Assessing recovery and establishing prognosis following total knee arthroplasty
Assessing recovery and establishing prognosis following total knee arthroplasty
复制标题
DOI：
10.2522/ptj.20070051
复制
发表时间：
2008-01-01
期刊：
影响因子：
3.2
通讯作者：
Gollish, Jeffrey D.
中科院分区：
文献类型：
--
作者：
Kennedy, Deborah M.;Stratford, Paul W.;Gollish, Jeffrey D.
背景和目的有关关节置换术后预期变化率的信息对于做出与康复相关的预后决策至关重要。本研究的目的是：(1)描述全膝关节置换术(TKA)术后1年内患者肢体功能状态的变化规律；(2)描述术前功能状态对随时间变化的影响。研究对象84例骨关节炎患者，平均年龄66岁(SD=9)。数据被绘制出来，以检查随时间变化的模式。采用考虑了术前状态和性别的非线性混合效应模型对不同的康复模式进行了探索。结果得到的生长曲线描述了术后1年内LEES评分和6MWT距离的变化率和变化量。这些曲线反映了患者的术前状态和性别差异。讨论与结论：TKA术后12周的改善最大。术后12周至26周持续改善较慢，术后26周以后改善不明显。物理治疗师可以利用这些发现来做出与TKA术后预期改善率和预期改善量相关的预后判断。
Background and Purpose Information about expected rate of change after arthroplasty is critical for making prognostic decisions related to rehabilitation. The goals of this study were: (1) to describe the pattern of change in lower-extremity functional status of patients over a 1-year period after total knee arthroplasty (TKA) and (2) to describe the effect of preoperative functional status on change over time.Subjects Eighty-four patients (44 female, 40 male) with osteoarthritis, mean age of 66 years (SD=9), participated.Methods Repeated measurements for the Lower Extremity Functional Scale (LEES) and the Six-Minute Walk Test (6MWT) were taken over a 1-year period. Data were plotted to examine the pattern of change over time. Different models of recovery were explored using nonlinear mixed-effects modeling that accounted for preoperative status and gender.Results Growth curves were generated that depict the rate and amount of change in LEES scores and 6MWT distances up to 1 year following TKA. The curves account for preoperative status and gender differences across participants.Discussion and Conclusion The greatest improvement occurred in the first 12 weeks after TKA. Slower improvement continued to occur from 12 weeks to 26 weeks after TKA, and little improvement occurred beyond 26 weeks after TKA. The findings can be used by physical therapists to make prognostic judgments related to the expected rate of improvement following TKA and the total amount of improvement that may be expected.