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重度膝关节血友病性关节病患者全膝关节置换术后的疗效指标分析

Outcome measures analysis following total knee arthroplasty in patients with severe haemophilic arthropathy of the knee.

作者信息

Zygogiannis Konstantinos, Kouramba Anna, Kalatzis Dimitrios, Christidi Styliani-Despoina, Katsarou Olga, Varaklioti Agoritsa, Thivaios Georgios C

机构信息

Department of Orthopaedics, Laiko General Hospital, 11527 Athens, Greece.

Blood Unit and National Reference Centre for Congenital and Bleeding Disorders, Laiko General Hospital, 11527 Athens, Greece.

出版信息

Biomed Rep. 2024 Apr 29;20(6):98. doi: 10.3892/br.2024.1786. eCollection 2024 Jun.

Abstract

Total knee arthroplasty (TKA) has been the gold standard for treating severe haemophilic arthropathy of the knee when all conservative measures fail. However, performing a TKA in patients with haemophilic arthropathy is difficult due to severe joint deformity and destruction, and poor bone quality. The aim of the present study was to evaluate the short-term results of TKA in the treatment of knee haemophilic arthropathy in a tertiary referral centre, with an emphasis on health-related quality of life and knee function. A prospective study was conducted that included 19 male patients with end-stage haemophilic knee arthropathy who underwent TKA in a tertiary referral centre. Clinical outcome and health-related quality of life were assessed by the Western Ontario and McMaster Universities Arthritis (WOMAC) index and the Short Form-36 (SF-36) both pre-operatively and at 1-year post-operatively. The mean age of the patients was 50.37±7.63 years (range, 40-65 years). Pre-operative health-related quality of life was impaired in all patients in all SF-36 domains but was markedly improved after TKA. Knee function in all dimensions (pain, stiffness and physical function), as measured by the WOMAC questionnaire, significantly improved after TKA. Pre-operative pain, stiffness and function, along with total WOMAC score, were strongly and negatively correlated with pre-operative SF-36. Overall, the present study indicated a significant improvement in quality of life and clinical outcome after TKA in patients with advanced haemophilic arthropathy. More studies with longer follow-up periods in a larger population are needed to fully elucidate the mid- and long-term values of TKA in haemophilic patients.

摘要

当所有保守治疗措施均无效时,全膝关节置换术(TKA)一直是治疗重度膝关节血友病性关节病的金标准。然而,由于严重的关节畸形和破坏以及骨质不佳,对血友病性关节病患者实施全膝关节置换术困难重重。本研究的目的是评估在一家三级转诊中心,全膝关节置换术治疗膝关节血友病性关节病的短期效果,重点关注与健康相关的生活质量和膝关节功能。我们进行了一项前瞻性研究,纳入了19例终末期血友病性膝关节病男性患者,这些患者在一家三级转诊中心接受了全膝关节置换术。术前及术后1年通过西安大略和麦克马斯特大学骨关节炎指数(WOMAC)和简明健康状况调查量表(SF-36)评估临床结局及与健康相关的生活质量。患者的平均年龄为50.37±7.63岁(范围40 - 65岁)。所有患者在所有SF-36领域的术前与健康相关的生活质量均受损,但全膝关节置换术后明显改善。通过WOMAC问卷测量,全膝关节置换术后膝关节在所有维度(疼痛、僵硬和身体功能)均显著改善。术前疼痛、僵硬和功能以及WOMAC总分与术前SF-36呈强烈负相关。总体而言,本研究表明,晚期血友病性关节病患者接受全膝关节置换术后生活质量和临床结局有显著改善。需要在更大规模人群中进行更长随访期的更多研究,以充分阐明全膝关节置换术在血友病患者中的中长期价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3038/11099587/d71f63523506/br-20-06-01786-g00.jpg

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