Knahr K, Kryspin-Exner I, Jagsch R, Freilinger W, Kasparek M
II. Allgem. orthop. Abteilung, Orthopädisches Spital Speising, Wien.
Z Orthop Ihre Grenzgeb. 1998 Jul-Aug;136(4):321-9. doi: 10.1055/s-2008-1053745.
Quality of Life of patients with Total Hip Arthroplasty is analysed before and one year after surgery. The evaluation included the functional capacity of our patients in every day life comparing the preoperative situation with the result one year after surgery. Age and duration of symptoms were analysed with respect to their influence on the success of the procedure. Finally the question should be answered, if clinical examinations and questionnaires concerning Quality of Life result in comparable data.
101 patients with an average age of 64.2 years were included into this study. All patients were evaluated preoperatively and one year after surgery using the Harris Hip Score, questionnaires for Quality of Life of the patients included the Nottingham Health Profile and the Functional Questionnaire Hannover.
The pre- and postoperative means of the Nottingham Health Profile showed in five of the six dimensions a significant improvement of Quality of Life (pain, mobility, energy, emotional reaction, sleep). Only the scale "social isolation" remained unchanged between the pre- and postoperative situation. The means of the functional capacity according to the Hannover questionnaire improved from 57.92 to 39.79, a highly significant result. The Harris Hip Score was poor in 97% of the preoperative evaluations. This score improved to 80.2% excellent or good, 7.9% fair and 11.9% poor at one year after surgery. Age and duration of symptoms had no influence in any parameter of Quality of Life. A classification of parameters on Quality of Life according to the Harris-Hip-Score at the 1-year results demonstrates a clear grading concerning the excellent and poor results. Based on the patients evaluations a differentiation between good and poor results is not recorded.
The objective evaluation of results after implantation of a total hip joint-endoprosthesis should not be based only on clinical scores (f.e. Harris-Hip-Score). Subjective informations by the patients using questionnaires on Quality of Life (f.e. NHP, FFbH-R) have to be included into these evaluations. The different judgments of the outcome of surgery underline the necessity, not only to use clinical scores but also to include the patients' feeling into the interpretation of the clinical result.
分析全髋关节置换术患者术前及术后一年的生活质量。评估包括患者日常生活中的功能能力,将术前情况与术后一年的结果进行比较。分析年龄和症状持续时间对手术成功率的影响。最后,应回答关于生活质量的临床检查和问卷是否能得出可比数据的问题。
本研究纳入了101例平均年龄为64.2岁的患者。所有患者术前及术后一年均使用Harris髋关节评分进行评估,患者生活质量问卷包括诺丁汉健康量表和汉诺威功能问卷。
诺丁汉健康量表术前及术后的均值显示,在六个维度中的五个维度上生活质量有显著改善(疼痛、活动能力、精力、情绪反应、睡眠)。只有“社会隔离”量表在术前和术后情况之间保持不变。根据汉诺威问卷,功能能力的均值从57.92提高到39.79,这是一个非常显著的结果。术前评估中97%的Harris髋关节评分较差。术后一年,该评分改善为80.2%优秀或良好,7.9%中等,11.9%较差。年龄和症状持续时间对生活质量的任何参数均无影响。根据术后一年的Harris髋关节评分对生活质量参数进行分类,显示出优秀和较差结果的明显分级。基于患者评估,未记录良好和较差结果之间的差异。
全髋关节假体植入术后结果的客观评估不应仅基于临床评分(如Harris髋关节评分)。患者使用生活质量问卷(如NHP、FFbH-R)提供的主观信息必须纳入这些评估。手术结果的不同判断强调了不仅要使用临床评分,而且要将患者的感受纳入临床结果解释的必要性。