Comparative outcomes of total hip and knee arthroplasty: a prospective cohort study
Comparative outcomes of total hip and knee arthroplasty: a prospective cohort study
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DOI：
10.1136/postgradmedj-2011-130715
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发表时间：
2012-11-01
影响因子：
5.1
通讯作者：
Simpson, A. Hamish R. W.
中科院分区：
文献类型：
--
作者：
Hamilton, David;Henderson, G. Robin;Simpson, A. Hamish R. W.
目的初次髋关节置换术和初次膝关节置换术的比较结果还不清楚。本研究的目的是调查这些程序的结果和满意度，并确定预测模型1年的患者结果，以期通知手术管理和患者expectations.Study设计前瞻性队列研究的所有主要髋关节和膝关节置换术在爱丁堡的皇家医院2006年1月至2008年11月之间进行的程序。在术前和术后6个月和12个月评估了一般健康状况（SF-12）和关节特异性功能（牛津评分）。结果1410例全髋关节置换术（THA）和1244例全膝关节置换术（TKA）的患者满意度进行了评估。THA患者的牛津评分比TKA患者提高了4.9分。一年时，THA患者的SF-12身体评分平均高出2.7分。THA术后的满意度（91%）也高于TKA（81%）。回归建模无法预测个体患者结局;然而，发现平均术前牛津评分是每种手术平均术后牛津评分的强预测因子。年龄，性别和术前一般健康评分并没有影响这些models.Conclusions THA和TKA赋予患者的结果显着改善，但是，更大的联合具体，一般健康和满意度评分THA后报告。这种差异是物理性质的。回归模型，可用于预测平均髋关节/膝关节置换术的结果的基础上术前值。
Purpose The comparative outcome of primary hip and knee arthroplasty is not well understood. This study aimed to investigate the outcome and satisfaction of these procedures and determine predictive models for 1 year patient outcome with a view to informing surgical management and patient expectations.Study design Prospective cohort study of all primary hip and knee arthroplasty procedures performed at the Royal Infirmary of Edinburgh between January 2006 and November 2008. General health (SF-12) and joint specific function (Oxford Score) was assessed preoperatively and at 6 and 12 months post-operatively. Patient satisfaction was assessed at 12 months.Results 1410 total hip arthroplasty (THA) and 1244 total knee arthroplasty (TKA) procedures were assessed. Oxford Score improved by 4.9 points more in THA patients than in TKA patients. SF-12 physical scores were on average 2.7 points greater in the THA patients at one year. Satisfaction was also greater (91%) following THA compared with TKA (81%). Regression modelling was not able to predict individual patient outcome; however, mean pre-operative Oxford Scores were found to be strong predictors of mean postoperative Oxford Scores for each procedure. Age, gender and pre-operative general health scores did not influence these models.Conclusions Both THA and TKA confer substantial improvement in patient outcome; however, greater joint specific, general health and satisfaction scores are reported following THA. This difference is physical in nature. Regression models are presented that can be applied to predict mean hip/knee arthroplasty outcome based on preoperative values.