Woodland Nicholas, Takla Antony, Estee Mahnuma Mahfuz, Franks Angus, Bhurani Mansi, Liew Susan, Cicuttini Flavia M, Wang Yuanyuan
School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia.
Alfred Hospital, Melbourne 3004, Australia.
J Clin Med. 2023 Feb 17;12(4):1613. doi: 10.3390/jcm12041613.
A previous systematic review showed positive patient-reported outcomes following total knee replacement (TKR) in patients aged < 65 years. However, the question remains as to whether these results are replicated for older individuals. This systematic review evaluated the patient-reported outcomes following TKR in individuals aged ≥ 65 years. A systematic search of Ovid MEDLINE, EMBASE, and Cochrane library were performed to identify studies examining disease-specific or health-related quality of life outcomes following TKR. Qualitative evidence synthesis was performed. Eighteen studies with low ( = 1), moderate ( = 6), or serious ( = 11) overall risk of bias were included, with evidence syntheses derived from 20,826 patients. Four studies reported on pain scales, showing improvement of pain from 6 months to 10 years postoperatively. Nine studies examined functional outcomes, showing significant improvements from 6 months to 10 years after TKR. Improvement in health-related quality of life was evident in six studies over 6 months to 2 years. All four studies examining satisfaction reported overall satisfaction with TKR results. TKR results in reduced pain, improved function, and increased quality of life for individuals aged ≥ 65 years. The improvement in patient-reported outcomes needs to be utilised in conjunction with physician expertise to determine what would comprise clinically significant differences.
一项先前的系统评价显示，年龄＜65岁的患者在全膝关节置换术（TKR）后患者报告的结果呈阳性。然而，这些结果是否适用于老年人仍是个问题。本系统评价评估了年龄≥65岁的个体在TKR后的患者报告结果。对Ovid MEDLINE、EMBASE和Cochrane图书馆进行了系统检索，以识别研究TKR后疾病特异性或健康相关生活质量结果的研究。进行了定性证据综合分析。纳入了18项总体偏倚风险低（=1）、中度（=6）或严重（=11）的研究，证据综合分析来自20826名患者。四项研究报告了疼痛量表，显示术后6个月至10年疼痛有所改善。九项研究检查了功能结果，显示TKR后6个月至10年有显著改善。六项研究在6个月至2年期间显示健康相关生活质量有改善。所有四项检查满意度的研究都报告了对TKR结果的总体满意度。TKR可减轻≥65岁个体的疼痛、改善功能并提高生活质量。患者报告结果的改善需要与医生的专业知识结合使用，以确定哪些构成临床上的显著差异。
