Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
BMC Musculoskelet Disord. 2023 Jan 6;24(1):9. doi: 10.1186/s12891-022-06104-z.
Distal femoral resection knee arthroplasty is a limb salvage procedure. The impact of distal femoral resection arthroplasty on patient function and health status is unknown. The aim of this study was to report knee function, quality of life, knee pain, and living conditions after distal femoral resection knee arthroplasty for non-tumor indications.
Of 52 patients (52 knees) undergoing distal femoral resection knee arthroplasty in a single institution between 2012 and 2021, 22 were excluded as 3 patients had ≤90 days follow-up, 6 had died, and 13 declined or were unable to participate for unrelated reasons. Thus, 30 patients were included and interviewed by telephone in March 2021 (mean follow-up 3.5 years after surgery). Patient completed the Oxford Knee Score (0-48, 48 best), EQ-5D-5L, and the Copenhagen Knee ROM, and information on pain and living conditions was obtained.
The mean age was 67.9 years (SD 13.6), and 21 (70%) were female. Mean total Oxford Knee Score was 29.9 (SD 10.5), mean Copenhagen Knee ROM flexion was 116° (SD 21.6), and mean extension was - 2° (SD10.1). Mobility aids were used by 18 (60%) patients, i.e. a cane (30%), walker (26.7%) or wheelchair (3.3%). Mean EQ-5D score was 0.70 (SD 0.22) and mean EQ-5D VAS score was 55.4 (SD 23.9). Nine (30%) patients used paracetamol or NSAID and 2 (6.7%) used opioids for knee pain. Mean VAS knee pain score was 1.30 (SD 2.2) at rest and 2.8 (SD 3.1) when walking. Most (90%) patients lived in their own home, with only 3 patients in nursing homes. Two-thirds (66.7%) required no home care, 5 (16.6%) received home care 1-2 times over 2 weeks, and 5 (16.6%) every day.
Distal femoral resection knee arthroplasty appears to be a viable treatment option for non-tumor indications. Acceptable patient outcomes were achieved in terms of functional status and quality of life, especially considering treatment alternatives such as femoral amputation.
股骨远端切除膝关节置换术是一种保肢手术。股骨远端切除关节置换术对患者功能和健康状况的影响尚不清楚。本研究的目的是报告非肿瘤适应证行股骨远端切除膝关节置换术后的膝关节功能、生活质量、膝关节疼痛和生活状况。
在 2012 年至 2021 年间，一家机构对 52 例（52 膝）股骨远端切除膝关节置换术患者进行了研究，其中 3 例患者的随访时间≤90 天，6 例患者死亡，13 例患者因其他原因拒绝或无法参与。因此，共纳入 30 例患者，并于 2021 年 3 月通过电话进行了访谈（术后平均随访 3.5 年）。患者完成了牛津膝关节评分（0-48，48 分为满分）、EQ-5D-5L 和哥本哈根膝关节 ROM 评分，并获得了疼痛和生活状况的相关信息。
平均年龄为 67.9 岁（标准差 13.6），21 例（70%）为女性。平均总牛津膝关节评分 29.9（标准差 10.5），平均哥本哈根膝关节 ROM 屈曲 116°（标准差 21.6），平均伸展-2°（标准差 10.1）。18 例（60%）患者使用了辅助工具，即手杖（30%）、助行器（26.7%）或轮椅（3.3%）。平均 EQ-5D 评分为 0.70（标准差 0.22），平均 EQ-5D VAS 评分为 55.4（标准差 23.9）。9 例（30%）患者因膝关节疼痛而使用对乙酰氨基酚或 NSAID，2 例（6.7%）患者使用阿片类药物。膝关节静息时平均 VAS 疼痛评分为 1.30（标准差 2.2），行走时为 2.8（标准差 3.1）。90%（27 例）的患者居住在自己家中，仅有 3 例患者居住在养老院。三分之二（20 例）的患者无需家庭护理，5 例（16.7%）患者在 2 周内接受 1-2 次家庭护理，5 例（16.7%）患者每天接受家庭护理。
股骨远端切除膝关节置换术似乎是一种可行的非肿瘤适应证的治疗选择。在功能状态和生活质量方面，患者获得了可接受的结果，特别是考虑到股骨截肢等替代治疗方法。
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