摘要
目的探讨膝骨关节炎患者全膝关节置换术(TKA)后运动恐惧、肌肉衰减、跌倒风险的影响因素及相关性。方法选取该院2021年7月至2024年6月收治的180例因膝骨关节炎行TKA的患者为研究对象,记录患者年龄、性别、病程、合并慢性病、下地时间等临床资料。于术后1个月采用纽约特种外科医院(HSS)评分评估膝关节功能,术后1周及术后1个月采用坦帕运动恐惧症量表(TSK)评估患者运动恐惧状况,术前及术后1个月采用相对骨骼肌质量指数(RSMI)评估肌肉衰减情况,术前及术后1个月采用摩尔斯跌倒评估量表(MFS)评估跌倒风险,计算相对危险度(RR)。结果患者术后1个月TSK评分及恐动症发生率较术后1周明显降低(P<0.05),术后1个月RSMI值及肌肉衰减综合征发生率较术前明显降低(P<0.05),术后1个月MFS评分及跌倒高危发生率较术前明显降低(P<0.05),手术前后跌倒风险的RR为5.47。影响恐动症、肌肉衰减综合征、跌倒高危发生的相关因素有性别、年龄、下地时间、膝关节功能(P<0.05)。出现恐动症与未出现恐动症患者肌肉衰减综合征发生率和跌倒高危发生率比较,差异有统计学意义(P<0.05)。出现肌肉衰减综合征与未出现肌肉衰减综合征患者跌倒高危发生率比较,差异有统计学意义(P<0.05)。术后1个月,RSMI与TSK评分、MFS评分均呈负相关(r=-0.62、-0.40,P<0.05),TSK评分与MFS评分呈正相关(r=0.44,P<0.05)。结论TKA后会出现恐动症、肌肉衰减综合征并增加跌倒高风险,与性别、年龄、下地时间、膝关节功能相关,且各因素间存在联系。
Objective To investigate the influencing factors and correlation among kinesiophobia,sarcopenia and fall risk following total knee arthroplasty(TKA).Methods A total of 180 patients with knee osteoarthritis who underwent TKA in our hospital from July 2021 to June 2024 were selected as the research subjects.The clinical data of patients,including age,gender,disease duration,concomitant chronic diseases and off-bed ambulation time,were recorded.The knee joint function was evaluated using the Hospital for Special Surgery(HSS)score at 1 month after surgery.The Tampa Scale for Kinesiophobia(TSK)was used to assess kinesiophobia at 1 week and 1 month after surgery.The Relative Skeletal Muscle Mass Index(RSMI)was adopted to evaluate sarcopenia before surgery and at 1 month after surgery.The Morse Fall Scale(MFS)was employed to assess the risk of falls before surgery and at 1 month after surgery,and the relative risk(RR)was calculated.Results The TSK score and incidence of kinesiophobia at 1 month postoperative were significantly reduced compared to those at 1 week postoperative(P<0.05).The RSMI value and incidence of sarcopenia at 1 month postoperative were significantly reduced compared to those preoperatively(P<0.05).The MFS score and incidence of high fall risk at 1 month postoperative were significantly reduced compared to those preoperatively(P<0.05),and the RR of fall risk before and after surgery was 5.47.Factors influencing kinesiophobia,sarcopenia,and high fall risk included gender,age,time-to-ambulation,and knee function(P<0.05).The incidence of sarcopenia and high fall risk differed significantly between patients with versus without kinesiophobia(P<0.05).A statistically significant difference existed in the incidence of high fall risk between patients with sarcopenia and those without sarcopenia(P<0.05).At 1 month after surgery,RSMI was negatively correlated with TSK score and MFS score(r=-0.62,-0.40;P<0.05),while TSK score was positively correlated with MFS score(r=0.44;P<0.05).Conclusion Kinesiophobia,sarcopenia,and increased fall risk may occur after TKA.These outcomes are related to gender,age,time to ambulation,and knee function,with interconnections among these factors.
作者
杨娟
卫晓恩
孙骏
YANG Juan;WEI Xiaoen;SUN Jun(No.12 Ward Area,Department of Orthopaedics and Traumatology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China;Department of Orthopaedics,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)
出处
《重庆医学》
2025年第7期1655-1660,共6页
Chongqing Medical Journal
