考虑进行全膝关节置换术的工作年龄膝骨关节炎患者的心理健康/身体活动与疼痛/功能障碍之间的关系：一项回顾性研究。
The relationship between mental health/physical activity and pain/dysfunction in working-age patients with knee osteoarthritis being considered for total knee arthroplasty: a retrospective study.
作者信息
Jiao Juyang, Tang Haozheng, Zhang Shutao, Qu Xinhua, Yue Bing
机构信息
Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145, Shandong Road, Shanghai, 200011, China.
出版信息
Arthroplasty. 2021 Jul 1;3(1):22. doi: 10.1186/s42836-021-00077-5.
BACKGROUND
Increasing total knee arthroplasty (TKA) surgeries are being performed on working-age patients with prominent manifestations of pain and dysfunction. But few studies have explored the risk factors for pain and dysfunction in working-age patients with knee osteoarthritis (KOA) being considered for TKA. Therefore, this study sought to explore the relationship between mental health/physical activity and pain/dysfunction in working-age patients with KOA being considered for TKA.
METHODS
This study was a secondary analysis of data derived from a public database, the Work participation In Patients with Osteoarthritis cohort study, which included 152 working-age patients (65 men and 87 women) with KOA planning for TKA. We analyzed preoperative data comprising age, educational level, body mass index (BMI), mental factors (Patient Health Questionnaire-9 [PHQ-9] and the 36-Item Short Form Survey Instrument [SF-36 mental health]), physical activity level, and clinical outcomes (the Western Ontario and McMaster Universities Osteoarthritis Index and SF-36 sub-item score). Multivariate regression analysis was performed to determine risk factors for pain and dysfunction in working-age patients with KOA being considered for TKA.
RESULTS
Women had lower pain, worse function, and higher PHQ-9 scores than men (p < 0.001). The depression scores were significantly linearly related to pain and function scores in women after adjusting for age, BMI, educational level, and physical activity (P < 0.05), whereas this relation was not observed in men. After adjusting for age, BMI, educational level, and mental factors, exercise time was found to be positively correlated with pain scores in women (P < 0.05).
CONCLUSIONS
Depression scores and exercise time were significantly correlated with pain and dysfunction in working-age women with KOA being considered for TKA.
背景
越来越多的全膝关节置换术（TKA）应用于有明显疼痛和功能障碍表现的适龄患者。但很少有研究探讨考虑接受TKA的适龄膝骨关节炎（KOA）患者疼痛和功能障碍的危险因素。因此，本研究旨在探讨心理健康/身体活动与考虑接受TKA的适龄KOA患者疼痛/功能障碍之间的关系。
方法
本研究是对来自公共数据库“骨关节炎患者工作参与队列研究”的数据进行的二次分析，该研究纳入了152名计划接受TKA的适龄KOA患者（65名男性和87名女性）。我们分析了术前数据，包括年龄、教育水平、体重指数（BMI）、心理因素（患者健康问卷-9[PHQ-9]和36项简短调查工具[SF-36心理健康]）、身体活动水平和临床结局（西安大略和麦克马斯特大学骨关节炎指数以及SF-36子项评分）。进行多因素回归分析以确定考虑接受TKA的适龄KOA患者疼痛和功能障碍的危险因素。
结果
女性的疼痛程度低于男性，功能更差，PHQ-9评分更高（p<0.001）。在调整年龄、BMI、教育水平和身体活动后，女性的抑郁评分与疼痛和功能评分呈显著线性相关（P<0.05），而在男性中未观察到这种关系。在调整年龄、BMI、教育水平和心理因素后，发现运动时间与女性的疼痛评分呈正相关（P<0.05）。
结论
抑郁评分和运动时间与考虑接受TKA的适龄KOA女性的疼痛和功能障碍显著相关。
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