摘要
背景:终末期踝关节炎由于疼痛、功能受限甚至丧失等问题严重影响患者的生活质量。目前人工全踝关节置换术随着假体材料和手术方式不断更新,在终末期踝关节的治疗中被广泛接受。目的:探讨行人工全踝关节置换术(TAA)治疗终末期踝关节炎患者术后早期生活质量及功能恢复情况。方法:选取2016年12月至2018年11月行TAA的终末期踝关节炎患者12例(观察组),男7例、女5例;年龄36~79岁,平均(52.4±7.3)岁;病程5~20年,平均(10.4±11.1)年。于术前、术后1、3、6、12个月采用中文版生活质量测量工具健康状况问卷(SF-36)、美国足踝外科协会踝-后足评分(AOFAS)、视觉模拟评分法(VAS)进行调查。采用SF-36调查30名健康人(对照组)生活质量情况,进行比较分析。结果:观察组患者在术后1、3、6、12个月均得到规律随访,随访时间15~27个月,平均(17.4±5.1)个月,随访期间未发生假体松动及踝关节力线异常等并发症,观察组术前生活质量显著低于对照组(P<0.05),术后12个月生活质量在生理机能、躯体疼痛、社会功能、情感职能、精神健康方面与对照组差异无统计学意义(P>0.05)。在生理职能、一般健康状况、精力方面低于对照组,差异有统计学意义(P<0.05)。在功能恢复方面,观察组术后12个月AOFAS评分高于术前,差异有统计学意义(P<0.05);在疼痛方面,观察组术后12个月VAS评分低于术前,差异有统计学意义(P<0.05)。结论:TAA手术治疗终末期踝关节炎可显著提高患者早期生活质量及功能恢复,减轻疼痛。
Background:The quality of life of patients with end-stage ankle arthritis is seriously affected by pain,limited function and even loss of function.At present,total ankle arthroplasty has been widely accepted in the treatment of end-stage ankle joint with the continuous updating of prosthesis materials and surgical methods.Objective:To evaluate the short-term quality of life and functional recovery of the patients after total ankle arthroplasty.Methods:A total of 12 patients(observation group)with terminal ankle arthritis undergoing the procedure of TAA from December 2016 to November 2018 were investigated by SF-36、AOFAS、VAS at admission and 1、3、6、12 months postoperatively,including 7 males and 5 females with the average age of(52.4±7.3)years(range,36-79)and the average course of disease of(10.4±11.1)years(range,5-20 years).Thirty healthy persons(control group)were investigated simultaneously.Results:Patients in the observation group were regularly followed up at 1,3,6 and 12 months after surgery,and no complications such as prosthesis loosening and ankle joint force line abnormality occurred during the follow-up period.The quality of life at admission was poorer in the observation group than in the control group(P<0.05).There was no significant difference in scores of physical functioning,body pain,social functioning,role-emotional and mental health(P>0.05),and significant difference in scores of role-physical,general health and vitality(P<0.05)between observation group at 12 months after operation and control group.The score of AOFAS was significantly higher and the score of VAS was significantly lower 12 months after operation in the observation group as compared with that at admission(P<0.05).Conclusions:TAA has significant advantages in improving the quality of life and functional recovery at the early stage,and can reduce pain in treatment of terminal ankle arthritis.
作者
李冰冰
覃颖
张艳
刘中砥
芦浩
徐海林
LI Bingbing;QIN Ying;ZHANG Yan;LIU Zhongdi;LU Hao;XU Hailin(Department of Orthopaedics and Traumatology,Peking University People’s Hospital,Beijing 100044,China)
出处
《中华骨与关节外科杂志》
2020年第12期1030-1033,共4页
Chinese Journal of Bone and Joint Surgery
基金
创伤救治与神经再生教育部重点实验室(BMU2019XY007-01)
教育部创新团队发展计划(IRT16R01)。
关键词
人工全踝关节置换术
踝关节炎
生活质量
功能恢复
Total Ankle Arthroplasty
Ankle Arthritis
Quality of Life
Functional Recovery
