期刊论文详细信息
BMC Musculoskeletal Disorders
Factors affecting the quality of life after total knee arthroplasties: a prospective study
Konstantinos N Malizos4  Theophilos S Karachalios1  Elias Zintzaras3  Lycurgos Liaropoulos2  Theodoros Papapolychroniou5  Zoe H Dailiana4  Ippolyti Papakostidou1 
[1] Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessalia, Biopolis 41110, Larissa, Greece;Center for Health Services Management and Evaluation, Faculty of Nursing, University of Athens, 123 Papadiamantopoulou Street, 11527, Athens, Greece;The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA;Center for Research and Technology, Thessaly (CERETETH), Department of Biomedical Research & Technology, 41222, Larissa, Greece;Department of Orthopedics, NIMITS Hospital, 10 Monis Petraki Street, Athens, Greece
关键词: Rehabilitation;    Osteoarthritis;    Quality of life;    Total knee arthroplasty;   
Others  :  1149303
DOI  :  10.1186/1471-2474-13-116
 received in 2011-11-24, accepted in 2012-06-17,  发布年份 2012
PDF
【 摘 要 】

Background

The purpose of the study is to evaluate the self-reported outcomes in the first year after primary total knee arthroplasty (TKA), and to determine factors influencing the quality of life (QoL) 6 weeks, 3, 6, and 12 months after TKA.

Methods

A cohort of patients with knee osteoarthritis undergoing primary TKA at two hospitals (a regional university hospital and a capital’s metropolitan hospital) was prospectively followed for 12 months. Patients were assessed preoperatively and at 4 postoperative time-points, with the use of self-reported measurements for pain, physical function and depression with the following evaluation tools: Western Ontario and McMaster Osteoarthritis Index [WOMAC], Knee Society Scoring system [KSS], Centre for Epidemiological Studies Depression Scale, [CES-D10] and visual analog scale [VAS] for pain). General linear modelling for repeated measures was used to evaluate the effect of each independent variable including clinical and sociodemographic data. Differences between groups at different time points were tested by the independent samples t-test.

Results

Of the 224 eligible patients, 204 (162 females, mean age 69.2) were included in the analysis. Response rate at one year was 90%. At 6 weeks after surgery, despite improvement in pain and alleviation of the depressive mood, the physical function remained less satisfactory. Females presented lower scores in terms of quality of life, both preoperatively and 6 weeks after TKA. Significant improvement was already experienced at 3 months postoperatively. According to WOMAC, KSS, CES-D10 and pain VAS scores the Qol was significantly improved 12 months after TKA (P < 0.001). CES-D10 score was positively correlated with WOMAC and pain VAS scores at all the time points assessed (P < 0.001). Age, body mass index (BMI), place of residence, level of education and social support were not significant predictors of QoL after TKA.

Conclusions

Patients experienced great improvement in their QoL after TKA in spite of a less satisfactory physical function in the first 6 weeks after surgery, with noticeable differences in the QoL among genders in the same time period. After that period all patients experienced significant improvement for all the measured parameters, until the third postoperative month with smaller changes thereafter.

