BACKGROUND Although total hip arthroplasty(THA)is an established intervention for advanced hip disorders,not all patients achieve the anticipated functional improvements.AIM To investigate the impact of various preope...BACKGROUND Although total hip arthroplasty(THA)is an established intervention for advanced hip disorders,not all patients achieve the anticipated functional improvements.AIM To investigate the impact of various preoperative factors on clinical outcomes after THA.METHODS Data of 411 patients who underwent unilateral THA were retrospectively analyzed.The associations between preoperative factors,such as age,body mass index,pain severity,functional impairment,psychological status,neuropathic pain,and central sensitization,and clinical outcomes assessed six months postoperatively using the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)and modified Harris Hip Score were evaluated.RESULTS Our results indicated that age and the WOMAC,Center for Epidemiologic Studies Depression Scale,and Central Sensitization Index(CSI)scores significantly predicted the modified Harris Hip Score outcomes,whereas age and preoperative WOMAC,EuroQol 5 dimensions,Center for Epidemiologic Studies Depression Scale,CSI,and Pain Detect Questionnaire scores were significant predictors of WOMAC outcomes.Age,WOMAC,and CSI were consistently significant factors.There were no significant differences in the operative time or blood loss across the outcome categories.CONCLUSION Our findings highlight the importance of preoperative assessment of central sensitization and psychological parameters.Patient-specific preoperative characteristics may play a greater role than intraoperative factors in determining recovery outcomes after THA.展开更多
目的探究中枢敏化(central sensitization,CS)与全膝关节置换术(total knee arthroplasty,TKA)术后西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎指数之间的关系。方法这项前瞻性研究纳入了2...目的探究中枢敏化(central sensitization,CS)与全膝关节置换术(total knee arthroplasty,TKA)术后西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎指数之间的关系。方法这项前瞻性研究纳入了2022年2月至2023年2月在西安交通大学附属红会医院接受初次单侧TKA的180例患者,男53例,女127例;年龄50~79岁,平均(64.8±5.9)岁。使用中枢敏化量表(central sensitization inventory,CSI)的A部分来评估术前CS。评估术前CSI与术后1年WOMAC评分之间的相关性,以及术后WOMAC评分与术前CSI严重程度之间的关联。此外,还评估了不同CSI严重程度与WOMAC评分各维度之间的关系。结果29例患者(16.1%)在术前有CS,术前CSI与术后WOMAC评分呈正相关(r=0.607,P<0.001)。术前CSI严重程度为中度或更高的患者,术后WOMAC评分显著高于术前CSI严重程度为亚临床或轻度的患者(P<0.001)。与亚临床组相比,中度或更高CSI严重程度的WOMAC评分各个维度得分显著较高(P<0.001)。结论术前CSI与TKA术后1年WOMAC评分呈显著正相关,对术前CS患者进行干预有助于改善TKA后的临床效果。展开更多
文摘BACKGROUND Although total hip arthroplasty(THA)is an established intervention for advanced hip disorders,not all patients achieve the anticipated functional improvements.AIM To investigate the impact of various preoperative factors on clinical outcomes after THA.METHODS Data of 411 patients who underwent unilateral THA were retrospectively analyzed.The associations between preoperative factors,such as age,body mass index,pain severity,functional impairment,psychological status,neuropathic pain,and central sensitization,and clinical outcomes assessed six months postoperatively using the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)and modified Harris Hip Score were evaluated.RESULTS Our results indicated that age and the WOMAC,Center for Epidemiologic Studies Depression Scale,and Central Sensitization Index(CSI)scores significantly predicted the modified Harris Hip Score outcomes,whereas age and preoperative WOMAC,EuroQol 5 dimensions,Center for Epidemiologic Studies Depression Scale,CSI,and Pain Detect Questionnaire scores were significant predictors of WOMAC outcomes.Age,WOMAC,and CSI were consistently significant factors.There were no significant differences in the operative time or blood loss across the outcome categories.CONCLUSION Our findings highlight the importance of preoperative assessment of central sensitization and psychological parameters.Patient-specific preoperative characteristics may play a greater role than intraoperative factors in determining recovery outcomes after THA.
