摘要
目的:评估对侧膝关节疼痛程度对骨性关节炎患者全膝关节置换术(total knee arthroplasty,TKA)后1年手术侧关节功能障碍及治疗满意度的影响.方法:2019年3月至2021年1月行TKA的635例患者,男296例,女339例;年龄(69.33±9.38)岁,病程(1.15±0.44)年.根据术后对侧膝关节疼痛视觉模拟评分(visual analogue scale,VAS)分为轻度或无疼痛(VAS 0～3分)423例,中度疼痛(VAS4～6分)105例,重度疼痛(VAS 7～10分)107例.分析比较对侧膝关节不同疼痛程度对术后12个月膝关节功能及满意度评分的影响.结果:对侧膝关节疼痛VAS在TKA术后明显降低,年龄大、身体质量指数高、术后手术侧膝关节WOMAC评分高、对侧膝关节中、重度疼痛是患者不满意的危险因素(P＜0.05),OR分别为1.285、1.665、2.319、1.863.手术侧膝关节疼痛度高、居家环境为步梯房是患者出院1年后WOMAC评分高的危险因素(P＜0.05);出院后坚持锻炼、功能性训练是患者出院1年后WOMAC评分高的保护因素(P＜0.05);OR分别为3.016、1.738、0.619、0.574.结论:TKA可以缓解患者对侧膝关节疼痛程度;对侧膝关节疼痛并不影响患者TKA术后WOMAC评分,但会降低患者的治疗满意度.
Abstract
Objective To evaluate the effect of contralateral knee pain on joint dysfunction and treatment satisfaction on the operative side 1 year after total knee arthroplasty(TKA)in patients with osteoarthritis.Methods From March 2019 to Jan-uary 2021,635 patients underwent TKA including 296 males and 339 females,with an average age of(69.33±9.38)years old,the duration of symptoms was(1.15±0.44)years.According to the degree of pain visual analogue scale(VAS)in the contralat-eral knee joint 12 months after operation,the patients were divided into three groups,423 patients with no or mild pain(VAS 0 to 3),105 patients with moderate pain(VAS 4 to 6),107 patients with severe pain(VAS 7 to 10).The related factors of knee function and satisfaction score 12 months after operation were analyzed and compared on different contralateral knee pain lev-els.Results The contralateral knee pain VAS was significantly reduced after TKA.Old age,high body mass index,high WOM-AC scores of postoperative knee joint,moderate and severe pain of contralateral knee joint were the risk factors of dissatisfac-tion(P＜0.05),OR were 1.285,1.665,2.319,1.863 respectively.The high degree of knee pain on the operation side and the ladder room in the home environment were the risk factors for the high WOMAC scores 1 year after discharge(P＜0.05).Adher-ence to exercise and functional training after discharge were the protective factors for patients with high WOMAC scores 1 year after discharge(P＜0.05),OR were 3.016,1.738,0.619,0.574 respectively.Conclusion TKA can alleviate the pain of con-tralateral knee joint.Contralateral knee pain does not affect the WOMAC scores after TKA,but it will reduce the treatment sat-isfaction of patients.
维普
万方数据