Ge Liru, Wang Junjie, Fang Haonan, Wang Yining, Shen Ziyuan, Cai Guoqi
Department of Epidemiology and Biostatistics, School of Public Health Anhui Medical University Hefei Anhui China.
Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia.
J Exp Orthop. 2025 Mar 22;12(1):e70185. doi: 10.1002/jeo2.70185. eCollection 2025 Jan.
To evaluate the effects of total knee arthroplasty (TKA) on symptoms, function and activity over 5 years in knee osteoarthritis (KOA) patients.
Data were from the Osteoarthritis Initiative (OAI). Participants who conducted the first TKA from (not before) enrolment to 48 months were propensity score matching (PSM) on their characteristics at the visit before surgery (treated as baseline) to those who did not conduct a TKA at 48 months (treated as baseline). Changes in knee pain and functional disability were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function subscales. Changes in physical activity, physical function and overall physical health and mental health were assessed using the Physical Activity Scale for the Elderly, the 20-m walk speed and the five times chair-to-stand tests and the 12-Item Short Form Survey, respectively.
Eighty-two pairs of participants in the TKA (56% women, mean 64.8 ± 8.4 years) and non-TKA groups were matched. Knee symptoms were significantly improved in the TKA group and flatted from 24 months (Pain: = -3.29, 95% confidence interval [CI] = [-4.59 to -1.99], < 0.001; Function: = -10.12, 95% CI = [-14.21 to -6.03], < 0.001). Physical function and overall physical health but not physical activity or mental health (PASE: = 5.72, 95% CI = [-15.46 to 26.90], = 0.597; Mental: = 0.04, 95% CI = [-2.47 to 2.54], = 0.976) was improved in the TKA group over 24 months.
TKA substantially improved knee symptoms and physical function over 60 months and physical health over 48 months, compared to those who had a similar severity of KOA but did not have a TKA, but this did not translate into increased physical activity or mental health.
Level III.
评估全膝关节置换术（TKA）对膝关节骨关节炎（KOA）患者5年期间症状、功能和活动的影响。
数据来自骨关节炎倡议组织（OAI）。从入组（而非入组前）至48个月内首次接受TKA的参与者，根据其手术前访视时（视为基线）的特征与48个月时未接受TKA的参与者（视为基线）进行倾向得分匹配（PSM）。使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）疼痛和功能子量表评估膝关节疼痛和功能障碍的变化。分别使用老年人身体活动量表、20米步行速度、五次从椅子上站起测试和12项简短调查问卷评估身体活动、身体功能以及总体身体健康和心理健康的变化。
TKA组（56%为女性，平均年龄64.8±8.4岁）和非TKA组匹配了82对参与者。TKA组膝关节症状显著改善，且从24个月起趋于平稳（疼痛： = -3.29，95%置信区间[CI]=[-4.59至-1.99]， < 0.001；功能： = -10.12，95%CI = [-14.21至-6.03]， < 0.001）。24个月内，TKA组身体功能和总体身体健康得到改善，但身体活动或心理健康未改善（老年人身体活动量表： = 5.72，95%CI = [-15.46至26.90]， = 0.597；心理健康： = 0.04，95%CI = [-2.47至2.54]， = 0.976）。
与患有相似严重程度KOA但未接受TKA的患者相比，TKA在60个月内显著改善了膝关节症状和身体功能，在48个月内改善了身体健康，但这并未转化为身体活动或心理健康的改善。
三级。
