CAJ | 학술논문

背景:双膝骨性关节炎患者,做单侧置换后,很大一部分患者未作二次对侧置换,有很多影响因素. 目的:双膝骨性关节炎患者一期选择性单侧全膝关节置换后未行二期对侧膝关节置换的影响因素分析. 方法:纳入初次一期单侧全膝关节置换的双膝骨性关节炎患者28例28膝,假体均采用施乐辉公司普通型,所有患者一期单侧全膝关节置换后1年内未行二期对侧膝关节置换.记录置换前后 HSS 评分、膝关节活动范围;同时对28例患者未行二期膝关节置换影响因素进行问卷调查. 结果与结论:2例失访,2例在外院行对侧膝关节置换,最终随访24例24膝,平均随访12.6个月(12-19个月).膝关节活动范围与HSS评分置换后与置换前比较均显著增加,差异有显著性意义(P=0.007,P=0.409).问卷调查分析影响患者选择二期手术因素,单因素随访结果围手术期疼痛是主因占到95%以上;多因素随访结果:围手术期的疼痛占95.8%,心理因素占87.5%,医院的软件条件占70.8%,3项原因平均占总因素的84.7%.说明24例24膝未行二期膝关节置换影响因素中置换后围手术期的疼痛、患者的心理因素及医院的软件条件占据主导地位.
배경:쌍슬골성관절염환자,주단측치환후,흔대일부분환자미작이차대측치환,유흔다영향인소. 목적:쌍슬골성관절염환자일기선택성단측전슬관절치환후미행이기대측슬관절치환적영향인소분석. 방법:납입초차일기단측전슬관절치환적쌍슬골성관절염환자28례28슬,가체균채용시악휘공사보통형,소유환자일기단측전슬관절치환후1년내미행이기대측슬관절치환.기록치환전후 HSS 평분、슬관절활동범위;동시대28례환자미행이기슬관절치환영향인소진행문권조사. 결과여결론:2례실방,2례재외원행대측슬관절치환,최종수방24례24슬,평균수방12.6개월(12-19개월).슬관절활동범위여HSS평분치환후여치환전비교균현저증가,차이유현저성의의(P=0.007,P=0.409).문권조사분석영향환자선택이기수술인소,단인소수방결과위수술기동통시주인점도95%이상;다인소수방결과:위수술기적동통점95.8%,심리인소점87.5%,의원적연건조건점70.8%,3항원인평균점총인소적84.7%.설명24례24슬미행이기슬관절치환영향인소중치환후위수술기적동통、환자적심리인소급의원적연건조건점거주도지위.
BACKGROUND:Most of the patients with bilateral knee osteoarthritis wil not receive the contralateral total knee arthroplasty due to many factors. @@@@OBJECTIVE:To analyze the factors for the bilateral knee osteoarthritis patients undergoing a selective unilateral total knee arthroplasty without contralateral knee arthroplasty at second stage. @@@@METHODS:A toal of 28 bilateral knee osteoarthritis patients (28 knees) treated with unilateral total knee arthroplasty were included, the prostheses were the Smith&Nephew ordinary type. Al the patients did not receive the second stage contralateral knee arthroplasty within 1 year after unilateral total knee arthroplasty. The HSS score and range of motion of knee were recorded before and after replacement;at the same time, the 28 patients that did not receive the second stage contralateral knee arthroplasty were questionnaired for the factors. @@@@RESULTS AND CONCLUSION:Two cases were lost, 2 cases underwent contralateral total knee arthroplasty at the other hospital. And final y, 24 patients (24 knees) received the final fol ow-up, the average fol ow-up time was 12.6 months (12 to19 months). The range of motion and the HSS score after replacement were improved compared with those before replacement, the difference was statistical y significant (P=0.007, P=0.409). Questionnaire survey was performed to analyze the factors for second stage surgery, single factor fol ow-up results showed that perioperative pain was the main reason that accounting for more than 95%;multivariate fol ow-up results showed that perioperative pain accounted for 95.8%, psychological factors accounted for 87.5%, conditions of the hospital's software accounted for 70.8%;the average of the three reasons accounted for 84.7%. It indicates that perioperative pain, psychological factors and conditions of the hospital's software are the dominate reasons for the 24 patients (24 knees) without second stage ontralateral knee arthroplasty.