The burden of wait for knee replacement surgery: effects on pain, function and health-related quality of life at the time of surgery
The burden of wait for knee replacement surgery: effects on pain, function and health-related quality of life at the time of surgery
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DOI：
10.1093/rheumatology/kep469
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发表时间：
2010-05-01
期刊：
影响因子：
5.5
通讯作者：
Fremont, Pierre
中科院分区：
文献类型：
--
作者：
Desmeules, Francois;Dionne, Clermont E.;Fremont, Pierre
Objective.检查术前至手术期间与膝关节计划手术相关的疼痛和功能变化、健康相关生活质量（HRQoL）变化和对侧膝关节疼痛变化。从加拿大魁北克市的三家医院招募了153例计划进行膝关节置换术的患者，并随访至手术。术前等待，定义为从登记到手术的时间，分为5类（3-6个月、>6-9个月、>9-12个月和>12个月）。采用西安大略和麦克马斯特骨关节炎指数（WOMAC）测量疼痛和功能限制，采用医疗结果研究36项简式健康调查测量HRQoL。平均术前等待时间为183（S。D. 121.9）天。等待>9-12个月的受试者显示WOMAC疼痛（-9.9; 95% CI-19.2，-0.54）和功能（-11.1; 95% CI-18.7，-3.4）评分显著恶化。在HRQoL SF-36身体功能量表上，观察到等待>9-12个月（-11.3; 95% CI-18.4，-4.2）和>12个月（-7.1; 95% CI-12.9，-1.3）的受试者显著恶化。在对侧膝关节WOMAC疼痛评分方面，观察到等待时间>6-9个月（-10.4; 95%CI-16.9，-3.9）和>12个月（-10.7; 95%CI-19.7，-1.7）的受试者疼痛程度显著恶化。术前等待时间对手术时的疼痛、功能和HRQoL有显著的负面影响。本研究中观察到的恶化程度可能具有临床意义。这种术前恶化对术后结局的影响需要进行研究。
Objective. To examine the change in pain and function related to the knee scheduled for surgery, change in health-related quality of life (HRQoL) and change in contralateral knee pain during pre-surgery wait up until time of surgery.Methods. One hundred and fifty-three patients scheduled for knee replacement were recruited from three hospitals in Quebec City, Canada, and followed until surgery. Pre-surgery wait, defined as the time between enrolment on the pre-surgery wait list and surgery, was considered in five categories (3-6, >6-9, >9-12 and >12 months). Pain and functional limitations were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC) and HRQoL was measured with the medical outcomes study 36-item short form health survey.Results. Mean pre-surgery wait time was 183 (S. D. 121.9) days. Subjects having waited >9-12 months showed significant deterioration of the WOMAC pain (-9.9; 95% CI -19.2, -0.54) and function (-11.1; 95% CI -18.7, -3.4) scores. On the HRQoL SF-36 physical functioning scale, a significant deterioration was seen in subjects having waited >9-12 months (-11.3; 95% CI -18.4, -4.2) and >12 months (-7.1; 95% CI -12.9, -1.3). On the contralateral knee WOMAC pain score, a significant deterioration was observed in subjects having waited >6-9 months (-10.4; 95% CI -16.9, -3.9) and >12 months (-10.7; 95% CI -19.7, -1.7).Conclusion. Pre-surgery wait time has a negative significant impact on pain, function and HRQoL at the time of surgery. The magnitude of deterioration seen in this study may be clinically important. The effects of this pre-surgery deterioration on post-surgery outcomes need to be investigated.