PDF(Pubmed)
Abstract：
Total knee arthroplasty (TKA) improves patients\' Health-related quality of life (HRQoL) compared to before surgery. However, based on our knowledge, the improvement in HRQoL after TKA, which depends on various factors, has yet to be investigated compared to healthy people. This study aimed to evaluate the HRQoL of patients compared to healthy people and the factors affecting the HRQoL after TKA. In this matched case-control study (1002 participants), HRQoL in 501 patients who underwent TKA between 2015 and 2022 at Shafa Yahyainan Hospital affiliated with Iran University of Medical Sciences were compared with 501 healthy controls. HRQoL was evaluated in two parts (before compared to 12 months after TKA and 12 months after TKA compared to the healthy population). The 36-item short-form health survey (SF-36) was used to evaluate HRQoL 12 months after surgery. The influencing factors on HRQoL were evaluated by multivariate logistic regression analysis. No significant difference was observed in the demographic characteristics of the participants in the two groups. The mean overall SF-36 score, 12 months after surgery, significantly improved compared to before surgery (64.21 ± 22.2 vs. 37.55 ± 15.13, p:0.001). The mean total score of SF-36 was statistically similar between the case and control groups (64.21 ± 22.2 VS 72.53 ± 25.3). The multivariate analysis showed that sex, BMI, number of comorbidities, postoperative compliance, and complications were significantly related to the decrease in patients\' HRQoL (P < 0.001).TKA can improve the HRQoL except for two subscales of happiness/vitality and physical performance, similar to the healthy population. Female gender, obesity and overweight, comorbidity, bilateral TKA, non-adherence to postoperative physiotherapy, and complications were associated with decreased HRQoL.
摘要：
与手术前相比，全膝关节置换术（TKA）改善了患者的健康相关生活质量（HRQoL）。然而,根据我们的知识，TKA后HRQoL的改善，这取决于各种因素，与健康人相比，还有待调查。本研究旨在评估患者与健康人相比的HRQoL以及影响TKA后HRQoL的因素。在这项匹配的病例对照研究(1002名参与者)中，将2015年至2022年在伊朗医科大学附属沙法叶海南医院接受TKA的501例患者的HRQoL与501例健康对照进行比较。HRQoL分为两部分进行评估（与TKA后12个月相比，与健康人群相比，TKA后12个月相比）。采用36项简短健康调查(SF-36)评估术后12个月的HRQoL。采用多因素logistic回归分析评价HRQoL的影响因素。两组参与者的人口统计学特征没有显着差异。SF-36总体得分的平均值，手术后12个月,与手术前相比显着改善（64.21±22.2vs.37.55±15.13，p：0.001）。病例组和对照组的SF-36平均总分相似（64.21±22.2VS72.53±25.3）。多变量分析表明,性别,BMI,合并症的数量，术后依从性,并发症与患者HRQoL下降显著相关(P<0.001)。TKA可以改善HRQoL，除了幸福/活力和身体表现两个分量表，与健康人群相似。女性性别,肥胖和超重，合并症，双侧TKA,不坚持术后物理治疗，并发症与HRQoL降低相关。
