The prevalence of knee pain and symptomatic knee osteoarthritis among veteran traumatic amputees and nonamputees
The prevalence of knee pain and symptomatic knee osteoarthritis among veteran traumatic amputees and nonamputees
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DOI：
10.1016/j.apmr.2004.04.034
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发表时间：
2005-03-01
影响因子：
4.3
通讯作者：
Weiss, NS
中科院分区：
文献类型：
--
作者：
Norvell, DC;Czerniecki, JM;Weiss, NS
目的：确定与非截肢者相比，截肢者患膝关节疼痛或症状性骨关节炎（OA）的风险是否增加。设计图：回顾性队列研究。设置：退伍军人管理局患者治疗和门诊护理文件。参与者：所有男性单侧（经胫骨或经股骨）创伤截肢患者和随机抽样的男性非截肢者。如果患者年龄小于40岁、膝关节有严重损伤或患有风湿性疾病，则将其排除。干预措施：不适用。主要结果测量：膝关节疼痛和症状性膝关节OA的患病率。与非截肢者相比，经年龄和平均体重调整的经胫骨截肢者膝关节疼痛患病率为1.3（95%置信区间[CI]，0.7-2.1）为完好肢体的膝关节和0.2（95% CI，0.05 -0.7）为截肢的膝关节。膝关节疼痛的标准化患病率在完整的肢体和症状OA之间的经股截肢者，与nonamputees相比，分别为3.3（95%CI 1.5-6.3）和1.3（95%CI，0.2-4.8），Conclusions：强调对侧膝关节的截肢者可能有助于继发性残疾。可能的解释包括步态异常、完好肢体膝关节生理负荷增加，以及许多年轻截肢者常见的跳跃和绊倒行为。(C)2005年由美国康复医学大会和美国物理医学与康复学院。
Objective: To determine whether amputees have an increased risk of knee pain or symptomatic osteoarthritis (OA) compared with nonamputees. Design: Retrospective cohort study.Setting: Veterans Administration Patient Treatment and Outpatient Care files.Participants: All male unilateral (transtibial or transfemoral) traumatic amputee patients and a random sample of male nonamputees. Patients were excluded if they were younger than 40 years, had sustained a significant injury to their knee(s), or had a rheumatic disease.Interventions: Not applicable.Main Outcome Measures: The prevalence of knee pain and symptomatic knee OA.Results: The age and average weight-adjusted prevalence ratio of knee pain among transtibial amputees, compared with nonamputees, was 1.3 (95% confidence interval [CI], 0.7-2.1) for the knee of the intact limb and 0.2 (95% CI,.05-0.7) for the knee of the amputated limb. The standardized prevalence ratio of knee pain in the intact limb and symptomatic OA among transfemoral amputees, compared with nonamputees, was 3.3 (95% CI 1.5-6.3) and 1.3 (95% CI, 0.2-4.8), respectively.Conclusions: Stresses on the contralateral knee of amputees may contribute to secondary disability. Possible explanations include gait abnormalities, increased physiologic loads on the knee of the intact limb, and the hopping and stumbling behavior common in many younger amputees. (C) 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.