CAJ | 학술논문

目的回顾性对比分析65岁及以上患者采用固定平台和活动平台型两种全膝关节假体置换术后的中期临床效果和生活质量状况. 方法随访2002年1月至2010年12月间,年龄≥65岁的人工全膝关节置换患者,使用美国西部Ontario和McMaster大学骨关节炎指数评分(Western Ontario and McMaster Universities,WOMAC)评估膝关节功能,用SF-16(Short Form-36)健康调查量表对生活质量进行评估,将数据资料根据手术采用假体的不同分为固定平台组和活动平台组进行统计学分析. 结果 157例(194个膝关节)获得完整随访,随访时间2.08～10.75年,平均(5.06±2.47)年,年龄65～86岁,平均(72.4±4.3)岁.入选病患者前与术后WOMAC评分分别为(48.2±14.9)分和(10.7±9.1)分,两者比较差异有统计学意义(P＜0.01).随访时固定平台组和活动平台组的WOMAC评分分别为(10.12±8.76)分和(11.38±9.55)分,两组比较差异无统计学意义(t=0.861,P=0.391);157例患者SF-36为(119.65±12.03)分,与良好和中等的最佳截断点117分比较差异无统计学意义(t=2.759,P=0.07).固定平台组和活动平台组的SF-16的分别为(120.17±11.06)和(119.06±13.07)分,两组差异无统计学意义(t=-0.575,P=0.566). 结论全膝关节置换术可提高老年膝关节严重骨关节炎患者的膝关节功能和生活质量,对于老年人无论术中采用活动平台型假体还是固定平台型假体,其中期临床效果和生活质量相近,两种假体均可选择使用.
목적 회고성대비분석65세급이상환자채용고정평태화활동평태형량충전슬관절가체치환술후적중기림상효과화생활질량상황. 방법 수방2002년1월지2010년12월간,년령≥65세적인공전슬관절치환환자,사용미국서부Ontario화McMaster대학골관절염지수평분(Western Ontario and McMaster Universities,WOMAC)평고슬관절공능,용SF-16(Short Form-36)건강조사량표대생활질량진행평고,장수거자료근거수술채용가체적불동분위고정평태조화활동평태조진행통계학분석. 결과 157례(194개슬관절)획득완정수방,수방시간2.08～10.75년,평균(5.06±2.47)년,년령65～86세,평균(72.4±4.3)세.입선병환자전여술후WOMAC평분분별위(48.2±14.9)분화(10.7±9.1)분,량자비교차이유통계학의의(P＜0.01).수방시고정평태조화활동평태조적WOMAC평분분별위(10.12±8.76)분화(11.38±9.55)분,량조비교차이무통계학의의(t=0.861,P=0.391);157례환자SF-36위(119.65±12.03)분,여량호화중등적최가절단점117분비교차이무통계학의의(t=2.759,P=0.07).고정평태조화활동평태조적SF-16적분별위(120.17±11.06)화(119.06±13.07)분,량조차이무통계학의의(t=-0.575,P=0.566). 결론 전슬관절치환술가제고노년슬관절엄중골관절염환자적슬관절공능화생활질량,대우노년인무론술중채용활동평태형가체환시고정평태형가체,기중기림상효과화생활질량상근,량충가체균가선택사용.
Objective To retrospectively analyze the mid-term functional outcome and quality of life in elderly patients undergoing the mobile-bearing versus fixed-bearing total knee arthroplasty.Methods Patients aged over 65 years who underwent total knee arthroplasty during January 2002 to December 2010 were followed up.The knee joint function was assessed by Western Ontario and McMaster Universities (WOMAC) score.Quality of life was assessed by using SF-16 (Short Form36) questionnaire.Data of mobile-bearing versus fixed-bearing groups were statistically analyzed.Results 157 cases (194 knees) were followed up completely.The mean follow-up period was (5.06±2.47) years (range 2.08-10.75 years).The mean age was (72.4±4.3) years (range 65-86 years old).Preoperative versus postoperative WOMAC scores were (48.2 ± 14.9) vs.(10.7±9.1) (P＜0.01).There was no significant difference in WOMAC score between the fixed-bearing group and the mobile-bearing group during the follow up [(10.12±8.76) vs.(11.38±9.55),t=0.861,P＞0.05].The mean SF-36 score was (119.65± 12.03) in the overall population of patients,which showed no significant difference as compared with the good and moderate optimal truncation value of 117 (t =2.759,P＞0.05).There was no significant difference in SF-36 score between the fixed-bearing group and the mobile-bearing group [(120.17±11.06) vs.(119.06±13.07),t=0.575,P＞0.05].Conclusions Total knee arthroplasty can improve the knee joint function and quality of life in elderly patients with severe knee osteoarthritis.For the elderly,the mid-term functional outcome and life of quality are similar in the mobile-bearing and the fixed-bearing total knee arthroplasty,and any kind of prostheses can be chosen to use,