【 授权许可】

   
2012 Papakostidou et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150405045226965.pdf 408KB PDF download
Figure 1. 37KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Kurtz S, Ong K, Lau E, Mowat F, Halpern M: Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007, 89:780-785.
  • [2]Mannoni A, Briganti MP, Di Bari M, Ferrucci L, Costanzo S, Serni U, Masotti G, Marchionni N: Epidemiological profile of symptomatic osteoarthritis in older adults: a population based study in Dicomano, Italy. Ann Rheum Dis 2003, 62:576-578.
  • [3]Zhang Y, Xu L, Nevitt MC, Aliabadi P, Yu W, Qin M, Lui LY, Felson DT: Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: The Beijing Osteoarthritis Study. Arthritis Rheum 2001, 44:2065-2071.
  • [4]Carmona L, Ballina J, Gabriel R, Laffon A, EPISER Study Group: The burden of musculoskeletal diseases in the general population of Spain: results from a national survey. Ann Rheum Dis 2001, 60:1040-1045.
  • [5]Kacar C, Gilgil E, Urhan E, Arikan V, Dündar U, Oksüz MC, Sünbüloglu G, Yildirim C, Tekeoglu I, Bütün B, Apaydin A, Tuncer T: The prevalence of symptomatic knee and distal interphalangeal joint osteoarthritis in the urban population of Antalya, Turkey. Rheumatol Int 2005, 25:201-204.
  • [6]Andrianakos AA, Kontelis LK, Karamitsos SI, Georgountzos AI, Kaziolaw GO, Pantelidou KV, Vafiadou EV, Dandis PC, ESCORDIG Study Group: Prevalence of symptomatic knee, hand, and hip osteoarthritis in Greece. The ESCORDIG study. J Rheumatol 2006, 33:2507-2514.
  • [7]Hawker G, Wright J, Coyte P, Paul J, Dittus R, Croxford R, Katz B, Bombardier C, Heck D, Freund D: Health-related quality of life after knee replacement. J Bone Joint Surg (Am) 1998, 80:163-173.
  • [8]Dieppe P: Osteoarthritis: time to shift the paradigm. This includes distinguishing between severe disease and common minor disability. BMJ 1999, 318:1299-1300.
  • [9]Dieppe P, Basler HD, Chard J, Croft P, Dixon J, Hurley M, Lohmander S, Paspe H: Knee replacement surgery for osteoarthritis: effectiveness, practice variations, indications and possible determinants of utilization. Rheumatology (Oxford) 1999, 38:73-83.
  • [10]Fitzgerald JD, Orav EJ, Lee TH, Marcantonio ER, Poss R, Goldman L, Mangione CM: Patient quality of life during the 12 months following joint replacement surgery. Arthritis Rheum 2004, 51:100-109.
  • [11]Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster JY: Health-related quality of life in total hip and total knee arthroplasty: a qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004, 86:963-974.
  • [12]Lingard EA, Katz JN, Wright EA, Sledge CB: Predicting the outcome of total knee arthroplasty. J Bone Joint Surg Am 2004, 86:2179-2186.
  • [13]Nuñez M, Nuñez E, del Val Luis J, Ortega R, Segur J, Hernandez MV, Lozano L, Sastre S, Macule F: Health-related quality of life in patients with osteoarthritis after total knee replacement: Factors influencing outcomes at 36 months of follow-up. Osteoarthritis and Cartilage 2007, 15:1001-1007.
  • [14]Statistical Yearbook of Greece 2008-National Statistical Service of Greece. [http:// dlib.statistics.gr/Book/GRESYE_01_0002_00060.pdf webcite]
  • [15]Charson M, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic co-morbidities in longitudinal studies: Development and validation. J Chron Dis 1987, 40:373-383.
  • [16]Bellamy N, Buchanan WW, Goldsmith GH, Campbell J, Stitt LW: Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of hip or knee. J Rheumatol 1988, 15:1833-1840.
  • [17]Bellamy N: WOMAC osteoarthritis index: user guide IX. Queensland (Australia); 2009.
  • [18]Insall JN, Dorr LD, Scott RD, Scott WN: Rationale of the Knee Society clinical rating system. Clin Orth Rel Res 1989, 248:13-14.
  • [19]Radloff LS: The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Meas 1977, 1:385-401.
  • [20]Irwin M, Haydari K, Oxman MN: Screening for depression in the older Adult. Criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med 1999, 159:1701-1704.
  • [21]Fountoulakis KN, Iacovides A, Kleanthous S, Samolis S, Kaprinis SG, Sitzoglou K, Kaprinis GS, Bech P: Reliability, validity and psychometric properties of the greek translation of the center for epidemiological studies-depression (CES-D) Scale. BMC Psychiatry 2001, 1:3. BioMed Central Full Text
  • [22]Jensen MP, Turner JA, Romano JM, Fisher LD: Comparative reliability and validity of chronic pain intensity measures. Pain 1999, 83:157-162.
  • [23]McQuay HJ, Moore RA: An evidence-based resource for pain relief. Oxford: Oxford University Press; 1998.
