目的：评价全膝关节置换术（ TKA）患者术前膝关节周围骨密度（ BMD）与术后疼痛、膝关节功能的关系。方法在术前3 d内运用双能X线骨密度仪测量患侧膝关节周围骨端的BMD。于术前1 d和术后6个月，分别使用视觉类比法（ VAS）测定疼痛积分，膝关节损伤和关节炎评分（ KOOS）测定膝关节功能。将患者分为正常组和下降组。运用t检验比较两组VAS和KOOS评分的差异，采用直线相关分析和多元线性回归分析BMD与术后6个月VAS和KOOS评分的关系。结果与术前相比，两组患者的术后VAS评分和KOOS评分均显著改善，差异有统计学意义（ P ﹤0.01）。与正常组相比，下降组的VAS评分和KOOS评分改善值较小，差异有统计学意义（ P ﹤0.05）。BMD与 VAS评分和KOOS评分改善值均呈正相关（ r ＝0.67和0.72），差异均有统计学意义（ P ﹤0.01）。多元回归分析表明，BMD是患者术后VAS评分和KOOS评分的重要影响因素（β＝0.35和0.42，P ﹤0.01）。结论 TKA患者术前BMD与术后恢复效果呈正相关，改善患者的骨密度有助于患者的术后康复。%Objective To investigate the influence of bone mineral density( BMD)on postoperative pain and knee function in patients undergoing total Knee arthroplasty( TKA). Methods BMD was measured by using dual-energy X-ray absorptiometry before surgery. At 1 day before and 6 months after surgery,the pain score were assessed with the visual analog scale(VAS)and knee function were quantified using the knee injury and osteoarthritis outcome score( KOOS). Patients were grouped into a normal group and a reduction group based in the BMD. The paired t test was applied to compare the difference in VAS and KOOS scores between before and after surgery,the linear correlation analysis and multiple linear regression analysis were used to evaluate the effect of BMD on VAS and KOOS scores after 6 months. Results Compared with the baseline,the VAS and KOOS scores were significantly improved after operation,the difference were statistically significant( P ﹤0. 01). Com-pared with the normal group,the reeducation group showed a lower improvement in both of VAS and KOOS score( P ﹤0. 05). BMD was positive-ly correlated with the improvement of VAS score and KOOS score,with statistically significant( r =0. 67 and 0. 72,P ﹤0. 01). Multiple regres-sion analysis showed that BMD was an independent predictor of postoperative VAS and KOOS scores(β=0. 35 and 0. 42,P ﹤0. 01). Conclu-sion BMD is positively related with postoperative recovery in patients undergoing TKA,and enhance bone mass may help to improve the surgical outcome of TKA in these patients.
展开▼
