Rothman Orthopaedic Institute, Philadelphia, Pennsylvania.
Clinical Affairs, Zimmer Biomet, Warsaw, Indiana.
J Arthroplasty. 2024 Apr;39(4):916-920. doi: 10.1016/j.arth.2023.10.014. Epub 2023 Oct 16.
Contemporary total knee arthroplasty patients have increased expectations of returning to predisease function, including sexual activity (SA). The purpose of this study was to determine whether patients using a digital care management platform (DCMP) were more likely to have a higher rate and frequency of return to SA.
We conducted an exploratory analysis of a prospective, multicenter, randomized controlled trial that enrolled patients undergoing total knee arthroplasty. A total of 304 patients were randomized to a DCMP (n = 119) providing preoperative and postoperative education regarding return to SA or standard postoperative care (control group; n = 185). Return to SA, assessed via questionnaire, patient-reported outcome measures, Timed Up and Go test, single leg stance, active range of motion and need for manipulation under anesthesia were assessed at 90 days postoperatively.
More patients in the DCMP group returned to SA compared to control at 90 days (58.4 versus 39.6%, P = .018); however, the control group resumed SA sooner (33.1 versus 42.0 days, P = .023). Patients who returned to SA were younger (61.6 versus 65.9 year), more often men (56 versus 35%) (P < .001), higher performing on the Timed Up and Go and single leg stance tests (P < .001), and had greater active range of motion (P = .007). There were no differences in patient-reported outcome measures or need for manipulation under anesthesia between patients that returned to SA and those who did not.
More patients using a DCMP resumed SA at 90 days; however, patients in the control group returned to SA sooner. Those who returned to SA were younger, possessed greater physical function, and were more often men.
当代全膝关节置换术患者对恢复术前功能(包括性生活)的期望增加。本研究旨在确定使用数字护理管理平台(DCMP)的患者是否更有可能更快地恢复性生活。
我们对一项前瞻性、多中心、随机对照试验进行了探索性分析,该试验纳入了接受全膝关节置换术的患者。共有 304 名患者被随机分为 DCMP 组(n=119)和标准术后护理组(对照组;n=185),DCMP 组在术前和术后提供有关恢复性生活的教育。术后 90 天,通过问卷调查、患者报告的结果测量、计时起立和行走测试、单腿站立、主动活动范围和需要在全身麻醉下进行操作来评估恢复性生活的情况。
与对照组相比,90 天时 DCMP 组有更多的患者恢复性生活(58.4%比 39.6%,P=0.018);然而,对照组更早恢复性生活(33.1 比 42.0 天,P=0.023)。恢复性生活的患者年龄较小(61.6 岁比 65.9 岁),更多为男性(56%比 35%)(P<0.001),计时起立和行走测试和单腿站立测试表现更好(P<0.001),且主动活动范围更大(P=0.007)。在恢复性生活和未恢复性生活的患者之间,患者报告的结果测量或需要在全身麻醉下进行操作方面没有差异。
更多使用 DCMP 的患者在 90 天内恢复性生活;然而,对照组患者更早恢复性生活。那些恢复性生活的患者年龄较小,身体功能更好,且更多为男性。