背景:除了重返工作(RTW)和重返运动(RTS)之外,患者也更喜欢恢复日常活动(RTA),如步行,睡觉,杂货店购物,以及全膝关节置换术(TKA)后的国内工作。然而,关于患者RTA的时间线和概率的证据很少。
目的:为了评估能够接受RTA的患者百分比,RTW,以及TKA之后的RTS,以及本次回归的时限和影响因素。
方法:在荷兰一家中型骨科医院进行了一项前瞻性收集数据的回顾性队列研究。RTA的评估,RTW,和RTS在TKA后3个月和/或6个月进行。调查因素包括患者特征,手术特点,和术前患者报告的结果。
结果:TKA患者[n=2063;66岁(四分位距[IQR]:7岁);男性47%;28kg/m2(IQR:4kg/m2)]显示RTA范围从跪下的28%到杂货店购物的94%,20d(IQR:27d)用于穿鞋到74d(IQR:57d)用于跪下。RTW率从中等影响工作的62%到低影响工作的87%不等,取33d(IQR:29d)至78d(IQR:55d)。RTS范围从中等影响运动的48%到低影响运动的90%,发生在43d(IQR:24d)至90d(IQR:60d)内。一个或多个被调查的因素影响了被调查的14项活动中每一项的回报,R²值范围从0.013到0.127。
结论:大约80%的患者可以RTA,RTW,以及TKA后6个月内的RTS。回报并不总是受到预测因素的影响。结果有助于设定现实的术前和术后期望。
BACKGROUND: Besides return to work (RTW) and return to sports (RTS), patients also prefer to return to daily activities (RTA) such as walking, sleeping, grocery shopping, and domestic work following total knee arthroplasty (TKA). However, evidence on the timelines and probability of patients\' RTA is sparse.
OBJECTIVE: To assess the percentage of patients able to RTA, RTW, and RTS after TKA, as well as the timeframe and influencing factors of this return.
METHODS: A retrospective cohort study with prospectively collected data was conducted at a medium-sized Dutch orthopedic hospital. Assessments of RTA, RTW, and RTS were performed at 3 mo and/or 6 mo following TKA. Investigated factors encompassed patient characteristics, surgical characteristics, and preoperative patient-reported outcomes.
RESULTS: TKA patients [n = 2063; 66 years old (interquartile range [IQR]: 7 years); 47% male; 28 kg/m2 (IQR: 4 kg/m2)] showed RTA ranging from 28% for kneeling to 94% for grocery shopping, with 20 d (IQR: 27 d) spent for putting on shoes to 74 d (IQR: 57 d) for kneeling. RTW rates varied from 62% for medium-impact work to 87% for low-impact work, taking 33 d (IQR: 29 d) to 78 d (IQR: 55 d). RTS ranged from 48% for medium-impact sports to 90% for low-impact sports, occurring within 43 d (IQR: 24 d) to 90 d (IQR: 60 d). One or more of the investigated factors influenced the return to each of the 14 activities examined, with R² values ranging from 0.013 to 0.127.
CONCLUSIONS: Approximately 80% of patients can RTA, RTW, and RTS within 6 mo after TKA. Return is not consistently influenced by predictive factors. Results help set realistic pre- and postoperative expectations.