Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Clin Orthop Surg. 2023 Feb;15(1):37-41. doi: 10.4055/cios22042. Epub 2022 Jul 25.
Preoperative concerns of patients undergoing total hip arthroplasty (THA) and their complaints during the initial postoperative period are not well investigated. We evaluated preoperative concerns of patients and patient-perceived problems during the operation and initial 5 days after the operation.
One hundred and thirty-two patients, who underwent primary THA at a tertiary referral hospital, were surveyed using a questionnaire and a face-to-face interview 1 day before the operation, operation day, and postoperative days 1, 2, 3, and 4. The severity of pain was assessed daily using a visual analog scale.
The most common preoperative concern was the severity of pain after the surgery (65.2%), followed by the need of transfusion (34.8%) and postoperative rehabilitation (32.6%). Among 29 patients who could recall the experience during the operation, 12 (41.4%) suffered from shoulder pain on the contralateral side, and 6 (20.7%) answered that hammering sound had been annoying. After returning to the ward, 29 patients (22.0%) suffered from nausea, 8 (6.1%) complained of back pain, and 7 (5.3%) had ipsilateral knee pain. On postoperative day 1, 7 patients (5.3%) had persistent back pain, 8 (6.1%) had headache, and 5 (3.8%) suffered from nausea. On postoperative day 2, nine patients (6.8%) complained of radiating pain due to aggravation of pre-existing spinal stenosis, 7 (5.3%) complained of weakness of the hip flexor due to periarticular injection of ropivacaine during the operation, and 5 (3.8%) had dressing-related skin problem at the wound. On postoperative days 3 and 4, patients had no problem other than hip pain. The mean pain score was the highest (3.1 ± 1.0) on postoperative day 1.
The results of this study might provide information needed to solve problems and improve satisfaction of patients undergoing THA.
接受全髋关节置换术（THA）的患者在术前存在一些担忧，并且在术后初期也会有一些不适。我们评估了患者在术前、手术中和术后最初 5 天的担忧和患者感知到的问题。
我们对在一家三级转诊医院接受初次 THA 的 132 名患者进行了问卷调查和面对面访谈，调查时间分别为术前 1 天、手术当天以及术后第 1、2、3、4 天。每天使用视觉模拟评分法评估疼痛程度。
最常见的术前担忧是手术后的疼痛程度（65.2%），其次是输血的需求（34.8%）和术后康复（32.6%）。在 29 名能够回忆起手术期间经历的患者中，有 12 名（41.4%）对手术侧的肩部疼痛有感觉，6 名（20.7%）表示锤击声很烦人。回到病房后，有 29 名（22.0%）患者出现恶心，8 名（6.1%）出现腰痛，7 名（5.3%）出现同侧膝关节疼痛。术后第 1 天，有 7 名（5.3%）患者持续出现腰痛，8 名（6.1%）患者出现头痛，5 名（3.8%）患者出现恶心。术后第 2 天，有 9 名（6.8%）患者因原有椎管狭窄加重而出现放射痛，7 名（5.3%）患者因手术中髋关节周围注射罗哌卡因而出现髋关节屈肌无力，5 名（3.8%）患者出现与伤口敷料相关的皮肤问题。术后第 3、4 天，患者除了髋关节疼痛外没有其他问题。术后第 1 天的疼痛评分最高（3.1±1.0）。
本研究结果可能为解决问题和提高 THA 患者满意度提供所需信息。
