对侧膝关节疼痛对全膝关节置换手术患者的临床影响

目的:评估对侧膝关节疼痛程度对骨性关节炎患者全膝关节置换术(total knee arthroplasty,TKA)后1年手术侧关节功能障碍及治疗满意度的影响。方法:2019年3月至2021年1月行TKA的635例患者,男296例,女339例;年龄(69.33±9.38)岁,病程(1.15±0.44)年。根据术后对侧膝关节疼痛视觉模拟评分(visual analogue scale,VAS)分为轻度或无疼痛(VAS 0～3分)423例,中度疼痛(VAS 4～6分)105例,重度疼痛(VAS 7～10分)107例。分析比较对侧膝关节不同疼痛程度对术后12个月膝关节功能及满意度评分的影响。结果:对侧膝关节疼痛VAS在TKA术后明显降低,年龄大、身体质量指数高、术后手术侧膝关节WOMAC评分高、对侧膝关节中、重度疼痛是患者不满意的危险因素(P<0.05),OR分别为1.285、1.665、2.319、1.863。手术侧膝关节疼痛度高、居家环境为步梯房是患者出院1年后WOMAC评分高的危险因素(P<0.05);出院后坚持锻炼、功能性训练是患者出院1年后WOMAC评分高的保护因素(P...

Clinical affect of contralateral knee pain on patients undergoing total knee arthroplasty

Objective To evaluate the effect of contralateral knee pain on joint dysfunction and treatment satisfaction on the operative side 1 year after total knee arthroplasty(TKA) in patients with osteoarthritis.Methods From March 2019 to January 2021, 635 patients underwent TKA including 296 males and 339 females, with an average age of (69.33±9.38) years old, the duration of symptoms was (1.15±0.44) years. According to the degree of pain visual analogue scale(VAS) in the contralateral knee joint 12 months after operation, the patients were divided into three groups, 423 patients with no or mild pain(VAS 0 to 3), 105 patients with moderate pain(VAS 4 to 6), 107 patients with severe pain(VAS 7 to 10). The related factors of knee function and satisfaction score 12 months after operation were analyzed and compared on different contralateral knee pain levels.Results The contralateral knee pain VAS was significantly reduced after TKA. Old age, high body mass index, high WOMAC scores of postoperative knee joint, moderate and severe pain of contralateral knee joint were the risk factors of dissatisfaction (P<0.05), OR were 1.285, 1.665, 2.319, 1.863 respectively. The high degree of knee pain on the operation side and the ladder room in the home environment were the risk factors for the high WOMAC scores 1 year after discharge(P<0.05). Adherence to exercise and functional training after discharge were the protective factors for patients with high WOMAC scores 1 year after discharge(P<0.05), OR were 3.016, 1.738, 0.619, 0.574 respectively.Conclusion TKA can alleviate the pain of contralateral knee joint. Contralateral knee pain does not affect the WOMAC scores after TKA, but it will reduce the treatment satisfaction of patients.