  • [24]Nuñez M, Losano L, Nuñez E, Segur JM, Sastre S, Magule F, Ortega R, Suso S: Total knee replacement and health-related quality of life: factors influencing long-term outcomes. Arthritis Rheum 2009, 8:1062-1069.
  • [25]Kane RL, Saleh KJ, Wilt TJ, Bershadsky B: The functional outcomes of total knee arthroplasty. J Bone Joint Surg Am 2005, 87:1719-1724.
  • [26]Neuburger J, Hutchings A, Allwood D, Black N, van der Meulen JH: Sociodemographic differences in the severity and duration of disease among patients undergoing hip or knee replacement surgery. J Public Health (Oxf) 2012. [Epub ahead of print]. PMID:22267293 [PubMed - as supplied by publisher]
  • [27]Petterson SC, Raisis L, Bodenstab A, Snyder-Mackler L: Disease-specific gender differences among total knee arthroplasty candidates. J Bone Joint Surg Am 2007, 89:2327-2333.
  • [28]Liebs TR, Herzberg W, Poth-Kroeger AM, Ruther W, Hassenpflug J: Women recover faster than men after standard knee. Clin Orthop Relat Res 2011, 469:2855-65.
  • [29]Nilsdotter AK, Toksvig-Larsen S, Roos EM: A 5 year prospective study of patient-relevant outcomes after total knee replacement. Osteoarthr Cartil 2009, 17:601-606.
  • [30]Karlson EW, Daltroy LH, Liang MH, Eaton HE, Katz JN: Gender differences in patient preferences may underlie differential utilization of elective surgery. Am J Med 1997, 102:524-530.
  • [31]Parsley BS, Bertolusso R, Harrington M, Brekke A, Noble PC: Influence of gender on age of treatment with TKA and functional Outcome. Clin Orthop Relat Res 2010, 468:1759-1764.
  • [32]Jones CA, Voaklander DC, Jhnston DW, Squarez-Almazor ME: The effect of age on pain, function, and quality of life after total hip and knee arthroplasty. Arch Intern Med 2001, 161:454-460.
  • [33]Stickles B, Phillips L, Brox WT, Owens B, Lanzer WL: Defining the relationship between obesity and total joint arthroplasty. Obes Res 2001, 9:219-223.
  • [34]Deshmukh RG, Hayes JH, Pinder IM: Does body weight influence outcome after total knee arthroplasty? A 1-year analysis. J Arthroplasty 2002, 17:315-319.
  • [35]Foran JR, Mont MA, Etienne G, Jones LC, Hungerford DS: The outcome of total knee arthroplasty in obese patients. J Bone Joint Surg Am. 2004, 86:1609-1615.
  • [36]Nuñez M, Lozano L, Nuñez E, Sastre S, Luis Del Val J, Suso S: Good Quality of Life in Severely Obese Total Knee Replacement Patients: A Case–control Study. Obes Surg 2011, 21:1203-1208.
  • [37]Larson SL, Fleishman JA: Rural–urban differences in usual source of care and ambulatory service use: analyses of national data using Urban Influence Codes. Med Care 2003, 41(Suppl 7):65-74.
  • [38]Iezzoni LI, Killeen MB, O’Day BL: Rural residents with disabilities confront substantial barriers to obtaining primary care. Health Serv Res 2006, 41:1258-1275.
  • [39]Nemet GF, Bailey AJ: Distance and health care utilization among the rural elderly. Soc Sci Med 2000, 50:1197-1208.
  • [40]Ethgen O, Vanparijs P, Delhalle S, Rosant S, Bruyere O, Reginster JY: Social support and health-related quality of life in hip and knee osteoarthritis. Qual Life Res 2004, 13:321-330.
  • [41]Blixen CE, Kippes C: Depression, social support, and quality of life in older adults with osteoarthritis. Image J Nurs Sch 1999, 31:221-226.
  • [42]Creamer P, Lethbridge-Cejku M, Hochberg MC: Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology 2000, 39:490-496.
  • [43]Kiefer RA: The effect of social support on functional recovery and wellbeing in older adults following joint arthroplasty. Rehabil Nurs 2011, 36:120-126.
  • [44]Dersh J, Gatchel RJ, Mayer T, Polatin P, Temple OR: Prevalence of psychiatric disorders in patients with chronic disabling occupational spinal disorders. Spine 2006, 31:1156-1162.
  • [45]Giesecke T, Gracely RH, Williams DA, Geisser ME, Petzke FW, Clauw DJ: The relationship between depression, clinical pain, and experimental pain in a chronic pain cohort. Arthritis Rheum 2005, 52:1577-1584.
  • [46]Creamer P, Lethbridge-Cejku M, Hochberg MC: Determinants of pain severity in knee osteoarthritis: effect of demographic and psychosocial variables using 3 pain measures. J Rheumatol 1999, 26:1785-1792.
  • [47]Geisser ME, Roth RS, Theisen ME, et al.: Negative affect, self report of depressive symptoms, and clinical depression: relation to the experience of chronic pain. Clin J Pain 2000, 16:110-120.
  • [48]Howard KJ, Ellis HB, Khaleel MA, Gatchel RJ, Bucholz R: Psychosocial profiles of indigent patients with severe osteoarthritis requiring arthroplasty. J Arthroplasty 2011, 26:244-249.
  文献评价指标  
  下载次数:12次 浏览次数:20次