医学
沃马克
骨关节炎
生活质量(医疗保健)
围手术期
骨科手术
关节置换术
物理疗法
膝关节置换术
关节置换术
髋关节置换术
痹症科
髋关节手术
外科
内科学
替代医学
护理部
病理
作者
Audrey Neuprez,Audrey Neuprez,Jean‐François Kaux,William Kurth,Christophe Daniel,Thierry Thirion,Jean-Pierre Huskin,Philippe Gillet,Olivier Bruyère,Jean‐Yves Reginster
标识
DOI:10.1007/s10067-019-04811-y
摘要
To study and identify the determinants of the impact on pain, function, and quality of life of a prosthetic replacement surgery after 5 years of survival in patients with osteoarthritis (OA) of the lower limb. In total, 626 osteoarthritic patients from a University Hospital, divided in 2 groups (according to surgical site), were prospectively followed for 5 years after hip (n = 346) or knee (n = 280) replacement. Validated specific Western Ontario and McMaster Universities Arthritis Index (WOMAC) and generic (SF-36 and EQ) instruments assessing quality of life were used prior to surgery and yearly, thereafter. We defined a good outcome as a clinically relevant improvement in WOMAC greater than or equal to the minimally important difference (MID). Regressions showed the relationships among preoperative, perioperative, and postoperative measures and the evolution of WOMAC scores after 5 years (percent change). We also examined any predictors of good outcomes. The beneficial effect on quality of life observed during the first year after hip and knee arthroplasty (HA and KA) was maintained for up to 5 years. More than 3/4 of the patients in our study experienced a good outcome (86.04% in HA group and 79.91% in KA group). Both the good outcome and the 5-year change in WOMAC are predicted by preoperative (i.e., radiological severity, comorbidities, disability, and level of education), perioperative (i.e., length of hospital stay and place of discharge), and postoperative (i.e., complications) variables in the two groups. Joint arthroplasty is a highly valuable therapeutic strategy for hip or knee OA patients who do not respond to pharmacological management. These results represent a step towards the collection of robust, scientifically sound data that will facilitate the completion of health economic analyses in the field of OA.
科研通智能强力驱动
Strongly Powered by AbleSci AI