Department of Anesthesiology, Intensive Care & Perioperative Medicine, Hautepierre Hospital, Strasbourg University Hospital, 1 Avenue Molière 67098, Strasbourg, France.
Department of Orthopedic and Trauma Surgery, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France.
Int Orthop. 2023 Nov;47(11):2637-2643. doi: 10.1007/s00264-023-05903-w. Epub 2023 Aug 5.
Increasing our knowledge about postoperative global Quality-Of-Recovery (QoR) after THA and TKA is important to improve perioperative medicine, in particular for preoperative patient information and benchmarking of postoperative patient status.
This study is a single centre, retrospective cohort study of prospectively collected data, conducted in Strasbourg University Hospital, Strasbourg, France. The main outcome was the modified French version of the QoR-15 (mQoR-15F) score monitored preoperatively, at postoperative day one, three, 14 and 28. We questioned the hypothesis: would THA and TKA recovery patterns differ and would postoperative health status eventually overreach the preoperative reference?
The mQoR-15F was statistically higher in the THA group compared to the TKA group in POD 1 and 28 (112 ± 17 vs. 107 ± 17; p < 0.01 and 131 ± 12 vs. 127 ± 15; p = 0.02, respectively). The mean postoperative time delay to reach preoperative mQoR-15F was seven and 16 days for THA and TKA patients, respectively.
Early postoperative health status after THA and TKA differs significantly; TKA being associated with a larger early decrease of global health status compared to THA. Both THA and TKA groups global health status overreached preoperative levels after one and two weeks postoperatively. These surgery-specific recovery profiles may favor improved patient information to steer advised operative decision and set specific recovery goals as part of enhanced recovery pathways.
提高我们对全髋关节置换术（THA）和全膝关节置换术（TKA）后术后整体恢复质量（QoR）的认识，对于改善围手术期医学具有重要意义，特别是对于术前患者信息和术后患者状态的基准比较。
这是一项在法国斯特拉斯堡大学附属医院进行的单中心、回顾性队列研究，收集前瞻性数据。主要结局是监测术前、术后第 1、3、14 和 28 天的改良法国版 QoR-15（mQoR-15F）评分。我们提出假设：THA 和 TKA 的恢复模式是否存在差异，术后健康状况最终是否会超过术前参考值？
在术后第 1 天和第 28 天，THA 组的 mQoR-15F 评分明显高于 TKA 组（112±17 比 107±17；p<0.01 和 131±12 比 127±15；p=0.02）。THA 和 TKA 患者达到术前 mQoR-15F 评分的平均术后时间延迟分别为 7 天和 16 天。
THA 和 TKA 术后早期健康状况存在显著差异；与 THA 相比，TKA 早期整体健康状况下降幅度更大。THA 和 TKA 两组患者的整体健康状况在术后 1 周和 2 周后均超过术前水平。这些特定于手术的恢复特征可能有利于改善患者信息，以指导建议的手术决策，并设定特定的恢复目标，作为强化康复途径的一部分。
