Department of Orthopaedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA.
Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, New York, USA.
Knee Surg Sports Traumatol Arthrosc. 2024 May;32(5):1324-1331. doi: 10.1002/ksa.12090. Epub 2024 Mar 26.
The purpose of this study was to determine if preoperative mental health status improves following unicompartmental knee arthroplasty (UKA) in patients with single compartment knee osteoarthritis (OA).
A total of 163 patients underwent UKA [115 (71%) medial, 48 (29%) lateral] (mean age = 65 ± 11) completed preoperative and minimum 2-year postoperative veterans RAND 12 item health survey (VR-12) mental component score (MCS). VR-12 MCS was the primary outcome measure. Secondary measures included VR-12 physical component summary score (PCS), knee osteoarthritis outcome score (KOOS) and KOOS patient acceptable symptom state at the final follow-up.
The median VR-12 MCS improved from 50.5 [interquartile range (IQR): 43.7-56.8] to 55.0 [IQR: 52.3-57.0] (p < 0.001) at a mean follow-up of 9.5 ± 4 years (range 2-19 years) following UKA. Preoperative VR-12 MCS was significantly correlated with patients postoperative VR-12 PCS (ρ = 0.294, p < 0.01), KOOS pain (ρ = 0.201, p = 0.012), KOOS ADL (ρ = 0.243, p = 0.002) and KOOS quality of life (ρ = 0.233, p < 0.01). Sixty-three (39%) patients improved from low VR-12 MCS (<50) to normal VR-12 MCS (≥50). One hundred forty-two (87%) achieved a normal VR-12 MCS score (≥50) postoperatively.
At a mean of 10-year follow-up, patients who underwent UKA for single compartment osteoarthritic knee pain demonstrated significant improvement in mental health scores. UKA resulted in normal mental health in a majority of patients (87%). The resultant improved mental health scores were associated with improved patient pain and activities of daily living.
Level III retrospective cohort study.
本研究旨在确定单髁膝关节置换术（UKA）是否能改善单室膝关节骨关节炎（OA）患者的术前心理健康状况。
共 163 例患者接受 UKA [115 例（71%）内侧，48 例（29%）外侧]（平均年龄 65±11 岁）完成了术前和至少 2 年的术后退伍军人 RAND 12 项健康调查（VR-12）心理成分评分（MCS）。VR-12 MCS 是主要的观察指标。次要指标包括 VR-12 身体成分综合评分（PCS）、膝关节骨关节炎结局评分（KOOS）和最终随访时 KOOS 患者可接受的症状状态。
UKA 后平均 9.5±4 年（2-19 年）的中位 VR-12 MCS 从 50.5[四分位距（IQR）：43.7-56.8]改善至 55.0[IQR：52.3-57.0]（p<0.001）。术前 VR-12 MCS 与术后 VR-12 PCS（ρ=0.294，p<0.01）、KOOS 疼痛（ρ=0.201，p=0.012）、KOOS ADL（ρ=0.243，p=0.002）和 KOOS 生活质量（ρ=0.233，p<0.01）显著相关。63 例（39%）患者的 VR-12 MCS 从低水平（<50）改善至正常水平（≥50）。142 例（87%）患者术后获得正常 VR-12 MCS 评分（≥50）。
在平均 10 年的随访中，接受 UKA 治疗单室膝关节骨关节炎疼痛的患者心理健康评分显著改善。UKA 使大多数患者（87%）的心理健康达到正常水平。改善的心理健康评分与改善的患者疼痛和日常生活活动能力相关。
三级回顾性队列研究。
