛)和日本矫形协会髋关节疾病评估问卷(JHEQ)评分。与不合并 CSSs 的患者相比,合并 CSSs 的患者在 THA 后 3 个月和 6 个月时 VAS 疼痛评分显著更高(3 个月和 6 个月,P < 0.001)。合并 CSSs 的患者满意度、疼痛和精神 JHEQ 评分均低于不合并 CSSs 的患者(满意度,P < 0.001;疼痛,P = 0.011;精神,P = 0.032)。多元回归分析表明,1 个和≥2 个 CSS 诊断显著影响满意度评分(1 个 CSS,β = -0.181,P = 0.019;≥2 个 CSSs,β = -0.175,P = 0.023)。≥2 个 CSSs 是唯一影响疼痛评分的因素(β = -0.175,P = 0.027)。合并 CSSs 的患者的疼痛反映了中枢敏感化,这可能对术后结局产生不利影响。外科医生应该关注接受 THA 治疗 HOA 的有 CSSs 诊断史的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d77/9468138/5cb0664342e0/41598_2022_19369_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d77/9468138/187f40b343c6/41598_2022_19369_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d77/9468138/b2861afd43bb/41598_2022_19369_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d77/9468138/5cb0664342e0/41598_2022_19369_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d77/9468138/187f40b343c6/41598_2022_19369_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d77/9468138/b2861afd43bb/41598_2022_19369_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d77/9468138/5cb0664342e0/41598_2022_19369_Fig3_HTML.jpg

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