严重关节骨关节炎的整体关节置换或抵抗训练
Thomas Frydendal1, Robin Christensen1, Inger Mechlenburg1
1From the Departments of Physiotherapy (T.F., K.G.I.) and Orthopedic Surgery (C.V., A.E.G., P.K.-A., P.H.R., C.H.), Lillebaelt Hospital-University Hospital of Southern Denmark, Vejle Hospital, Vejle, the Departments of Clinical Research (T.F., R.C., S.M.N.) and Regional Health Research (C.V., K.G.I.), University of Southern Denmark, and the Research Unit of Rheumatology, Department of Clinical Research (R.C., S.M.N.), and the Department of Orthopedic Surgery and Traumatology (S.O.), Odense University Hospital, Odense, the Section for Biostatistics and Evidence-based Research, Parker Institute, Bispebjerg and Frederiksberg Hospital (T.F., R.C., S.M.N., K.G.I.), the Department of Orthopedic Surgery and Traumatology, Copenhagen University Hospital Bispebjerg (S.O.), and the Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen (S.O.), Copenhagen, the Department of Orthopedic Surgery, Aarhus University Hospital, and the Department of Clinical Medicine, Aarhus University, Aarhus (I.M., S.S.J.), the University Clinic for Orthopedic Pathways, Elective Surgery Center, Regional Hospital Silkeborg, Silkeborg (L.R.M.), and the Department of Orthopedic Surgery, Næstved Hospital, Næstved (M.J.B., H.Q., M.S.M.) - all in Denmark.
与严重关节骨关节炎的抵抗训练相比,整体关节置换显著改善了关节疼痛和功能. 这种手术干预为需要部手术的50岁以上患者提供了更好的结果.
科学领域:
- 整形外科 整形外科 整形外科
- 类风湿病学 类风湿病学
- 临床试验 临床试验
背景情况:
- 严重的关节骨关节炎往往导致推进行全关节置换.
- 随机试验数据比较全关节置换与像抵抗训练这样的保守治疗是有限的.
研究的目的:
- 为了比较全关节置换与抵抗训练对严重关节骨关节炎的有效性.
- 为了评估患者报告的部疼痛和治疗开始后六个月的功能结果.
主要方法:
- 一个多中心的,随机的,受控的试验,涉及109名50岁或以上的严重关节骨关节炎患者.
- 患者被分配到完全关节置换或抵抗训练.
- 主要结局指标是六个月后牛津部分数 (部疼痛和功能) 的变化.
主要成果:
- 与抵抗训练 (4.5分) 相比,全关节置换在牛津关节评分 (15.9分) 中显示出明显更大的改善.
- 整体关节置换和抵抗训练之间的改善差异为11.4分 (P<0.001).
- 严重不良事件的发生率在两组之间是相似的,大多数事件是已知的关节置换手术并发症.
结论:
- 整体关节置换为患有严重关节骨关节炎的患者提供了临床显著和优异的关节疼痛和功能改善,与抵抗训练相比.
- 这些发现支持全关节置换作为这一患者群的有效治疗方法.
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