在膝关节关节整形术后,夜间膝关节疼痛的演变和特征
Jeremy Daxhelet1, Gerald Delfosse2, Patricia Lavand'homme2
1Department of Orthopaedic Surgery, Hospital Saint Luc Bouge, Rue Saint-Luc 8, Namur, 5004, Belgium. daxheletjeremy@gmail.com.
Archives of orthopaedic and trauma surgery
|September 13, 2024
概括
在膝关节置换手术后,夜间膝关节疼痛和睡眠不良很常见,影响超过一半的患者. 虽然手术后一年的疼痛显著减少,特别是在单间膝关节关节整形术 (UKA) 后,持续的睡眠问题仍然令人担忧.
科学领域:
- 整形外科 整形外科 整形外科
- 疼痛管理 疼痛管理
- 睡眠医学 睡眠医学
背景情况:
- 夜间膝关节疼痛和睡眠障碍是影响膝关节关节整形术后患者满意度的普遍问题.
- 这些条件往往在外科手术结果的背景下不太了解和研究.
研究的目的:
- 为了确定在接受膝关节关节整形手术的患者中夜间膝关节疼痛和睡眠障碍的患病率.
- 为了确定与这些问题相关的因素,在术前和术后.
主要方法:
- 一项前性观察性研究包括111名患者 (79名膝关节关节整形手术[TKA],32名单部关节整形手术[UKA]).
- 睡眠质量,夜间膝盖疼痛,动员过程中的疼痛和神经病痛被评估,在多个时间点使用验证的得分.
- 记录了药物摄入量 (止痛药,安眠药) 和夜间疼痛的潜在预测因素.
主要成果:
- 54%的患者在手术前报告睡眠质量不佳,在手术后一年持续53%.
- 夜间膝盖疼痛的患病率从手术前的38.7%降至手术后一年的2.9%.
- 夜间疼痛与更高的整体疼痛评分,神经病症症状,增加药物使用和更差的睡眠质量有关. 与全膝关节整形术 (TKA) 相比,单部位膝关节整形术 (UKA) 在3周和6周显著减少了夜间疼痛.
结论:
- 睡眠质量不佳仍然是超过一半的膝关节关节整形患者的重要问题,持续长期.
- 在手术后,夜间膝盖疼痛显著减少,大多数病例在一年内消失.
- 与TKA相比,UKA显示夜间疼痛的缓解速度更快,术后六周左右的显著差异.
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