Health-related quality of life after open-wedge high tibial osteotomy
Health-related quality of life after open-wedge high tibial osteotomy
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DOI：
10.1007/s00167-015-3938-4
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发表时间：
2017-03-01
影响因子：
3.8
通讯作者：
Hinterwimmer, Stefan
中科院分区：
文献类型：
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作者：
Saier, Tim;Minzlaff, Philipp;Hinterwimmer, Stefan
(1)为了监测胫骨高位截骨术（HTO）治疗内侧间室骨关节炎（OA）后健康相关生活质量（HRQOL）、疼痛、膝关节功能和重返工作岗位（RtW）的纵向变化，以及（2）调查精神病理学共病对术前损害和术后病程的影响，对64例患者进行了HTO后24个月的前瞻性随访，以确定HRQOL、疼痛、功能结果和RtW。术前确定精神病理学共病（例如抑郁症）。将无心理困扰（ND）的患者与有心理困扰（PD）的患者进行比较，以研究精神病理学共病对结局的影响。从6个月随访开始，HRQOL显著增加，疼痛减轻。从12个月随访开始，功能结局显著增加。总的来说，在6- 12个月的随访中，结果稳定。2在最后的随访中，90%的人无限制地恢复了他们以前的职业。RtW与心理健康总分（MCS）和功能结局呈正相关，与抑郁呈负相关。在基线和早期随访时观察到PD组的结局显著劣于ND组。PD组的RtW显著延长（8.9 +/- 7.6 vs. 3.9 +/- 3个月; p < 0.001）。在最终随访时，两组的结果相当。HTO治疗内侧间室OA显著改善了HRQOL、疼痛和膝关节功能。到达RtW的时间很长，并且主要取决于PD。此外，术前损伤的程度、初始较差的病程和较差的MCS结局受PD的影响。然而，在最终随访时，PD组和ND组之间没有观察到显著差异。
(1) To monitor longitudinal changes in health-related quality of life (HRQOL), pain, knee function, and return to work (RtW) following high tibial osteotomy (HTO) for medial compartment osteoarthritis (OA), and (2) to investigate the influences of psychopathological comorbidities on preoperative impairment and post-operative course.Sixty-four patients were prospectively followed for 24 months after HTO to determine HRQOL, pain, functional outcome, and RtW. Psychopathological comorbidities (e.g. depression) were determined preoperatively. Patients with no psychological distress (ND) were compared to patients with psychological distress (PD) in order to investigate the influence of psychopathological comorbidities on outcome.There was a significant increase in HRQOL and decrease in pain from 6 month follow-up on. Functional outcomes increased significantly from 12 month follow-up on. In general, there was a steady state of outcomes from 6- to 12-month follow-up on. At final follow-up, 90 % returned to their previous occupation without limitations. Mental component summary (MCS) and functional outcome showed a positive correlation with RtW, while depression had a negative one. A significantly inferior outcome of group PD versus ND was observed at baseline and early follow-up. RtW was significantly prolonged in group PD (8.9 +/- 7.6 vs. 3.9 +/- 3 months; p < 0.001). At final follow-up, both groups presented with comparable outcomes.HTO for medial compartment OA significantly improves HRQOL, pain, and knee function. Time to RtW is high and critically depends on PD. Further, extend of preoperative impairments, an initially inferior course, and inferior MCS outcome was influenced by PD. However, otherwise no significant differences were observed between groups PD and ND at final follow-up.Prospective case series, II.